Best Approach to Loose Skin and Fat on Upper Arms?

Based on the information you've provided and your photo, you'll probably need an arm lift rather than liposuction. This is because if you remove a lot of fat in your upper arms with liposuction alone, you'll have loose skin that may not be able to retract to your leaner contour. This loose skin will make the results of your liposuction hard to see. An arm lift will remove the excess fat and skin to give you a better result.  

Congratulations on such a great weight reduction. You probably will not get enough benefit from lipoosuction alone, whether laser-assited liposuction or tumescent lipoosuction followed by Thermage external radiofrequency tightening After these procedures, your skin will not retract enough and you will end up seeking a plastic surgeon to do an arm lift, so I would suggest you see a board-certified plastic surgeon to discuss the type of scarring that is expected with the arm lift and other risks and consequences.
 

Judging by your photos I would recommend an arm lift.  Liposuction will produce a slight improvement but you already have laxity in the skin and excessive skin as well.  So liposuction will not address the loose skin that you have and will need the skin resected.  In some patients there is some benefit to staged surgery with liposuction and then a brachioplasty at the second stage.  It really depends what the patient expectations are.

But with brachioplasty alone, the excess skin will be removed while with liposuction if will only get more loose.

Based on the photograph that you posted, its difficult to assess how heavy your arms are. For patients with heavy arm tissues and loose skin, I recommend a staged arm liposuction followed by arm lift 2-3 months later. The scars appear to be better in this sequence.

Your photo shows both excess of fat and skin of the upper arm that will not be resolved satisfactorily with liposuction alone.  I recommend a combination of liposuction and surgical skin reduction that can be safely done in one setting.  Your elasticity at your current age may not be adequate to tuck the incisions into the axilla alone, you should consider a longitudinal ellipse to be excised that would carefully place the closure on the inside surface of the arm.

Congrats on your weight loss. But you have enough extra skin and fat on your upper arm that you will need a bracioplasty (arm reduction). Liposuction will be 'whistling in the wind' for you.

Brachioplasty will cut off all the excess. The 'trade-off' is that you have to accept a scar on the inner surface of your upper arm. In your case, I think the scar is worth it, but you have decide for yourself.

You have so much extra skin that liposuction alone will actually make things worse.

Liposuction is the fastest way to say good-bye to bulky arms. Usually, a tiny incision is made near the elbow and the cannula is passed all the way up to the armpit. Sculpting of the arm can be done at the same time as an arm lift, avoiding the need for multiple surgeries. Smart Lipo uses laser light to liquefy fat and tighten the surrounding skin. It involves less downtime and side-effects than traditional liposuction and is particularly good for small areas of fat deposits. An effective non-surgical option is Thermage, a non-invasive (no incision!) treatment that can tighten skin, and stimulate your body to make healthier collagen—the building block that provides structure to your skin.

 While  even heavy and moderately droopy arms can be recontoured very effectively with liposuction because the act of liposuction itself causes the surrounding skin to tighten and lift with  very large weight loss and severe hanging skin a brachioplasty will be the most effective procedure—but the trade-off is a big scar and longer recovery.

The best way to protect yourself is to consult a board-certified plastic surgeon who is professionally bound to engage only in techniques that have been deemed safe--after rigorous testing.

Congratulations on losing all that weight!  The rewards are better health, but unfortunately the loose skin on the arms will not get better without cutting out the loose skin.

The beast result will be by doing liposuction and arm lift at the same time. The Amount of the excess skin make liposuction by itself less effective. The scar lenght and postion will depend on the amount of extra skin.

Based on the picture you have showed, an arm lift is the best option. The main consideration is will additional liposuction help. I think it will help if it is "deflated" first, so a staged approach might be best - liposuction first, let the swelling come down and then do the arm lift. I wish you all the best. J. Vicente Poblete, MD. Avon lake plastic and cosmetic surgeon.