Hi Erica61793, Thank you for your question regarding "What's the best way to fix elbow fat/brachioplasty revision?" Thank you for your history and pictures. In regards to how to "fix" your elbows, most plastic surgeons would suggest a arm lift/reduction or brachioplasty revision. For your arm lift revision, a plastic surgeon would need to extend your prior arm lift incision. You have two options: you can extend the incision to slightly below your elbow or extend the incision slightly and go 90 degree above the back of your elbow. If you choose to extend the incision past the elbow, the arm lift scar would only extend about three or four cm past the medial epicondyle (inner elbow) and onto your proximal forearm. If you chose to make the incision 90 degress behind your elbow, your current arm lift incision would be extended about four cm. Then, the incision would turn 90 degree behind your elbow. The advantage of this 90 degree turn is that the arm lift scar does not extend down the forearm, like option number one. Also, the 90 degree turn allows for the skin and fat that hangs over the elbow to be tightened and removed. These are some things for you to consider regarding your arm lift revision. These revisions can be done in the office under local or under general anesthesia in the operating room. I hope that I have answered your questions regarding the best way to revise or fix your elbow fat/brachioplasty. Good luck. Sincerely, Dr. J Timothy Katzen, MD