Hi Vivid122862, Thank you for your question regarding is an arm lift the only solution for your arms.  Thank you for your history and your pictures.  First, we should analyze your pictures to determine the best arm procedure.  You have mild lipodystrophy (excess fat) from the axillae (armpit) to the elbow.  You have mild cutis pleonasmus (excess skin) and dermatocholosis (loose skin) from the axillae (armpit) to the elbow. You do not appear to have arm stretch marks.  Do you have a history of significant weight loss of over 100 pounds?  Do you have any other medical problems?  Most experienced board-certified plastic surgeons would not recommend a brachioplasty (arm lift or arm reduction) in your case.  Most experienced board-certified plastic surgeons would recommend VASER liposuction or VASER Hi-Def arm liposuction.  VASER is an acronym that stands for Vibration Amplified Sound Energy at Resonance.  A VASER is basically an ultrasound probe.  The VASER is a powerful addition to liposuction.  The VASER helps liposuction results by melting the fat and heating the skin for maximum benefit.  In your case, you should undergo VASER arm liposuction.  "Traditional" VASER arm liposuction can help you achieve slender, feminine arms.  Another alternative to "traditional" VASER liposuction is VASER Hi-Def arm liposuction.  During VASER Hi-Def arm liposuction, the VASER is used to sculpt the muscles and remove the fat between the deltoid, triceps, and biceps. The results of VASER Hi-Def arm liposuction are sculpted, athletic arms.  The degree of muscle definition will be determined by you and your chosen plastic surgeon before surgery.  The procedure takes about 2 to 3 hours under general anesthesia.  Plan on a 7 to 10 day recovery.  You will need to wear arm compression sleeves for 6 to 8 weeks for maximum results.  Lymphatic massage and hyperbaric oxygen can help to accelerate healing and final results.