Back Lift: What You Need to Know

Pros

• The surgery has high patient satisfaction, earning a 93% Worth It Rating from RealSelf members who have had it. In addition to creating a slimmer, more defined back contour, the procedure can increase self-esteem and quality of life. 
• It can address loose skin after fat reduction procedures and is the best available solution for anyone who has both excess fat and excess tissue, or sagging skin alone. (Body contouring procedures like CoolSculpting and liposuction only remove fat, which can create more sagging skin.) 
• Results are considered permanent (although it's possible for new sagging to develop over time, due to aging or weight gain). 

Cons

• Back lift surgery leaves significant scars, though they can usually be hidden under clothing. 
• As with any major surgery, there’s considerable downtime as well as risks of infection, bleeding, and other complications (more on that below). 
• The procedure requires general anesthesia, which adds to the risks and cost.  
• Though a back lift can produce dramatic results, the procedure is underutilized by many plastic surgeons today, primarily due to a lack of experience, notes Dr. Paul Vitenas, a plastic surgeon in Houston.

• Average Cost:
• $7,250

• Range:
• $4,000 - $14,500

How much you’ll pay will depend on your surgeon’s level of experience and where your surgery is performed.

Combining this procedure with other body lift surgeries, like an arm lift, thigh lift, or breast lift, will add to your overall cost, though you can save on anesthesia and facility fees (and minimize recovery time) by having multiple procedures done at once. 

This procedure is considered elective aesthetic plastic surgery, so it’s typically not covered by health insurance. Most practices offer payment plans or accept financing to make it more affordable.

You can finance your treatment with CareCredit.

People who been left with sagging skin after significant weight loss (often following bariatric surgery) or have fat rolls, bulges, and loose skin on their back can be good candidates for back lift surgery. 

Though it's a cosmetic procedure, back lift surgery is a major procedure with significant recovery time, so patients need to be in generally good health with a BMI (body mass index) under 30. 

If you smoke, you'll need to stop using all nicotine products for the month prior to your surgery and throughout your recovery, to help your body heal and avoid complications. 

Consult with a board-certified plastic surgeon to find out if you're a good candidate.

There are a few different techniques for a back lift procedure. To lift the upper back, you have two options: a bra-line back lift, which leaves a horizontal scar along the bra line area, or a vertical back lift (or vertical torsoplasty), which leaves more discreet, vertical scars on either side of the torso. 

A vertical torsoplasty can take four to five hours, while a bra-line back lift procedure is slightly shorter, lasting two to three hours.

“Usually, it's a trade-off between the better lift with a more visible scar versus not as good a lift and a more hidden scar,” says Beverly Hills, California, plastic surgeon Dr. J. Timothy Katzen.

Bra-line back lift surgery can improve the appearance of back rolls as well as the overall shape and contour of the upper back, mid-back, and waist. In this popular technique, the surgeon cuts a butterfly-shaped area of excess skin from the upper back, removing both fat and skin. 

Depending on your anatomy, the incision will often extend around and under the breasts, to tighten up the lateral breast line, explains Dr. Herluf Lund, a plastic surgeon in Chesterfield, Missouri. The scar, which runs horizontally along the bra line, is harder to hide, but it may not be visible underneath a bra or bathing suit top.

A vertical back lift, also known as a vertical stealth back lift or vertical torsoplasty, involves vertical incisions from the armpits to the top of the hip bones and removal of an ellipse of excess side torso skin and fat. Skin can also be pulled from the upper abdomen, if you want an hourglass shape.

Once the incisions have healed and the scars have faded, they aren’t too noticeable when your arms are at your sides. "In addition, you could wear dresses with a low back without visible scars," says Dr. Katzen. If the incisions are planned appropriately, another benefit is that you get a slight breast lift. 

The trade-offs: the body contouring results from a vertical lift aren't as dramatic as what you'd get with a bra line lift, plus there are two vertical scars instead of one horizontal scar.

Lower back lift surgery is typically combined with a tummy tuck (abdominoplasty) and butt lift, to improve the contour, size, and shape of the buttocks, as part of a lower body lift. “In my practice, we do lower back lifts more often than upper back,” says Dr. Ellen Janetzke, a plastic surgeon in Bloomfield Hills, Michigan. “A combination of both is very common after massive weight loss.” 

Your surgeon makes an incision low along your waistline—low enough that it won’t be visible when you're wearing underwear or a bikini—and removes excess skin and fat to give you a smooth contour before closing the incision. 

Immediately after your surgery, you'll be taken to a recovery room where your vitals will be monitored as you wake up from the anesthesia. 

You'll be groggy, so make sure you have a responsible adult there to make sure you get home safely and have everything you need for your initial recovery.

When you wake up, you'll be wearing a compression garment, to help reduce swelling, bruising, and scarring. Typically, patients are advised to wear compression garments 24/7 for the first 1–3 weeks. It's okay to take the garment off to bathe or wash it, but the more you wear compression during your initial recovery, the more effective it will be in facilitating the healing process.

You can expect to need to take at least two weeks off work after a lower back left, especially if your surgery was combined with a tummy tuck. You may have surgical drains in place for more than 10 days, to reduce the possibility of fluid build-up. 

For an upper back lift alone, “most patients return to work—with restrictions—after 7 to 10 days, but the total recovery time after an upper back lift is six weeks for most patients,” says New York City-based plastic surgeon Dr. Matthew Delmauro.

In the first few days after surgery, bruising, swelling, numbness around the surgical site, and moderate pain are common. Your doctor can prescribe pain medication to help keep you comfortable, and the discomfort may be mild enough after a few days that you can switch to over-the-counter medication.

You'll have surgical dressings over your incisions, to help keep them clean and prevent separation (which can increase your risk of infection and make scars more noticeable). Your surgeon will provide detailed aftercare instructions.

As your incisions heal, your upper body movement will be limited, and you’ll need to abstain from strenuous activity and workouts. 

Most people can also resume regular activities, including exercise, after six weeks, although your surgeon will let you know when they think you’re ready. 

Within six months, all swelling should have resolved so you can see your final results.