Hello, thank you for your question about arm lipo or arm lift, arm reduction, or brachioplasty. Based on your pictures alone, I would suggest VASER arm liposuction. Traditional arm liposuction may cause skin laxity and loose, hanging skin. The VASER not only melts arm fat, but the VASER will help to maximally contract the arm skin. You may also want to consider if you want to have athletic arms sculpted with the VASER. This can achieved with accurate VASER arm liposuction. A physical examination and medical history is essential. If you have a history of significant weight loss, age over 45 or my phyical examination reveals arm stretch marks, you may do better with an arm lift, arm reduction, or brachioplasty. During the brachioplasty, arm liposuction is performed and then the arm skin is resected. Since these are relatively complex procedures, please seek an experienced, board certified plastic surgeon with significant experience in VASER arm liposuction and arm lifts, arm reductions, or brachioplasties. Travel out of state if you must to find such an arm reduction expert. If you have any more questions regarding an arm lift, arm reduction, brachioplasty, VASER arm liposuction, or plastic surgery in general, please contact my office. Sincerely, Dr. Katzen. (Certified by the American Board of Plastic Surgery and member of the American Society Plastic Surgeons, International Society of Aesthetic Plastic Surgery, American Academy of Cosmetic Surgery, and Fellow of American College of Surgeons and American Board for Metabolic and Bariatric Surgery, Awardee: RealSelf 100.)