Size 4, 133 pounds. I HATE my arms! What treatment options would be best? (Photo)

Hello, and thank you for your question regarding your arms, your dislike of them, and the best treatment options. Thank you for your history and your picture. Since you are 48 years old and have a history of weightlifting, if you undergo VASER liposuction on your triceps region, you will likely be left with excess hanging arm skin. Therefore, the most definitive treatment would be a brachioplasty or a longitudinal arm reduction. During a brachioplasty, an upper arm incision is made from the armpit to the elbow, and excess skin and fat of the inner arm are permanently removed. The upside as you would get skinny arms. The downside is that there is a scar on the inside of your arm. Typically, a longitudinal brachioplasty takes approximately 3 to 4 hours to complete under general anesthesia. Plan on a two-week recovery. You’ll have to lay off weightlifting for approximately two months. Drains are usually not necessary. Arm garments will be required for approximately six weeks. The other alternative is undergoing VASER high-definition arm liposuction—ideally, your upper arm skin contracts. If your arm skin does not contract to your liking, then you need to undergo brachioplasty. However, if you undergo successful arm liposuction, you may be able to avoid an arm lift scar, but there’s no guarantee that your arm skin will contract. Good luck. To get an accurate assessment of what exactly you need, schedule a free virtual consultation. Most plastic surgeons offer free virtual consultations. I hope that I have answered your questions regarding the arm lift or arm reduction. If you have any further questions regarding arm lifts, arm reductions, brachioplasty, or arm crease fat grafting, please consult with an experienced plastic surgeon. Since a brachioplasty, or arm lift surgery, is a complex procedure, please seek an experienced, board-certified plastic surgeon with significant experience performing these types of arm lifts. Do your research. Make sure your chosen plastic surgeon has performed at least 100 arm lifts. Make sure they have the before-and-after pictures to prove it. Carefully examine their before-and-after pictures and check their reviews on RealSelf.
Sincerely, Dr. Katzen, MD, MBA. (Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic surgery, Fellow of the International Society of Aesthetic Plastic surgery, American College of surgery, International College of surgery, and American Board of Metabolic and Bariatric surgery, and member of the American Society of Plastic surgery, American Academy of Cosmetic surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Tough to say totally based on this photo, but your best bet will be a surgical arm lift. Scar runs from elbow to armpit, takes about 90 minutes and in and out. Recovery is pretty easy, you have to wear compression and pain is minimal. It can be done under local anesthesia (although I recommend general anesthesia for comfort reasons).
If you're really trying to avoid the scar, you can do liposuction plus a skin tightening device (I like bodytite). That works fairly well but won't be as tight as surgery, however if you really dont want the scarring, that's the thing to try.

In cases like this, the most effective approach is typically a brachioplasty (arm lift) with liposuction. Liposuction reduces excess fat, while brachioplasty removes redundant skin and reshapes the arm contour. Renuvion skin tightening can also provide additional tissue contraction, improving overall definition. While the procedure does involve a scar, it can be hidden on the underside of the arm, and most patients find the trade-off worthwhile for achieving proportionate, balanced results.

There is really only one good option for you and that is a brachioplasty or arm lift. The procedure will require the removal of skin and fat in order to narrow and tighten your upper arms. The older, traditional way of doing this results in the removal of not only the excess skin and fat but also all the blood vessels, lymphatics and nerves contained in the area. This can result in an increased risk of fluid collection, numbness and swelling in the forearm. My preferred technique is to suction out all the fat in the area to be excised so that only skin is left and then cut away the skin only. This preserves all the underlying structures, reducing the risk of complications and eliminates the need for drains. The tradeoff will be a long scar from armpit to elbow. Ask your surgeon about using Brijjits and Embrace to help with the appearance of the scars.

Unfortunately, arms can be extremely stubborn.

Many patients will benefit from Vaser ultrasound liposuction to remove the bulky fat and tighten skin to a degree.

However, you most likely will also need skin removed via arm lift (brachiaplasty)

An exam and consultation with a plastic surgeon is recommended to confirm this as well as discuss your options and expectations.

The best treatment for you would be a brachioplasty. An incision is made at the axilla and goes down to the elbow. I also use liposuction at the same time to feather the transition between the lifted and no lifted areas. This takes 2 hours to perform under general anesthesia and costs $8,000.

Best Wishes,

Gary Horndeski, M.D.

From the submitted photo you appear to be a candidate for an arm lift. This would remove the excess fat and skin on the upper arm to give you a contour that is more harmonious with the rest of your body. The drawback of this procedure is that it does involve a scar that extends from the underarm down to about the elbow. I've included a video I hope you find helpful.

Hi there,Thank you for your question. There really is only one solution for you and that would be to have a Brachiaplasty, or Armlift. This procedure involves having an incision that runs down the inside of the arm from the armpit to just above the elbow. Excess skin would be removed leaving a tighter appearance of the upper arms. Please consult with a Board Certified plastic surgeon who can guide you through a treatment plan.

Based on the one poster photo you were candidate for a brachioplasty or arm lift. Best of virtual console with for a better understanding. Expect fees to arrange from $8000-$10,000. Again, best of virtual consult with.