Skin tightening of the arm can be divided into 3 categories:
1. Patients with modest skin droop can be treated with an arm lift procedure leaving a scar around the armpit.
2. Patients with moderate skin excess can be treated by a standard excision of a skin ellipse extending down the inside of the arm. This may be modified to a "fish" pattern if a lift is considered desirable.
3. In individuals with extensive skin laxity also involving the lateral chest wall, consideration is given to extending the reduction to tighten the skin on the side of the chest.
Liposuction is frequently used as an adjunct to arm reduction to reduce the fat prior to skin excision. This helps to preserve underlying fine structures.