Unfortunately, the only way to pull up and tuck excess arm skin is with an arm lift procedure. When patients develop hanging skin following aging or weight loss, it's essential that excess skin be removed. Attempts to tuck excess skin without excision will result in gathering of tissue in the axillary region. This would obviously result in a significant aesthetic deformity. Under these circumstances, the only viable alternative for someone with loose, saggy upper arm skin is a brachioplasty.This procedure involves placing an incision from the armpit to the elbow along the inner aspect of the arm. In many cases, a transverse axillary incision is utilized, as well. This approach tightens skin in multiple dimensions and dramatically improves contour.The procedure involves a series of trade-offs between excess upper arm skin and the scarring that's associated with this procedure. Despite scarring, brachioplasty is associated with excellent clinical results and high levels of patient satisfaction.It's virtually impossible to make a specific recommendation without pictures or a physical examination. For these reasons, it's appropriate to consult a board certified plastic surgeon with experience in this area. This surgeon should be able to formulate a treatment plan that addresses your anatomic deformity and achieves your aesthetic goals.