For loose upper arm skin, whether by weight loss or age and genetics, there is no exercise, laser treatment, RF (radio frequency, like Thermage), or other alternative that can remove or successfully tighten this loose skin without scars. These scars usually run from armpit to elbow, occasionally further down the arm, and the skin thickness and innate healing in this area of the body yields scars that are all-too-often thick (hypertrophic), wide, contracted (like a burn scar), or otherwise unsightly--regardless of the surgeon's skill or precision of closure. Of course, a poor closure makes any scar, however good or bad, even worse. Poor incision placement further complicates the issue, since proper placement can help you hide the scars in many arm positions. Liposuction can help contour arms with good skin tone but is generally not helpful at tightening skin, even laser or ultrasonic versions. Mini-brachioplasties give mini-results and smaller but still-bad scars (rarely recommended).
That's the bad news. Now for some good news: Because of the popularity of gastric bypass and lap bands, many more patients are now candidates for brachioplasty, and well-trained, experienced, board-certified plastic surgeons are getting better at mastering this challenging procedure and giving patients good results. Photos don't really help you--who would show you bad scars? Honesty and experience are often the best predictors of who can give you the best results.