Hello, thank you for your question about what to do with your arms: arm liposuction, mini arm lift or two arm liposuctions. Basically, let's examine and analyze your arm pictures. You have Type 3 arms with excess upper arm skin and fat from your axillae (armpit) to your elbows. Your best treatment would be removal of arm SKIN AND FAT. Whatever type of arm liposuction you have, whether its is VASER, Smart, or Laser Liposuction), your arm skin will NOT be removed and your arm skin will only SLIGHTLY tighten. You need a formal or longitudinal arm lift from the axillae to the elbow. If you do ANYTHING less than this, you will have unsatisfactory results. Also, a crescent arm lift will NOT significantly improve your arms. in regards to your specific questions...Hi, I'm having arm liposuction in Oct but I've seen horror stories. Do you think my arms will wrinkle with lipo? Yes, I think your arms will wrinkle after arm liposuction. Basically, your plastic surgeon will try one of two options. One, they will try to get you great results with arm liposuction, but they will probably over suck your arms, and you will have loose, wrinkly arm skin. Or option two, to avoid loose, wrinkly arm skin, they will under suck your arms and will wonder why you had arm liposuction at all. Are my arms too large to benefit drastically from lipo? Correct, yes. Would I need two liposuction procedures instead of one for good results? No. You need an arm reduction or brachioplasty. One or two or three or four arm liposuctions will just results in loose, hanging arm skin since you have excess arm skin. I really don't want an extended scar...I workout everyday but my arms are my problem area. Would a crescent arm lift help? No. Would J plasma with lipo be a good idea? No. I did coolsculpt 5 years ago, made things worse. I would NOT have recommended cool sculpt to your arms. I specialize in arm lifts. If you have any more questions regarding the arm lift, arm reduction, brachioplasty, please contact my office. Please seek an experienced, board certified plastic surgeon with significant experience performing these types of arm lifts. Do your research. Make sure your chosen plastic surgeon has performed at least 100 arm lifts. Make sure they have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon , Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)