70 pound weight loss - Will a vertical torsoplasty eliminate my back rolls? (Photos)

Question

I’ve lost 70 pounds naturally and at first thought this was back fat but no matter how much diet and exercise I do they won’t go away. I’m assuming I need a back lift and would prefer not to have that horizontal scar across my back. Any other additional info will be helpful.

J. Timothy Katzen, MD, FACS · Answer

Hello, Lolatheflorist. Thank you for your question regarding a 70-pound weight loss and whether a vertical torsoplasty will eliminate your back rolls.  Congratulations on your weight loss.  Thank you for your history and your pictures.  First, let’s analyze your pictures to determine the best procedures.  You have cutis pleonasmus (excess skin) and dermatocholosis (loose skin) of the back.  From the pictures, it is hard to tell if you have striae (stretch marks).  Striae indicate that your skin has been stretched.  There are two methods for removing fat from the back: vertical torsoplasty and horizontal torsoplasty.  A horizontal torsoplasty is also referred to as a braplasty, bra straplasty, upper back lift, bra lift, or upper body lift.  An hourglassing procedure is also referred to as a vertical torsoplasty.  You would benefit most from a horizontal torsoplasty, as indicated by your back pictures.  However, if you cannot handle the horizontal torsoplasty scar across your back, do not undergo the horizontal torsoplasty.   Alternatively, the second choice would be the vertical torsoplasty.   
A vertical torsoplasty involves an incision extending from the axilla down the lateral aspect of the chest along the mid-axillary line.  Tissue dissection proceeds posteriorly towards the dorsal aspect.  The lateral breast dermis and adipose tissue are drawn anteriorly.  A substantial expanse of extra lateral breast and back tissue and adipose is excised in a football-like configuration.  The vertical torsoplasty scar is located along the midaxillary line and can be concealed when the arms are positioned at your sides.  The vertical torsoplasty procedure takes place under general anesthesia and requires around 3 to 4 hours for completion.  A drain on each side is typically maintained for around 7 to 10 days. A two-week recuperation period is necessary.  To reduce scarring, swelling, and discomfort, a medical-grade compression garment is recommended for at least 6 weeks.  
Good luck.  I hope I’ve answered your question regarding a 70-pound weight loss, and whether a vertical torsoplasty eliminate your back rolls.  I hope I have answered your question regarding combining the vertical and horizontal torsoplasty versus back liposuction.  If you have any more questions regarding back liposuction, back lift, vertical torsoplasty, hour-glassing procedure, horizontal torsoplasty, bra strap plasty, or braplasty, contact an experienced plastic surgeon.  Since the torsoplasty is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience performing the vertical and horizontal torsoplasty.  Do your research.  Make sure they have performed at least 100 torsoplasty surgeries and have the before-and-after pictures to prove it.  Carefully examine their before-and-after photos and review their RealSelf profile.   If you cannot find an experienced torsoplasty plastic surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (President of  the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Gary M. Horndeski, MD · Answer

After massive weight loss of 70 lbs., you have excess skin of your back. The skin appears to be mostly vertical not horizontal. Horizontal excision will take care of the vertical skin. Vertical excision would not be helpful. Unfortunately, you have not provided any frontal views but it is possible that a breast lift would be necessary. Sometimes the breast lift will take care of some of the excess of the upper back. You would also benefit from a brachioplasty, which can deal with some the upper back problems as well.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Mehmet Ozdemir, MD · Answer

I would recommend a combination of liposuction and a back lift with a horizontal scar, as this approach provides the most effective correction for the amount of excess skin present.

70 pound weight loss - Will a vertical torsoplasty eliminate my back rolls? (Photos)

Answers (3)

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