I can imagine your concern and I hope I can provide you some information that will help ease your concerns! Usually, with almost any plastic surgery procedure, I inform my patients that patience is key! Typically after surgery there is so much swelling that patients may even feel like they are bigger than before surgery!!!! When I perform an arm lift I almost always perform liposuction at the same time because I feel like I can achieve better results than with just an arm lift alone. The issue with performing liposuction and an arm lift at the same time however is that you have to put a lot more of the numbing solution (called tumescent) all throughout the tissues of the arm where liposuction is going to be performed. This solution helps decrease bleeding and pain. One can easily fit about 1/2 a liter of this solution in each arm! When I perform this surgery, I make markings on how much skin I think I will be able to remove and then in the operating room I try and assess if I can remove even more skin then I marked. Sometimes I'm able to and sometimes I'm not.Even with an arm lift alone, the arms will swell. Adding the tumescent into the tissues of the arm will lead to the arms being even more swollen. This swelling should all come down with time and when the swelling comes down, depending on your skin quality, your skin may contract (shrink) and then your arms may look smaller. Majority of swelling can take anywhere from 3-6 months to come down and this is why I remind my patients that patience is the key. Without fail, as time goes by, they start to notice the difference and there concerns are put to rest.I have not seen your before photos and have not performed a physical exam on you, so I don't know what your skin quality was before hand and I can't assess the amount of fat present. You have to also remember that it is not only fat and skin that make up the size of our arms. There is underlying muscle, bone, arteries, nerves and many other structures that cannot be made smaller and are fixed in their size/thickness. This limits the amount of tightness one can achieve with the arms. I try and explain this to all my patients before this surgery. Also, you have to remember that there are pros and cons to everything. If one removes too much extra skin and makes the arm really tight, this can potentially lead to wound healing issues and a very unsightly scar. I hope this helped. You should express your concerns with your plastic surgeon and maybe a discussion with him may also make you feel more at ease. I wish you all the best during your recovery!Ankur Mehta MD