Thank you for your question on what to do with your “man arms” or a large upper arm that are disproportionate with the rest of your body. Based on your history and your pictures. I would suggest VASER HI-DEF arm liposuction for your arm reduction procedure. VASER HI-DEF not only melts the arm fat, but also heats the arm skin and maximizes arm skin contractility. In my opinion, VASER HI-DEF arm liposuction is the best form of arm liposuction. If you want to get even better results, I would suggest a mini-arm reduction or a crescent arm reduction. During a crescent arm reduction, a crescent area upper arm skin is removed, and the upper arm again is pulled tightly. Another form of arm reduction would be modified T or mini-brachioplasty. This would be a combination of the crescent arm lift with the short incision down the upper, inner arm. Whether it's VASER arm liposuction or the crescent arm lift or modified T arm lift, I would suggest you find an experienced plastic surgeon. I perform all these arm reduction or arm lift procedures under general anesthesia. All these arm reduction procedures take approximately three to four hours to complete. If you undergo arm liposuction, plan on a 7 to 10 day recovery. If you plan on the crescent or modified T arm reduction, plan on 10 to 4 day recovery. I specialize in arm lifts. I hope that I have answered your questions regarding your arm reduction. If you have any more questions regarding arm liposuction, arm lift, arm reduction, or brachioplasty, please contact my office. 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. (“Verified” Plastic Surgeon, 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 and RealSelf Hall of Fame.)