Hello aging mess, Thank you for your questions about addressing sagging and wrinkled skin extending from the upper arms to the forearms and whether skin tightening procedures can be combined with brachioplasty (arm lift). Based on your inquiry, it sounds like you're looking for an effective solution to improve the appearance of your arms. Full Brachioplasty: Given your concern about sagging skin extending beyond the elbows, a full brachioplasty might indeed be appropriate. This procedure typically involves liposuction from the elbow to the armpit, followed by an incision from the armpit to the elbow, often placed in the bicipital groove (the crease between the biceps and triceps) or on the inner aspect of the arm. The goal is to hide the scar as much as possible when the arms are resting by your side. Extension Beyond the Elbow: In cases where sagging skin extends into the forearm, the incision can be extended past the elbow. Experienced surgeons often carry this incision down the forearm, possibly even to the wrist, though the incision placement and extent vary based on individual needs. A technique that involves extending the incision and creating a 90-degree turn behind the elbow can effectively address excess skin and fat around the elbow and partially lift the forearm without leaving visible scars on the forearm itself. Skin Tightening: In terms of combining skin tightening with brachioplasty, the removal and redraping of skin during the brachioplasty itself offer significant skin tightening effects. Additional skin tightening technologies or treatments can be discussed with your surgeon, especially if they could enhance the overall result. The choice to combine procedures depends on various factors, including the extent of skin laxity, the quality of your skin, and your overall health. It's important to have a thorough consultation with a board-certified plastic surgeon experienced in brachioplasty and arm rejuvenation procedures. They can provide a personalized assessment and recommend the most effective approach to achieve your desired outcomes, ensuring the incisions and techniques used are tailored to your specific needs. I hope this information helps guide your decision-making process and provides a clearer understanding of the options available to address your concerns. Wishing you the best as you explore your surgical options. Good luck, and take care. Sincerely, Dr. Katzen