We have multiple options when it comes to performing an enhancement of the arms. Depending on the anatomical particularities of the patient and the amount of skin that is in excess, the patient can be recommended one of these procedures: – Liposuction: Recommended if the skin is elastic enough to retract on the new contours of the arms after fat removal. If the skin is of poor skin quality, the results of a liposuction on the arms would be the accentuation of sagginess. However, we can use liposuction in association with a brachioplasty to remove the adipose tissue and make the arms thinner. – Brachioplasty with a small incision: if you have sagging skin only on the interior side of the arm, close to the axilla, the surgeon will be able to pull and fold the excess skin under the arms, in the natural fold of the skin. The scar is a semi-circular one, of small dimensions and practically impossible to see if you don’t know what you are looking for. The procedure is recommended for people who have lost a moderate amount of weight and the skin on the triceps has lost elasticity. – Traditional brachioplasty: if the degree of skin ptosis is high and it stretches from under the arms towards the elbow. The incision is performed in the axilla and elbow. This procedure is the most commonly performed one to reduce skin excess. – Extended brachioplasty: Targets patients who have lost an important amount of weight either after a weight loss program or bariatric surgery. The folds of the skin are extending from the elbow towards the axilla and even on the sides of the chest. The incision is different from a traditional brachioplasty. The incision will descend from the arms towards the body to be able to excise the fat and skin tissues that are localized under the arms. Depending on the type of brachioplasty that will be performed, the surgeon will mark the incision place first. Then a general anesthesia will be performed. The next step is making the incision or performing liposuction if the thickness of the fat layer is significant. After this, we have the surgical removal of the excess skin, the redraping, and repositioning of the remaining tissues so the contour is harmonious. The incisions are sutured, and special care is taken to minimize the size of the scar. Absorbable sutures can be used.