For Paula Kumar, it\'s like many middle classes.
The older woman is her bingo wings.
Sagging skin cracks around the triceps at the back of the arm-
Even after the diet and exercise system would hold gwynys Paltrow back, it was a mistake that was unique to her.
Paula, a management consultant from Hayward Heath in Sussex, has made up her mind to start fitness by the age of 40 last year.
For eight months, she insisted on a strict diet and went to the gym six times a week.
She lost an incredible 9 stone and changed from 24 to 10, and in the end she boasted about her coveted, toned belly and trimmed thighs in her 30 s.
But her arm is not strong yet.
Paula said: \"I worked tirelessly to shift myself from overweight and slack to healthy and slim, but my bingo wings are still there. And their nine-year-old daughter, Maisie.
I\'m a typical yo-yo.
I \'ve been losing weight all my life, and the skin behind my arm is completely covered --
The result was stretched.
\"My personal trainer tried to help me build my muscles with triceps descent and weight, but it was completely invisible under loose skin swings.
As a result, like more and more women, Paula has begun to consider more extreme measures: a cosmetic operation called wrist plastic surgery --
Or raise your arm-
To expel her bingo wings forever.
The cost of the operation is approximately £ 5,000, which takes two to three hours under general anesthesia, during which the surgeon cuts the armpits down from the elbow and then cuts off any loose skin and tissue.
Not for the faint.
But that didn\'t stop the popularity of the program.
Research by private medical search engine WhatClinic.
Com showed that in the past 12 months, the number of women undergoing plastic surgery on the wrist increased by 60 percentage points.
In the past year alone, the number of clinics providing such surgery in the UK has also increased by 25 percentage points.
Despite the British Association of Cosmetic Plastic Surgeons (BAAPS)
Official figures for the UK and the US are not retainedS.
The American Association of Plastic Surgeons has seen a staggering 4,473 increase in wrist plastic surgery since 2000, when only 300 women underwent surgery, compared with 15,000 last year.
Soaring demand may not be surprising.
While flat tums and tightened bums have been popular, its chest has become necessary in recent years --have show-off body part -
Any badge of honor that wants to be seen as a thin, healthy and strong woman.
Think about Jennifer Aniston, Samantha Cameron, and especially Michelle Obama, who has become a poster girl for the sculptural arm that perfectly displays a sleeveless top.
Paula admits high
A side upper limb like this helped her with surgery.
She said: \"I read a lot of magazines and always find myself hanging around in women photos like Michelle Obama . \"
It\'s not like wanting an arm like her.
I just want arms that will allow me to wear more exposed, stylish and elegant clothes.
According to Angelica Kavouni, a plastic surgeon at Harley Street, not just the celebrity\'s arm has fueled a surge in wrist plastic surgery.
We are in the throes of the obesity epidemic, she said.
As a result, more and more people lose weight through surgery or their own equipment.
\"Normally this makes their skin very loose, especially the thighs, abdomen and upper arms, and no movement can be reduced.
I would say that for this reason, about one of my patients with wrist plastic surgery had surgery.
\"The rest is often women in their 50 s who are healthy and athletic, and they are tired of their own arms covering up their original slim figure.
They have taken care of themselves, but since their skin naturally loses its elasticity as they grow older, they have developed bingo wings.
It is not an easy decision for Paula to remove the knife.
\"I have never considered surgery before and my pain threshold is not high,\" she said . \".
Not only is there a cost of £ 4,500, but I also need to take a few weeks off to recover, which is a big deal for meemployed.
But last summer, when I actually started running, the last trigger came.
The swing of the excess skin on the arm was very uncomfortable, which started to delay my exercise.
After working so hard in the gym for so long, I don\'t want to let things slip away.
On May 2012, she had an initial conversation with Paul Banwell, a plastic surgery consultant.
Since 2010, he has seen an increase of 30 percentage points in wrist plastic surgery patients at the East Grinstead clinic.
\"Weight loss surgery and an increase in extreme weight loss will certainly drive this growth, but it is also becoming more and more aware that surgery is first and foremost to address this issue,\" Banwell explained . \".
The skin around the arm is naturally very thin, so once it is stretched through weight gain, or loses its elasticity as it grows older, no more coloring exercises will tighten it.
\"It doesn\'t make any difference whether you lose weight quickly or longer --
Once the skin is stretched, it can cause damage.
