Touch is the primary way that users interact with smartphones. However, building mobile user interfaces where touch interactions work well for all users is a difficult problem, because users have different abilities and preferences. We propose a system, Reflow, which automatically applies small, personalized UI adaptations, called refinements -- to mobile app screens to improve touch efficiency. Reflow uses a pixel-based strategy to work with existing applications, and improves touch efficiency while minimally disrupting the design intent of the original application. Our system optimizes a UI by (i) extracting its layout from its screenshot, (ii) refining its layout, and (iii) re-rendering the UI to reflect these modifications. We conducted a user study with 10 participants and a heuristic evaluation with 6 experts and found that applications optimized by Reflow led to, on average, 9% faster selection time with minimal layout disruption. The results demonstrate that Reflow's refinements useful UI adaptations to improve touch interactions.