Why have my arms drooped 9 months after arm lift surgery? (photos)

Thank you for raising the concern about your arms drooping nine months after undergoing an arm lift or brachioplasty. I have carefully reviewed your medical history and images, and here's my evaluation:
It's my professional opinion that the drooping of your arms can be attributed to a combination of genetic factors related to your skin and the natural aging process. While the arm lift surgery seems to have been performed appropriately, your age of 63 years has led to decreased collagen and elastin levels in your skin. Elastin is essential for skin resilience, especially post-surgery. Unfortunately, your arm skin hasn't regained optimal firmness.
To address this issue, a more assertive approach is recommended. This would involve a combination of aggressive arm liposuction and a revision of your arm lift procedure. Extending the incision from your armpit to your elbow would enable more effective removal of excess arm skin. It's important to note that isolated arm liposuction might worsen the condition rather than improve it. Consequently, a comprehensive approach involving the removal of excess skin and fat is advisable.
I hope this recommendation provides a path forward in addressing your arm drooping concerns. Please feel free to reach out if you need further clarification.
Best regards,
Dr. Katzen

From the photos it appears that you have healed appropriately from the surgery. You may be noticing that the tissues have less elasticity due to the natural aging process. If there is extra fat you may find improvement with liposuction. Regular exercise including weight training will help you to maintain your results.

Although the skin was likely tightened properly, your skin remains elastic and can continue to stretch following the procedure. This may result in a skin deformity similar to your preoperative exam. At this point, if you are unhappy with the look of the arm, a re-tightening of the skin with another skin removal procedure is likely necessary, although it is admittedly difficult to tell from the provided pictures.