This is a 40-year-old woman who had bariatric surgery and lost over 125 pounds. As is typical with massive weight loss, she had excess loose skin that had lost its elasticity and recoil and caused hanging loose skin folds. To address the upper arm and “batwing” appearance, we performed a traditional brachioplasty, excising all of the excess skin of the arms and used liposuction to smooth the contours with the adjacent shoulder and elbow areas. She couldn’t be happier with the results and is so much more comfortable with her body now