What can be done to remove lumps/creases in my arms make them the same size and address visible crooked puffy scaring? (photos)

Hello SERYCKA in New York,
Thank you for reaching out with your concerns about the lumps, creases, and scarring on your arms, and for providing your history and pictures for a better understanding of your situation.
Based on your description and the photos:
Arm Bands: The creases you're observing, often referred to as arm bands, are indeed believed by many in the medical community to be congenital in nature. This means they might have been present since birth. Reviewing childhood photographs could confirm if these bands were evident at an early age.
Z-Plasty for Treatment: To address these bands, a Z-plasty is a highly regarded surgical technique. This procedure involves rearranging local tissue to smooth out indentations or bands, which sounds appropriate for your situation. Z-plasty is designed to break up the linear scar or band, reorient the tension lines, and potentially make the scar less noticeable while releasing the constricted tissue.
Procedure Details: Typically, Z-plasty can be performed in an office setting under local anesthesia. It can be done either during the initial arm surgery or after the initial arm lift has healed, depending on various factors including the severity of the bands, the overall condition of the skin, and your healing process.
Concerning Further Liposuction and Fat Grafting: As you have experienced, additional liposuction might lead to more skin irregularities, and fat grafting might not adequately correct the issue. The key is addressing the underlying adhesive band surgically.
Post-Operative Expectations: Post-surgery, you can expect some swelling and bruising, which typically resolves over a few weeks. Your surgeon will provide specific post-operative care instructions to ensure optimal healing and the best possible aesthetic outcome.
It's important to have a detailed discussion with a board-certified plastic surgeon experienced in arm rejuvenation and corrective procedures like Z-plasty. They can provide a personalized assessment and tailor the procedure to address your specific concerns effectively.
I hope this information is helpful in guiding you toward a solution for your arm concerns and in understanding the options available to improve both the function and appearance of your arms.
Wishing you the best in your journey towards a successful treatment outcome.
Good luck, and take care.
Sincerely,
Dr. Katzen

It is difficult to give you advise without any pictures, I recommend you consult in person for a detailed exam. Always see a board certified PS.

You need a personal consultation for a comprehensive review of your arms before advise on revision surgery can be offered.  Arrange a review with a fully qualified plastic surgeon to discuss your options. 

Thank you for the question and helpful photos,  although I would like to see the arms side by side and of course in person.   I am sorry for all you have been through.  It seems like it might be time for fresh eyes and a second opinion.  There are certainly techniques to improve your scars including z-plasty to help with the contour irregularity and areas of scar contracture.   Usually additional liposuction and fat grafting as well as some scar revisions can help with the asymmetry and "puffiness" you are talking about.  Please be sure to consult a board certified plastic surgeon and look at photos.  Best