I had upper arm reduction three times with liposuction. The skin on my arms is very saggy to the point that my arms actually look deformed. What can I do to correct this?

From the brief history provided, it appears that skin contraction did not respond favorably following liposuction. The best and probably the only way to correct the non contractile skin would be a brachioplasty or arm lift, more likely, a full lift that would involve an incision on the inner aspect of the arm with removal of excess skin and fat and restore the arms to a more acceptable appearance.

With advancing age, and sometimes following major weight loss, or multiple previous surgeries the upper arms can become 'flabby', with excess skin that sags when the arm is held upright. Many patients I see with this problem will wear only long-sleeved shirts and dresses. In some patients the problem is primarily excess skin, in others it is mainly excess fat, and many it is a combination of both.

Brachioplasty is designed to remove excess upper arm skin (and some cases, fat as well) and requires an incision that runs from the underarm area to the elbow. The scar is placed in the inner aspect of the upper arm, facing the side of the chest, to help conceal its presence. This is a great operation for fair-skinned patients who are generally in their fifties or older, as the skin is often fairly thin, and results in a scar which is faint and minimally visible. In younger patients, this fairly long scar tends to widen, become pigmented, and even thicken - which means that younger patients must seriously consider if the scar is an acceptable trade-off for the improvement in upper arm contour.

In some cases, when the skin excess exists primarily in the upper half of the upper arm, the skin excision can be performed in the underarm area only, avoiding the scar along the inner aspect of the upper arm. Underarm incision brachioplasty can often be combined with liposuction to produce a very favorable upper arm contour. This can be a good option for some younger patients and for those with more deeply pigmented skin. In some patients with an 'in between' amount of skin laxity, the underarm incision may be combined with an incision that extends only halfway down the arm, thereby avoiding the 'armpit to elbow' scar