Why do plastic surgeons say back rolls are hard to eliminate?

Question

I have read online and on RealSelf that many plastic surgeons say that eliminating back rolls (bra rolls) with liposuction is tough. I've read only a few people come out of liposuction surgery with zero back rolls while the majority of other people, of all ages, have them still (but are improved).

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding why some plastic surgeons say your back rolls are hard to eliminate. It's hard to truly give you an answer without pictures. Back rolls come from excess fat and excess skin. When the fat is removed, you'll be left with (visually) more excess skin than you started with. Some people have great skin quality and their skin snaps back after the liposuction of the back. They also maybe didn't have as much fat. Surgeons can't guarantee that they will get rid of back rolls (or any type of rolls for that matter) with strictly liposuction. However, I do believe that as far as back liposuction goes, VASER will be your friend.

Please consult with more plastic surgeons and get their opinions on your body type. Please then check their site for before and after photos.

Thank you for your question regarding back rolls and how to eliminate them. I wish you luck.

Please consult with more plastic surgeons and get their opinions on your body type. Please then check their site for before and after photos.

Thank you for your question regarding back rolls and how to eliminate them. I wish you luck.

Connie Hiers, MD, FACS · Answer

The fat in the back area can be removed with liposuction, but the thick stretched skin remains. Minimally invasive radiofrequency treatments like /Renuvion or ThermiTight can be used to help tighten the skin. Otherwise, excess skin can be removed surgically, but it leaves a long scar across the back that may stretch with bending over time.

Camille Cash, MD · Answer

When addressing back rolls it is important to determine if the undesirable look is caused by excess fat, excess skin, or both.  If there is excess skin with poor elasticity liposuction could make the area look worse.  Each case has to be evaluated individually so the proper procedure can be recommended.

Mats Hagstrom, MD (license on probation) · Answer

Whenever choosing a surgical procedure, patients and surgeons need to have a clear understanding of what the underlying problem is. Skinfold is skin laxity that due to connective tissue in certain areas causes the skin laxity to create a fold. Skin laxity is best treated by direct skin excision like loose skin on the abdomen should be treated with a tummy tuck. People are reluctant to having skin surgery on their back because the scars can be unforgiving. Fat can be removed from the back very effectively, consistently, and with excellent results. back liposuction is a high patient satisfaction, high quality procedure. It can reduce the size of the skin folds, but it doesn’t eliminate them because skin folds are due to skin laxity not excessive amounts of subcutaneous fat. 
There’s nothing difficult about treatment of the back. Fairly good improvements can be had even on individuals with moderate skin laxity, but they should not expect skin folds to go away unless they have a skin excision procedure.
It’s very important to have a clear understanding of what the underlying problem is both in regards to choosing the correct procedure, and also understanding inherit limitations to what age procedure can accomplish. People with skin laxity should not expect Liposuction to address the skin laxity issues.
I typically view the torso as a single anatomic unit, and generally treat the entire torso when doing any type of abdominal liposuction. There are exceptions, but generally speaking, my preference is to treat the entire torso. A full torso includes upper abdomen, lower, abdomen, love handles, waist, entire back and under arm areas all the way to the side of the breast. I treat the entire back on almost every single case where I do abdominal liposuction. By treating the torso as a single anatomic unit patients are left with an even consistent natural, thin fat, distribution without transition zones between treated and I treated areas anywhere along the torso. 
So far in my career, I have done over 8000 and liposuction procedures. The great majority of those have been female abdomens including the back. The back is an excellent area to treat with Liposuction but I am also very clear about explaining what the procedure can, and cannot accomplish from liposuction to each patients during my consultations. I have thousands of before and after pictures and can show accurately Based on previous patients who had similar body characteristics so patients have a very good understanding of what results will look like before they schedule surgery. 
Best,
Mats Hagstrom, MD

Why do plastic surgeons say back rolls are hard to eliminate?

Answers (4)

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