None of the treatments you describe are appropriate for what you’re trying to achieve. Liposuction is the gold standard, and even though there is significant variation in skill and experience among plastic surgeons for this procedure, the only way to get a quality outcome he’s going to be well done Liposuction by a surgeon who is sufficient experience. Doing liposuction of the upper extremities is technically challenging and the area is prone to contour, irregularities, and undesirable outcomes. If you don’t select providers correctly. It’s also important to recognize that you candidacy for the procedure should not be determined by yourself, but rather by somebody who has the training and experience to do so correctly and accurately. To find the right provider, I suggest having multiple in person, consultations with local, board-certified plastic surgeons, who seem to do a lot at Liposuction. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients, who had similar arm and body characteristics to your own. And experience plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Being shown a handful of pre-selected images, representing the best results of the providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider. The providers you went to show you quality before and after pictures in sufficient quantity and what was their response when your results were different than what they had explain to you? My best suggestion to you is to find the most experienced and talented provider, and that should be a board-certified plastic surgeon with years of experience with a strong emphasis on Liposuction. Your disappointment with the stated treatment options is totally predictable. Those treatment options are notorious for not delivering quality outcomes. If the treatment you described were truly effective and the best option then all plastic surgeons would use them. Best, Mats Hagstrom, MD