Background. Isolated arm liposuction may be insufficient to achieve good aesthetic results due to skin laxity. Radiofrequency-assisted liposuction (RFAL) and aggressive superficial liposuction (SL) are used to stimulate soft tissue tightening to improve results. We compared these methods and described a classification scheme taking into account skin laxity, skin quality, and Fitzpatrick type to develop and provide treatment recommendations.
Methods. Ten patients underwent RFAL on one arm and SL on the contralateral arm. All patients had Fitzpatrick skin type III, IV, or V, and the average body mass index (BMI) was 27.0. Key points on the skin of the arms were marked with a fluorescent tattoo and used for pre- and postoperative measurements to determine changes in surface area.
Results. There were no complications in the group and all patients reported satisfactory aesthetic results. All patients showed a reduction in skin surface area after surgery. At one year, the anterior arm surface area decreased by 18.0% after RFAL and by 10.2% after SL, and the posterior arm surface area decreased by 16.1% after RFAL and by 8.1% after SL. The mean linear reduction in the anteroposterior direction one year after surgery was 25.8% for RFAL and 16.9% for SL.
Conclusion. Both RFAL and AL on the arms demonstrated quantitative and sustainable skin surface area reduction. Good contour and soft tissue reduction were achieved with both techniques, but RFAL with its safety characteristics represents an alternative to SL, which has a higher complication rate, risk of contour distortion, and a steeper learning curve.

Keywords: clinical results, surface area changes, Fitzpatrick skin type, skin laxity classification, soft tissue tightening, aesthetic result, aggressive superficial liposuction (SL), radiofrequency-assisted liposuction (RFAL), skin laxity, arm liposuction, comparative study, effectiveness, complications