Large arms look appropriate on men but not women.
A few men who have a large weight loss may have excess skin hanging from the underside of the upper arms which call for a lift.
In most cases, if arms are big but not hanging loose, liposuction works very well. We have removed up to one quart of fat from a single arm. However, the average arm that needs reduction may have a pint or less removed to make it look good. Since the development of liposuction far fewer people have needed surgical lifts of the arms. With the addition of internal ultrasound during the liposuction, the loose skin can shrink a surprising amount. One way to tell if the skin will shrink is to look for stretch marks. Those who don’t have stretch marks have thicker, more elastic skin which will shrink very well. Those who don’t shrink well will have loose hanging skin which needs excision if the owners cannot stand them. Younger people have more elastic skin and do better after surgery.
People who have very loose skin with stretch marks need excision of the excess skin. There are various patterns for the incision. The ones that are easiest to hide end up as a line on the inside of the arm from the elbow to the armpit. Often there is a “T” incision in the armpit because horizontal excess skin is cut off in the armpit. Other surgeons use a “J” shaped incision with the curve of the “J” in the armpit. Nobody, including the surgeon, likes scars, but they are sometimes preferable to walking around with “bat wings”. Sometimes a compromise is made between having a long scar along the inside of the arm and a short scar only in the armpit with incomplete tightening of the skin under the arm.
As in all surgeries there is a small risk of infection, bleeding, or numbness. The risk of surgery is similar to the risk of having an accident when driving a car. If you are interested in reducing arm size be sure to talk to a surgeon certified by the American Board of Plastic Surgery who has gone through years of formal training in surgery.