Background: There has been a renewed interest in upper arm contouring secondary to recent advances in plastic surgery that have made it safer and more appealing to both the plastic surgeon and the patient. Objectives: the aim of the work was to describe the aesthetic outcome of different techniques used for correction of arm ptosis to try to obtain a new treatment-based algorithm for management of brachioplasty. Patients and Methods: This prospective study included a total of 40 patients with different degrees of arm ptosis, requesting arm contouring attending at Al-Hussein and Bab Al-Shairia, Al-Azhar University Hospitals. Different techniques used for brachioplasty as liposuction or skin excision by different types of skin incision according to the degree of fat deposit, redundancy and skin ptosis, or both were used in this study. Results: Patient's satisfaction within clothes was 100% in all techniques used in brachioplasty while patients' satisfaction without wearing clothes or light clothes was 84.6% in surgical resection due to the presence of complications in the form of wound dehiscence in 5 patients (19%) and hypertrophic scar in 4 patients (15.4%) and it was 100% in liposuction patients and it was 83.3 in combined method patients due to the resent of wound dehiscence with ugly scar in 1 patient (16.7%). Conclusion: Brachioplasty operation whether liposuction alone or surgical excision or combined methods is a good method to treat patients with arm obesity or post massive weight loss skin ptosis. The proper method was selected according to the degree of fat deposit, redundancy and skin ptosis.