Hello bevkeller. Thank you for your question regarding the options for addressing sagging arms and lower stomach after weight loss. Due to your age, genetics, and history of 70-pound weight loss, your skin will not bounce back on its own. Unfortunately, no matter how much you exercise or diet, the skin will not tighten without surgical intervention. Since you have excess skin and fat, the skin needs to be surgically removed. Liposuction alone will only remove fat and not tighten the skin, so a more comprehensive procedure is necessary. You need a tummy tuck, also known as abdominoplasty. This can be combined with, or staged with, an arm reduction, arm lift, or brachioplasty. During a tummy tuck, an incision is placed low on the abdomen and extended to your hips. The skin of the lower abdomen is removed, the pubic region is raised, reduced, and flattened. Additionally, the rectus abdominis muscle is tightened, and the belly button is repositioned. For your arms, arm liposuction can be performed, and at the same time, an incision is made from the armpit to the elbow. Excess skin and fat of the upper arm are thus removed. The tummy tuck will require a drain for approximately 10 to 14 days, while arm reduction surgery does not require drains. Your tummy tuck surgery should take approximately 3 to 5 hours to complete, and your arm lift should take approximately 3 to 4 hours to complete. Both procedures are performed under general anesthesia under the guidance of an anesthesiologist and can be done on an outpatient basis. Good luck. When seeking plastic surgery procedures after massive weight loss, please seek a plastic surgery specialist in the field. There are plastic surgeons who specialize in weight loss patients. Sincerely, J. Timothy Katzen, MD, FASMBS, FICS