20 days po arm lift (no lipo). L arm is an inch larger due to swelling I think. Worried surgery wasn't aggressive enough?(photo)

Thank you for your question regarding swelling and arm asymmetry after your arm lift.  First of all, congratulations on your massive weight loss.  This is a great achievement, and you should be very proud of yourself.  Congratulations also on embarking upon staged reconstruction to rebuild your body after massive weight loss.  In regards to your specific question, you are only 20 days after your arm lift or brachioplasty.  This is way too early to determine anything.  In addition, you state that you are still swollen.  This is entirely normal.  Some patients recover earlier and are able to go back to work at two weeks.  Some patients require longer to heal.  In my experience, the bigger the surgery, the longer it takes for a patient to recover.  Therefore, if only a mild to modest amount of fat and skin are removed from the arm, patients are usually able to return to work at two weeks.  However, if more skin and fat is removed from the arm during the arm lift, the recovery is longer.  Some patients take a month to 6 weeks to return to their full-time active job.  My suggestion would be to wait before any conclusions are drawn.  I suggest you continue to wear your arm compression garments for the full six weeks after your surgery.  In regards to your arm scars, I would suggest a silicone based scar cream and silicone strips to minimize the scars.  I would not analyze your arms or reach any conclusions now.  I would wait at least until you are 6-8 weeks post-op from your brachioplasty.  Thank you for your questions regarding arm lift healing, arm asymmetry and results of your arms.  If you have any more questions regarding your arm lift or arm reduction, please contact my office.  Sincerely, Dr. Katzen

You seem to be healing well, arms take  bit longer for swelling to go down you just have to be patient and wait a few months  continue to follow up with your PS.

Hello Dear!Thanks for the question and provided information.
Remember that you still are early on healing process, it is too soon to determine how your results are going to be, but per now, they look normal. The healing process depends on each patient, most of the time is between 6 months and one year to see the final results. 
Good luck :)