Thank you for your question regarding whether you can get away with Vaser liposuction or if an arm lift is necessary. By examining your photos, I believe you can achieve great results with Vaser liposuction, especially with the skin tightening benefits it offers. However, it's important to note that Vaser liposuction may not provide the same degree of skin removal as an arm lift. While the Vaser procedure will reduce fat and give you more definition, the skin-tightening aspect may not completely eliminate any excess or sagging skin you have, especially if you've lost significant weight. In comparison, an arm lift would result in a slimmer, more contoured arm by removing both the excess fat and skin. However, as you mentioned, it does leave a significant scar, which is a common concern for many patients. If scarring is a major concern and you’re comfortable with slightly looser skin, then Vaser lipo is a good option for you. Your arm won’t be as tight and slim as it would be with an arm lift, but I do believe you’ll be pleased with the outcome of Vaser lipo, especially considering you still have 10 kilos left to lose. I also recommend getting closer to your goal weight and maintaining that weight for at least 3 months before undergoing surgery. This will give you a better idea of what your arms will look like with further weight loss and allow your surgeon to make a more accurate assessment of your skin elasticity. I suggest discussing this further with your plastic surgeon, who can assess your skin and help guide you towards the best choice for your desired outcome. Sincerely, Dr. Katzen