For your arm lift or brachioplasty, I would suggest a full arm lift. This would include extensive arm liposuction to remove arm fat. In addition, an incision would be made from the axillae (armpit) to the elbow. Your arm lift or brachioplasty should take 3-4 hours to perform. Since you have a desk job, you should be able to return to work 2-3 weeks after your arm lift. You did not include forearm pictures. It is possible that you may also need a forearm reduction. In this surgery, the arm lift incision is extended past the elbow onto the forearm. In some patients, I have extended this incision to the mid-forearm while in other patients, I have extended this incision to the wrist. Since you have significant excess arm skin and fat, you should seek insurance coverage. Unless there is exclusion for massive weight loss, your brachioplasty or arm reduction should be covered by insurance. Good luck with your arm lift or brachioplasty surgery.