1.         Elbow plasty diagnosis background

—     Elbow wrinkling in the extended forearm:   excessive and inelastic skin.

—     Patient unable or unwilling to wear short sleeves or no sleeves.

—     “OldAge” stigma.

2.         Elbow Markings Methods

—     Pinch the skin with the forearm extended at 180 degrees.

—     Flex the arm slowly while the skin escapes the pinching fingers.

—     Mark the proximal and distal point of cooptation of the skin on 90 degrees flexion of the elbow.

—     The position of the ellipse of excision varies according to the location of the excess of skin.

—     Elliptical curved or straight excision depending on the excesslocation (straight if the excess is over  the bony prominence  of the radius, taper the edges to avoid a dog ear).

3.         Technique

—     Local infiltration with xylocaine 1% c epinephrine 1/100000.

—     Skin ellipse excision.

—     Skin undermining superiorly and inferiorly depending on the skin excess and laxity.

—     Closure in two layers.

—     Subcuticular closure.

—     Avoid the ulnar nerve

—     Closure in two layers

—     Avoid dog ears

4.         Results

4.1.  Before

4.2.  After

5.         Post op care

—     Limit full arm flexion for a week to ten days.

—     Reduce the extent of flexion for 3 weeks.

—     Long term taping of the wound to prevent breakdown or scar widening.

6.         Complication

—     Hematoma

—     Dog ears

—     Scar widening

7.         Elbow plasty

·         Limited elbow flexion  for three weeks, compressive circular  bandages sub cuticular closure.

8.         Conclusion

·         Anew simpletechnique for rejuvenation of the elbows.