Dear N33_in Miami. Thank you for your question regarding whether you need a back lift surgery to fix prior back lipo. Thank you for your history and your pictures. Upper back excess skin is not uncommon after back lipo. It is even more common if you’ve had multiple liposuction sessions to your upper back. Now you’re left with excess upper back skin. The only way to get rid of excess upper back skin is with an excision of the upper back skin. This procedure is called a torsoplasty. There are several variations of the torsoplasty, including, the horizontal torsoplasty and the vertical torsoplasty. The horizontal torsoplasty has several other names including the bra-plasty and the bra strap-plasty. During a horizontal torsoplasty, an incision is made across the center of your back. Ideally, the incision is horizontal and hidden under your bra-strap postoperatively. During a horizontal torsoplasty, a large amount of upper back skin in the shape of a butterfly is removed. A vertical torsoplasty is different from a horizontal torsoplasty. During the vertical torsoplasty, a large elliptical area of skin and fat is removed from your sides. During the vertical torsoplasty, an incision is made from your armpit down to the hip region. A vertical torsoplasty is also called an hour-glassing procedure because it can significantly bring in your waist, especially when the incision is carried to the hip. The advantage of the horizontal torsoplasty is that a significant amount of upper back skin can be removed; more upper back skin can be removed with a horizontal torsoplasty than a vertical torsoplasty. Also, with the horizontal torsoplasty, you can hide your back lift scar under a bra strap. However, if you wear a low back dress without a bra, the horizontal scar may be visible. In that case, you may consider opting for the vertical torsoplasty where the scars are hidden by your sides. I would definitely not do the “wing cut/scar “. The "wing cut/scar" may seem easy and reasonable to perform. However, finding clothes to conceal the back scar is very difficult. If you wear a low-cut dress or even a one piece bathing suit, that "wing cut/scar" scar will be seen from the top. Therefore, most plastic surgeons do not perform the "wing cut/scar", and either perform the horizontal or vertical torsoplasty. Whether you undergo a vertical or horizontal torsoplasty, plan on a 2 to 3 week recovery. Both horizontal and vertical torsoplasties are performed under general anesthesia and are considered outpatient surgeries. Thank you for your question regarding whether you need a back lift after multiple liposuctions to your back. I hope that answers your question regarding how to fix your back after multiple liposuctions. Good luck with your back lift surgery. Sincerely Dr. J.T. Katzen.