What is the best procedure to remove hanging fat after weight loss? (Photos)

Question

30 yr old, 5'3", 200 lbs. I've recently lost about 50lbs and my arm is left with fat hanging. Are there any procedures that will remove the fat and tighten the skin apart from an arm lift as I don't want a big scar.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding what to do with your arms after a 50-pound weight loss. In analyzing your pictures, you have excess skin and fat. Fortunately, you do not have excess skin and fat all the way to the elbow. Most of your excess skin and arm fat is localized to the inner third of your upper arm closer to your armpit. If you have only excess fat and good quality skin, the surgical solution would be liposuction. I’m afraid due to your age, stretch marks, and significant weight loss of 50 pounds, your skin will not contract. Therefore, I would highly suggest you undergo a limited incision arm lift and arm reduction. The incision would extend from the armpit slightly down your inner arm to remove excess skin and fat. I know this is not the answer you are seeking but it is the best surgical solution. I believe if you just have arm liposuction, you will be left with hanging skin. Therefore, you would have spent that money and recovery time on disappointing results. I would go for the best procedure possible and in your case, this would be an arm reduction with an incision from the armpit and slightly down the inner arm. The procedure will take approximately 2 to 3 hours to complete. Your arm lift and reduction would be done under general anesthesia. Please plan for a two-week recovery after an arm lift. Please seek an experienced board-certified plastic surgeon who has performed hundreds of arm lifts.

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Bryan Armijo, MD · Answer

congratulations on your weight loss! Based on your photos you would likely need the excess loose skin removed surgically. Due to the stretch marks and laxity of the skin liposuction or lasers alone would not achieve your desired result. I do recommend my patients getting within 15lbs of their goal weight in order to maximize your end result. I would recommend seeing a board certified plastic surgeon for an in person consultation.

Carmina Cardenas, MD · Answer

It is wonderful what you have achieved after losing weight!! Your BMI still high (35) so it will be great if you reach a healthier BMI below 30 in order to have a safer procedure and the most beautiful result. 
After losing the weight your arms automatically will become saggier and worst than now, so you will be highly benefited with an Arm lift and some liposuction to create slim and tight arms. 
Non invasive procedure will improve only 5-10%. 
Exercise and toning your muscles will help a lot on improving the appearance of your arms. 
Be encouraged!!
Dr. Cárdenas

Daniel Barrett, MD · Answer

Dear Original998453,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from arm lift. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

You can have liposuction with radiofrequency skin tightening like Renuvion to remove excess fat and tighten your arms. This is done with a small scar. If needed, you can have a limited arm tuck to remove just the excess hanging down and not go all the way down to your elbow.

Ahmad H. Ahmadi, MD · Answer

Your photos show both excess skins with stretch marks and fatty tissue. You will get better results by combining liposuction to remove the fatty tissue and an arm lift to remove the sagging skin. Since the excess skin is limited, the arm lift scar need not be long but just enough to remove the hanging skin.

Camille Cash, MD · Answer

Congratulations on your weight loss!  From your photos you will have the best results from an arm lift.  You can consider liposuction alone but will likely be left with more hanging skin.  From your photos it appears there is too much laxity to get good results from RF skin tightening.

Arian Mowlavi, MD, FACS (license on probation) · Answer

You would make a great candidate for a traditional vertical arm lift. This requires experience to gauge the amount of skin excised. Please consider a consultation with a high definition body contoruing specialist to determine what is feasible.

Jose A. Munoz, MD - Account Suspended · Answer

Hi and welcome to our forum!Congratulations on your weight loss!From your photos, I note a moderate-considerable amount of upper arm fat and redundant stretched out skin at the proximal 1/3 of the upper arms. A liposuction procedure of the upper arms removes fat only, while a brachioplasty removes excess skin and underlying fat. If there is a significant amount of fat present (with its associated added weight), if the skin demonstrates no evidence of overstretching (stretch marks), and if the sag is only minimal to moderate, a liposuction may correct the deformity. On the other hand, if there is stretched out skin, only a brachioplasty can achieve correction. However, one must accept a scar from armpit to elbow. The scar is placed on the inside (medial side) of the arm to minimize exposure, but the scar is readily apparent in certain positions. The mini-arm lift is not of much benefit. Your skin laxity exceeds the abilities of non-surgical modalities.It appears that you would be best served with brachioplasty.Seek a consultation with a board certified plastic surgeon.Best wishes...