Do I need a 360 tummy tuck to get rid of the back rolls or will lipo fix this? (Photos)

Thank you for your question and congratulations on your weight loss. The area in your upper back where you see the rolls is really most skin as opposed to fat. Therefore liposuction will not be very effective in terms of smoothing this area out.  The only way is by excising it or removing the skin surgically.  This of necessity will leave you with a long scar across the back which will be difficult to cover. So consider carefully the tradeoff: smoother contour versus scar. You may decide it isn't worth it. Liposuction of the back may make the rolls a bit smaller without significant scars.  On the plus side, from your photos it seems as though you are an excellent candidate for a tummy tuck and the result should be dramatic. Best wishes.

Thank you for sharing your question and photographs and congratulations on your impressive weight loss.  Due to the amount of skin sagging and skin excess that your weight loss has caused I think you are an excellent 360 tummy tuck candidate. It will address all of the areas that you mentioned in your narrative except for your back and flank skin.  This would require a bra-line back lift to correct.  Be sure to see an ASPS board certified plastic surgeon in consultation, they can offer you the best advice.

You look very similar to a patient I operated on last Thursday.  A complete body lift, which is an incision completely around your waist, is the best way to tighten up the loose skin of your abdomen, lower back, buttocks, and lateral thighs.  It's kind of like pulling your pants up except, in this case, it's skin.  To address the loose skin of the upper back, this would need a separate incision to remove this loose skin.  I would suggest that you schedule an appointment with a board-certified plastic surgeon who can examine you and review your options with you.