Bra line/Back Lift or aggressive lipo? (Photo)

Thanks for the question.

I would definitely proceed with liposuction first before doing any incisions.  I have had patients with worst bra line rolls get major improvement with using the smart liposuction.  The skin in the back is different than other places in the body, (1) its usually thicker than most other skin,  (2) usually there are no stretch marks in that area, and (3) ethnic skin is usually thicker and has greater recoil.
So for the 3 reasons above I would go with the liposuction and allow 6-8 months time for the healing process and then see if you want to put scar on your back which is not easy to conceal like the tummy tuck scar.
The improvement might be enough to make you happy!!
I hope this is helpful and you should see your plastic surgeon so he can examine and determine if you are a good candidate.  

Thank you for your question and for sharing your history and photos. Based on your picture, I strongly recommend considering a bra line lift, also known as a back lift or horizontal torsoplasty.

Despite the potential benefits of aggressive liposuction, you might still be left with loose skin rolls on your back, even using advanced techniques like Vaser. A bra line lift can address this issue more effectively.
This procedure is typically performed under general anesthesia. During the operation, an incision is made across your back, hidden beneath your bra strap. Then, a large butterfly-shaped area of excess skin and fat is removed, leading to a smoother, flatter back contour.
However, it's important to consult with an experienced, board-certified plastic surgeon to discuss the potential risks and benefits and to ensure the bra line lift is the best choice for your specific situation.
Thank you for your inquiry regarding a bra line backlift.
Sincerely,
Dr. Katzen

From your photo you will have improvement with liposuction to the back. JPlasma can be added for extra skin tightening. An in person evaluation is best, along with discussion of your goals, to give you a recommendation. See a board certified plastic surgeon to learn more.