What's really the best fix for batwing arms without surgery?

This is a difficult question to answer without pictures or physical examination.if you have only a mild amount of arm fat excess, arm liposuction may work. There is no medically proven laser that has been shown to significantly reduce on fat.Due to your age and history, I believe even with arm liposuction, you would be left with excess arm skin.  The only way to remove excess arm skin is with a surgical incision. Sorry. 

It's not unusual for women to develop redundant saggy upper arm tissue with normal aging. When this situation arises, women frequently seek treatment of this condition. A variety of treatment options are available, but with the exception of brachioplasty, most of these procedures have limited value.Your history suggests that you have a relatively severe deformity, but without pictures or a physical examination, it's hard to make a specific treatment recommendation. With this said, it's safe to say that the vast majority of patients with bat wings will require brachioplasty surgery.This procedure utilizes an incision that extends from the armpit to the elbow. In some cases, it may utilize a transverse incision in the axilla, as well. It removes excess skin in multiple dimensions and dramatically improves arm contour. It's associated with excellent clinical results and high levels of patient satisfaction.This procedure involves trade-offs between excess upper arm skin and additional scarring. For this reason, it's appropriate to consult a board certified plastic surgeon with experience in this area. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Liposuction can be helpful only if you have minimal skin laxity.  This can only be determined by an in person examination.

In patients who have mild excess skin on the underarm, a laser assisted arm lift can tighten the skin without big incisions or surgical drains.SmartLipo uses a laser to heat the underside of the skin which helps form new collagen for skin tightening over time. Excess fat is also removed at the time of surgery. This decreases the effects of gravity on the hanging skin to further tighten the arm's appearance.Laser-assisted liposuction is the most aggressive form of non-surgical skin tightening clinically available. The other treatments (massage, radiofrequency) are not aggressive enough to generate an appreciable difference in my opinion. Find a board certified plastic surgeon who is experienced in laser assisted liposuction.

If your skin is not too bad, there may be subtle improvement with various radiofrequency devices to carefully heat and tighten the skin. Liposuction alone will not help loose skin but can be used selectively to sculpt and reduce if localized fat is more of a problem and not so much skin. If however, skin is very loose, then the most effective treatment is surgery with removal of excess skin/fat and tightening with incisions. Sometimes a short  incision in the armpit only is sufficient but a longer incision down the arm may be needed. Have a consultation with a plastic surgeon to discuss your options.

Hi Mimi; I perform Smart Lipo Triplex Laser system which is an unsurpassed  technology to to provide skin tightening with liposuction. There are limits to how much tightening any device can do however. Keep in mind that liposuction is an invasive procedure that requires small incisions and fat extraction which requires healing time. Other devices simply will not give enough skin tightening. It is best to evaluate this in a consultation to provide a thorough discussion of your alternatives.   

It is difficult to provide a specific recommendation without the ability to view photographs or to perform a physical examination. However judging by your description and your age the only effective treatment for you would be a brachioplasty or "arm lift". Attempts to correct this problem with liposuction or laser treatments would very likely be a waste of money.It would be helpful for you to consult a surgeon board certified by the American Board of Plastic Surgery who is experienced in all forms of body contouring. This will provide you with the opportunity to discuss realistic options for your particular situation. Good luck.

Unfortunately, surgery is the only predictably good option if you have excess skin. Liposuction alone usually leaves the now unfilled skin looser than ever and every patient I have seen that tried the various skin tightening machines was either disappointed or very angry at the money wasted.

There are a number of alternatives to surgery or cutting out the excess skin of your arms, a procedure called a brachioplasty.  These include simple in office liposuction as well as a couple of different skin tightening techniques or treatments.  Which one is best for you depends upon your condition and the only way to tell is to see a board certified surgeon to be assessed. I hope that helps.  Best regards.