Arm lift or arm liposuction? Advise please (Photo)

When liposuction is performed (or someone has significant weight loss) it creates deflation of the skin. If the elasticity of the skin is good or the amount of fat being removed is small then the skin can contract adequately so an arm lift isn’t necessary. In contrast, if skin elasticity is poor or significant volume is being removed then the skin will tend to hang or develop wrinkles and an arm lift may be a better procedure to achieve your goals. In the video below I perform liposuction on a patient before I perform the brachioplasty so you can see what happens to the skin and why an arm lift might be desirable.
 

Thank you for reaching out with your question about choosing between an arm lift and arm liposuction, and for providing your history and photos. Your decision is an important one, and it's great that you are seeking detailed information to make an informed choice.
Excess Skin and Fat: Based on the photos and your description of excess skin and fat extending from the armpit to the elbow, and the presence of stretch marks, it sounds like you are experiencing conditions that liposuction alone may not fully address.
Stretch Marks and Skin Elasticity: Skin with stretch marks often lacks the necessary elasticity to respond effectively to liposuction. This is because stretch marks are essentially scars in the skin where the elastic fibers have been damaged, reducing the skin's ability to contract.
Area Around the Elbow: The presence of excess fat around the elbow can be particularly challenging, as this area may not contract well even with advanced liposuction techniques.
Arm Lift (Brachioplasty) Recommendation: A formal arm lift, or brachioplasty, which combines arm liposuction with the removal of excess skin, is likely to offer the best result in your case. This procedure involves an incision from the armpit to the elbow, allowing for the removal of excess skin and fat and resulting in a more contoured arm.
Concerns About Scarring: It's understandable to have concerns about the scars from an arm lift. However, considering your specific anatomical factors and the presence of stretch marks, an arm lift may be the most effective way to achieve significant improvements.
Liposuction Alone: While you can opt for arm liposuction, the outcome may not be as satisfying, given the likelihood of residual loose skin. Even with advanced techniques like VASER or J-Plasma, which are designed to tighten the skin to some degree, the amount of excess skin you have might be too significant for these methods alone to suffice.
Weighing Options: It's a matter of weighing the benefits of significant contouring improvement (with a brachioplasty) against the presence of scars, versus potentially suboptimal results from liposuction alone with less scarring.
Consulting with a board-certified plastic surgeon can provide further clarity. They can offer a more precise recommendation after a physical examination and a detailed discussion of your goals and concerns.
I hope this information helps you in making the best decision for your needs and goals. Wishing you the best as you consider your options.
Good luck, and take care.
Sincerely,
Dr. Katzen

It must always be considered that liposuction is only for removing fat. When there is excess skin, only an arm lift can remove the excess skin. If only liposuction is performed on the arm, fat would be removed, but excess skin would still be present. It would be a matter of whether you prefer a scar or excess skin, because liposuction won't tighten up the skin.
My best wishes, I hope it is helpful.