Thank you for your question regarding what your options are for fat removal. They are 71 years old and approximately 50 lbs overweight with non-insulin-dependent diabetes. First, a physical examination and consultation would need to be established. In general, there are several ways to make the arm smaller. If you are only concerned about removing fat, I suggest arm liposuction. This can be done with either traditional or micro air power-assisted liposuction or VASER liposuction. However, your skin is probably elastic due to your age and will not bounce back. Therefore you will probably do best with an arm lift or brachioplasty. There are three types of upper arm lifts. There is a crescent, modified T, and longitudinal upper brachioplasty. During a crescent, a crescent area of skin and fat is removed high up in the upper inner arm. The advantage of a crescent arm lift is that the arm is hidden. The main disadvantage of a crescent arm lift is that not much skin is removed from the arm. A. modified T incision combines the crescent arm lift mentioned above with an incision slightly down the inner arm. The resulting pattern is in the shape of a letter T. Much like the crescent arm lift; a modified T incision results are hampered by the inability to remove significant skin. The ultimate arm treatment would be a longitudinal brachioplasty. During this procedure, typically, arm liposuction is performed, and an incision is made from the armpit to the elbow. A large elliptical of skin and fat is then removed. Depending on the selected method, these procedures take approximately 2-4 hours. These procedures are done under general anesthesia and are performed on an outpatient basis. Thank you for your question regarding your options for arm fat removal.