For those with good skin elasticity but too much fat in the upper limbs, liposuction is more appropriate.
In addition to this, the only option is wrist osteoplasty.
After removing the excess skin and tissue, add a long needle under the surface of the skin and fix everything together while healing.
\"Of course, I was very nervous about doing such a big operation, but I decided there was no worse scar than my loose triceps,\" Paula said . \" 11 cm of her skin was removed from each arm.
To my surprise, I felt almost no pain.
This actually makes the recovery even more tricky.
Although I was strictly required to take a break in the first two weeks to avoid stitches and open wounds, I felt good enough to complete the basic tasks.
\"Even though I just did something like making a cup of tea and putting away a few pieces of clothing, it was enough to make my arms swollen.
\"It became very uncomfortable, causing me to be re-
I stayed at the clinic for one night and my arms were raised to help the swelling subside.
I was very careful after that.
I won\'t be able to get back to normal exercise until eight weeks later, but the shift was a big hit --
I have shapes and muscle definitions on my arms that I never knew.
The only sign of Paula\'s \"wings\" is the scar from the elbow to the underarm, although the daily use of skin healing oil means they have faded.
But it\'s only a small price, she said.
This is an emotion shared by 46-year-old Katie Southwell, who underwent plastic surgery on her wrist after deciding in 2008 that her arm was severely aging.
\"I \'ve always been a swimmer and it\'s great to keep my arms tight but I \'ve
For years, you \'ve been on a diet between the 12 th and the 18 th, \"said Katie, a housewife living in Woodford Green, Essex, with her 47-year-old husband Dean working in the traffic management department, james, 14, and Jordan, 15.
\"When I was 40 years old, my arm suddenly fell and wrinkled like an old lady.
\"Bingo wings can be a giveaway of age like a pair of lining edges or hands.
I feel like my upper body has seriously disappointed this side.
A friend bought me a beautiful Tiffany bracelet, but I never wore it because the watch or jewelry caught my attention.
I still remember the pictures taken on Dean\'s 40 th birthday.
I thought I looked pretty good in a gorgeous strap top, but was shocked by how bad my arms looked in the picture.
\'Katy consult the plastic surgeon Angelica Kavouni to see what can be done.
She had surgery on January 2008.
The £ 5,000 price tag was paid by her father, a retired police officer, who said he just wanted her to feel good about herself.
\"I have scars on the lower side of my arm, and even if I lift them up in the air, you have to look carefully to see them,\" she said . \".
Five years later, I\'m still excited about the results, and I haven\'t had to do anything extra to keep them looking slim since surgery.
Even if my weight gained a little as I did recently, my arms wouldn\'t relax. \'Clare Calcott-
James is another happy customer.
After she lost her life eight times in 2007, she was cut off by a knife, which gave her wrinkled skin on her arm, which she called \"similar to the eyes of the Venetian \".
Claire, 51, said: \"They look like my mother\'s arm. She is 90 years old . \" Claire is the data and performance manager for the UK\'s national health care system.
She lives in Hastings with 49-year-old partner Greg Solomon, who works in a bank in the city and has six children between them.
\"It took me five months to make a meal replacement, from 20st 4 lbs to 12st, from 24 to 12
This is the thinnest time I \'ve ever seen, she said.
But while I looked great when I was dressed, I left the ocean of embarrassing excess skin.
I always cover my arms with long sleeves.
She thinks the only answer is plastic surgery on the wrist.
\"One thing that makes me hesitate is the price of 4,500.
When I was single, I realized that most of my savings were running out.
Claire gave the surgeon Mark Pickford at the mackindo surgical center in East Grother to take care of the arm modification.
In December 2007, he removed 5 kg of his excess skin.
Claire was happy with the results.
\"A pair of lovely arms have something very feminine,\" she said . \".
\"Now I often show off.
I sing at the Opera Association and now I\'m happy to put on my charming armsBearing set.
No one can see the scars even under the stage lights.
Still, Paul Banwell said that anyone tempted by wrist plastic surgery must seriously consider the side effects of surgery before surgery.
This is a very invasive operation.
The term scar and the original wound took time to heal, he said, because the skin was very delicate in that area.
There is no doubt that this can produce very good results, but this is not a procedure that anyone should rush.
The question I often ask patients is, would you prefer to live with such people?
Is it called Bingo\'s wings, or is there a slender arm that always leaves scars?