Thank you for your question on arm skin tightening without fat removal or brachioplasty. The procedure that may meet your criteria is J-plasma, also known as Renuvion. J-plasma combines helium gas with radio frequency energy, producing cold helium plasma. This ionized gas is believed to stimulate collagen production, which can result in skin tightening. However, it's essential to be aware that the efficacy of J-plasma varies. Some plastic surgeons report satisfactory outcomes, while others might be less enthusiastic about its results. I recommend thorough research and consultation with a board-certified plastic surgeon experienced with J-plasma to understand its potential benefits and limitations for your specific situation. Sincerely, Dr. Katzen