Hi GMA04 in Santa Barbara. Thank you for your question regarding being 61 years old and having crepey skin forming on my upper arms and are there any suggestions? Thank you for your history. Crepey skin on the upper arms is a common concern as we age, primarily due to the natural loss of collagen, elastin, and hydration. Since you’ve been consistently working out, this issue is likely related to skin aging rather than weight loss. Fortunately, there are several options to improve skin texture and tightness. For non-surgical treatments, topical products like retinol or tretinoin can stimulate collagen production and skin renewal, while growth factors, peptides, and hyaluronic acid help repair, hydrate, and plump the skin. Vitamin C is also beneficial for supporting collagen synthesis and improving elasticity. Energy-based treatments, such as radiofrequency (RF) microneedling, ultrasound therapy (Ultherapy), and laser resurfacing (Fraxel or CO2 laser), can further enhance skin firmness by stimulating collagen. Collagen-boosting injections, like Radiesse (hyper dilute) or Sculptra, encourage long-term collagen production while skin-tightening creams containing DMAE, caffeine, and antioxidants offer temporary firming effects. For more noticeable results, minimally invasive and surgical options include liposuction with skin tightening, such as Renuvion or BodyTite, which removes mild excess fat while using radiofrequency or plasma energy to contract the skin. If there is significant laxity, a brachioplasty (arm lift) is the most definitive solution, though it does require a scar along the inner arm. In addition to these treatments, lifestyle and nutrition play a key role. Staying hydrated prevents the skin from appearing looser while increasing collagen intake through bone broth, collagen peptides, and vitamin C-rich foods can support skin health. Continuing strength training, especially on the triceps and biceps, helps create a more toned appearance. For the best results, a combination of treatments—such as RF microneedling with collagen-boosting injections—can be highly effective. A consultation with an experienced board-certified plastic surgeon will help determine the best approach tailored to your skin. Since a brachioplasty or arm lift surgery is a difficult 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. (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.)