Full back lipo or back lift? (Photos)

I want to completely get rid of all my back fat and rolls and have it flat. I am 21 years old. What are my options?

Doctor Answers 15

Lipo or Back Lift?

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Your photo suggests that you may have had a significant weight loss which is great for your overall health, but it can leave you with these unpleasant skin rolls. Many patients mistake this for a problem of fat excess when in reality it is really an issue of excess skin. Liposuction of any type (laser, vaser, water, standard) is primarily directed at thinning the fat layer. Some techniques may provide a bit more skin retraction than others, but none of them are going to work miracles, particularly if this problem is a result of weight loss.  In fact, significant thinning of the fat layer will only result in worsening of the skin rolls. Also there are no invasive or non-invasive skin tightening procedures which will tighten the skin enough to give you a flat back.

The alternative would be so do some type of "back lift", and the procedure that would likely give you the best outcome, with the least objectionable scar, would be a bra line skin excision which is designed to hide the scar within your bra line. Still, it is not a trivial scar and some patients would find it unacceptable. Others are willing to accept the scar in exchange for the significant improvement that can be achieved. You should look for someone who has experience doing this type of procedure.

Back liposuction

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I have found liposuction with SafeLipo technique to be very effective for back liposuction.  The procedure can dramatically change the fat rolls and allow the skin to shrink.  The key is constant compression garments for weeks after.  You can not allow the area to become swollen post treatment or the skin will not retract fully.  Good luck. 

Back Rolls

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It is very difficult to assess you through photos alone. Some people who have your appearance do very well with aggressive liposuction, others don't do as well and have residual, albeit smaller rolls. Regardless, you are not burning any bridges by doing liposuction first, and there is no evidence that expensive high tech machines do a better or more consistent job than standard liposuction.  Go visit a few ABPS certified/ASAPS member surgeons. Best of luck!

Excess fat and rolls of the back

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You have excess fat and skin rolls on your whole trunk.  Your first option would be to lose weight, exercise and change your dietary habits.  At a young age of 21 if that is not changed it really does not matter what surgical procedure is done you will re-accumulate all the fat within a short time after surgery. 

Back fat and rolls

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Thank you for your photos. You currently have both excess skin and excess fat on your back. Liposuction alone can remove a significant amount of fat and dramatically improve your contour. The stretched skin on the back tends to "snap-back" better than other skin because of the thicker dermis and higher elasticity associated with the skin. You may be able to have enough improvement with liposuction alone. If liposuction is not enough, you can always have a secondary procedure to excise the extra skin through an incision along your bra-line. This will leave a scar on your back which can be hidden by your bra. It is best to have an in-office examination to determine the best treatment plan given your concerns and preferences. Hope this helps! 

Johnson C. Lee, MD Plastic Surgery


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Thank you for your pictures. I think you can benefit from back liposuction and back lift due to your loose skin,in person consultation would better evaluate you, consult with a board certified PS, best of luck!

Liposuction, Laser Liposuction (Smartlipo) is a good option, may need >1 session

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I would advise laser-assisted liposuction, also termed Smartlipo as this can be used to target the fat and also tighten the skin, especially in the areas of the multiple folds of the lateral and posterior back.

In my 28 years of experience in plastic surgery and 6 year experience with laser-assisted lipoplasty, I have found that if I combine skin tightening laser settings, as well as the settings to target destruction of the fat cells, I can get good results, especially in the back where the dermis is thick and can retract postoperatively.  

You have significant back rolls, that are multiple and vertically stacked so I will be very honest and tell you that you may need a 2nd session in which the laser can be used to just tighten the skin further after you wait ~ 6 months from the Smartlipo procedure.  This 2nd session can be done with a minimally invasive technique that would require going inside and under the dermis, using the previous Smartlipo incision sites and avoiding additional new scars.  However, I am excited to tell you, I can also offer you SculpSure, which is a noninvasive laser procedure that can be used to treat the skin rolls in 25 minutes with no downtime.  I have used ScupSure on post op liposuction patients and seen very good results with additional skin tightening and textural changes.  

SculpSure is not FDA approved for skin tightening, but many physicians using the device, including me, are seeing some skin tightening with SculpSure.  It would be an "off label" use of SculpSure if we discussed using it for "skin tightening".  It is FDA cleared for fat reduction.  

Using SculpSure alone for your back rolls from the get go would not be recommended, just so you understand.  There is too much for the noninvasive technique to conquer, but after a Smartlipo procedure, it may be used as adjunct.

Many surgeons do not use Smartlipo laser-assisted liposuction, but may have other techniques that you may consider, but this is what works best in my hands and has been proven in my patient population over time.

It would be worth considering these options, that are much less deforming and leave a more natural results with minimal scars, in my opinion.

I personally do not do body lifts or back lifts, as I do not want to deal with unsightly scars in my patients and I have laser devices that can be used in the OR or non invasively that can offer options that obviate the need for large, permanent unsightly, and sometimes even terribly painful raised scars.  

You will never have the back of a person who never had skin stretch, but there can be significant improvements that you may enjoy, if you are realistic in your expectations.

I wish you the best.

Back Lipo vs back lift

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Thanks for your question and sending photos. Based on what I'm seeing Lipo alone will not give you a "flat back." You will need a skin tightening procedure as well for the treatment of your skin laxity. Seek experienced Board Certified Plastic Surgeons. Good luck. 

Liposuction or Back Lift for Back Rolls

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Thank you for your question and photos. Understand that answers on this portal are no substitute for a consultation with a board certified plastic surgeon.

Liposuction addresses the fat present and can cause some improvement in the overlying skin. There is a limit to how much improvement in the tightness of the skin can be achieved regardless of the type of liposuction performed.

Deflated skin which does not retract can make the appearance of the rolls worse.

A bra line back lift is a very nice contouring operation but the trade is a scar across the back. This will fall in a bra and bathing suit line but will be visible when out of clothing. From the wording of your post my sense is the bra line back lift is the best option for you.

Another option is to perform the liposuction and evaluate the results over the following 6 months to 1 year. There will be a significant reduction in fullness of the area and at age 21 you may have somewhat more skin retraction than an older woman. However, I would only move forward with this if you have accepted the idea of a bra line scar. I say this because the skin will not retract as much as you would like and you would then most likely need to perform the back lift to address the lax skin.

Seek out a board certified plastic surgeon to evaluate you and discuss these options in more detail.

Good luck and I hope this was helpful


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The best procedures for your anatomy would include a posterior belt lipectomy to remove the excess skin and fatty tissue from the back of your waistline and a bra strap roll excision for the excess skin and fatty tissue of the upper back.  

Hope this helps.

Dr, Ali Mosharrafa

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.