Hello, and thank you for your question about whether you need an arm lipo or an arm lift. Thank you for your history and your picture. Based on your arm picture, you have excess skin and fat from the armpit to the elbow. By classification, you have Type 4 arms with excess skin and fat from the axilla to the elbow. Liposuction is best for patients with isolated pockets of fat and excellent skin and ideal recoil factors. Since you have excess arm fat AND SKIN, liposuction will not address the excess arm skin, even if you use Renuvion or J-Plasma. The best treatment for your arms would be an arm lift or brachioplasty. During a typical brachioplasty, arm liposuction is performed on the medial (inner) aspect of the arm as well as the triceps region. Then, an incision is made from the armpit to the elbow. The tissue dissection is then carried to the posterior aspect of the triceps region. The excess arm skin and fat are then resected, and the arm scar is mobilized. The scar should be placed between the biceps and triceps. This leads to maximum arm scar concealment when your arms are by your side. If the arm scar is placed on the triceps region, the scar is much more visible when the arm is down by your side. Usually, a formal brachioplasty (arm lift or arm reduction) is performed under general anesthesia with an anesthesiologist. Arm liposuction combined with an arm skin reduction typically takes approximately 3 to 4 hours to complete. Usually, drains are not required. For the first two weeks, you’ll wear ACE bandages on the upper arms. After the ACE bandages are discontinued, you will be placed in an arm garment for approximately 6 to 8 weeks. ACE bandages and garments help to minimize swelling, flatten the scar, provide physical support to the healing arms, and offer emotional support, knowing that the scar will not break open. Arm scars usually heal very well. However, if you are concerned about the appearance of the arm scar, you may need laser treatment, scar revision, micro-needling, or Morpheus 8. Most plastic surgeons would agree you should not waste your money on arm liposuction. Arm liposuction will get rid of some of the fat, but you’ll be left with arms that will probably look worse because of the excess hanging skin. Good luck. Since a brachioplasty or arm lift surgery is a difficult procedure, please seek an experienced, board-certified plastic surgeon with significant experience performing these types of arm lifts. Do your research. Make sure your chosen plastic surgeon has performed at least 100 arm lifts. Make sure they have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. Sincerely, Dr. Katzen, MD, MBA. (Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)