Cause of sudden upper arm skin crepe/creasing? How long to wait before taking action? What procedures to consider first?

Thank you for your question about crepe upper arm skin and what to do about it.  I believe your sudden weight loss caused your body to burn fat and muscle stores. With this loss of arm fat and muscle, your arm skin tried to shrink.  Due to your age, genetics, amount of radiation from sun exposure, your skin tried to recoil.  Unfortunately, your skin could not completely recoil and that is why you are left with crepe like upper arm skin. For now, I would suggest you eat healthy foods, hire a personal trainer and work on your upper arms. I would try this for six months.  If this does not achieve the arms you desire, I would consider a full or longitudinal arm lift or brachioplasty. During an  arm lift, arm liposuction is performed to remove arm fat.  During the same procedure, excess arm skin is removed.  From your pictures, I would suggest the full or longitudinal arm lift because you have excess skin and fat to the elbows.  The full arm lift takes about 3 to 4 hours to complete.  The arm lift is performed under general anesthesia.  Recovery is about 2 weeks.  Post-operatively, you  will need to wear an arm garment for 6 weeks. If you have any other questions regarding how to get rid of crepe like arm skin, or about the arm lift or brachioplasty, please contact my office.  Sincerely, Dr. J. Timothy Katzen

Weight changes can certainly result in excess skin in the arm.  Rapid weight change seems to have a greater tendency to create the problem that you describe compared to slower weight loss.  That said, I have had patients without any noticeable weight change feel like they woke up one day with the loose skin.  If your weight is stable for 6 months and the skin is unchanged, it is likely not going to improve, sorry.  

As for your options, brachioplasty or arm lift is really your only option in my opinion.  As with any body contouring, we are trading shape for a scar.  That assessment and evaluation is going to be facilitated with a consultation with a plastic surgeon.