Circumferential Upper Arm & Thigh Liposuction + Calf Botox (Full Body) | 24-Year-Old Woman, 3 Months After Surgery
A 24-year-old woman. She was concerned about the thickness of her upper arms and the volume of her thighs, so we performed circumferential liposuction of the upper arms (back, shoulders and front) and of the thighs (inner, outer, front and back), and on the same day injected 200 units of Botox into her calves. The photos show her full body before surgery and 3 months after surgery, mainly comparing the line from the upper arms to the shoulders.
The short answer
This case combines circumferential liposuction of the upper arms and thighs with Botox for the calves. In the photos 3 months after surgery, the roundness from the outer upper arms to the shoulders has decreased, giving a cleaner line from the shoulders to the elbows.
Case overview
| Procedure | Circumferential upper arm liposuction / circumferential thigh liposuction / Botox injection for the calves |
|---|---|
| Details | Upper arms, circumferential (back, shoulders, front): 450ml removed / thighs, circumferential (inner, outer, front, back): 1,800ml removed / Botox 200 units (calves) |
| Anesthesia / duration | General anaesthesia / approx. 1 hour 50 minutes |
| Photo timing | Before and 3 months after surgery (full body) |
| Sessions | 1 session |
| Cost | JPY 1,336,000 (tax included, monitor price) Price list |
| Main risks | Swelling, bruising, pain, oedema, skin irregularity, asymmetry, scars, skin laxity, prolonged oedema, temporary weakness from Botox, etc. (see details below) |
| Doctor | Dr. Shin Moriwaki (Director) |
Her concerns
She was concerned about the thickness of her upper arms and the volume of her thighs, and wanted to balance her upper and lower body.
We proposed reducing the thickness of the upper arms and thighs with liposuction, and combining it with Botox for the calves, which works on muscle tension rather than fat.
Treatments performed
Circumferential upper arm liposuction
We removed fat not only from the back of the arm (the so-called "bingo wings") but also from the connected areas of the shoulders and front, because treating only one part tends to leave a step at the border or remaining thickness when viewed from the front or side.
Through 6 small incisions at both elbows and the front and back of both armpits, we reduced the thickness evenly while leaving a thin layer of fat under the skin to prevent irregularities. 450ml was removed, the same as the median (450ml) of 70 cases of upper-arm-only liposuction in our case data (Japanese, as of October 2026).
Circumferential thigh liposuction
We treated the inner, outer, front and back of the thighs as one continuous area so that differences in thickness are less noticeable from any direction. Because the thighs cover a large area where uneven removal can remain as irregularities, we proceeded while checking for asymmetry and steps. 1,800ml was removed; the median for thigh/knee-only cases in our case data is 900ml (10 cases), and the amount was larger here because the entire circumference of the thighs was treated at once.
Botox for the calves
We injected 200 units of Botox (Botulax) into the calves. Botox relaxes muscle tension and works differently from liposuction, so we combined the two according to whether the cause is fat or muscle.
Anaesthesia and operating time
The procedure was performed under general anaesthesia (propofol, sevoflurane and nitrous oxide), with 800ml of tumescent solution injected into the upper arms and 2,000ml into the thighs. The operating time was approximately 1 hour 50 minutes.
Changes from before surgery to 3 months after
Before surgery, there was roundness from the outer upper arms to the shoulders, and the thickness of the arms stood out when they were lowered. In the photo 3 months after surgery, the bulge on the outer upper arms has decreased, giving a straight, slim line from the shoulders to the elbows.
Clothing, posture and photo conditions differ between the before and after photos. Because her thighs and calves are covered by jeans in the before photo, changes in the legs cannot be compared in these photos.
Her condition 2 months after surgery (back view, upper arms to shoulders) is shown in Upper Arm & Thigh Circumferential Liposuction + Calf Botox | 24-Year-Old Woman, 2 Months After.
Recovery and aftercare
Pain peaks 2–3 days after surgery and settles in about 10 days. Swelling and bruising gradually subside over 2–3 weeks. Firmness in the treated areas (induration) peaks around 1 month after surgery and usually settles in about 3 months.
Compression garments (a bolero for the arms and a girdle for the thighs) are worn 24 hours a day for 1 week, and thereafter as much as possible, such as at home or while sleeping, until swelling and bruising subside. Short, lukewarm showers are allowed from the next day; baths, saunas and strenuous exercise from 2 weeks after surgery.
These photos were taken 3 months after surgery. Swelling in the thighs may take longer to settle, and the effect of Botox gradually wears off over time.
Risks and side effects
Liposuction may cause swelling, bruising, pain, oedema, skin irregularity or tightness, asymmetry, pigmentation and scars at the small incisions. Rarely, complications such as infection, haematoma, numbness or reduced sensation may occur.
In the upper arms and shoulders, skin laxity, rippling or a pulling sensation may occur; in the thighs, oedema may persist longer, and reduced sensation or temporary firmness and irregularity due to induration may occur.
Botox for the calves may cause pain, bruising or swelling at the injection sites, temporary weakness or heaviness, difficulty walking and asymmetry. The effect gradually wears off over several months, and its degree and duration vary from person to person. General anaesthesia may temporarily cause nausea, dizziness or throat discomfort.
These symptoms may occur during recovery and most gradually improve over time, but their severity and the recovery period vary from person to person. If any symptom concerns you, please consult your surgeon rather than judging by yourself.
Free consultation available
1 min walk from Exit 6, Ginza-itchome Station / Open 10:00–19:00
The doctor in charge of this case
Shin Moriwaki, MD
Director, AVAN TOKYO Ginza Liposuction Clinic
Graduated from Tokushima University School of Medicine. Worked at Tokushima University Hospital, Tokyo Chuo Cosmetic Surgery and Gracia Clinic before taking up the current position. Over 5,000 liposuction procedures performed (including previous positions).
Member, Japan Society of Aesthetic Surgery (JSAS) / Member, American Academy of Aesthetic Medicine / ECFMG Certificate