Do I need a back lift or can I do liposuction with J plasma/skin tightening ? (Photo)

Question

I have had liposuction twice in my back Trying to avoid back lift scars

J. Timothy Katzen, MD, FACS · Answer

Hi Celebrated912686, Thank you for your question regarding whether you need a back lift or if you can do liposuction with J plasma/skin tightening.  Thank you for your history and your pictures.  First, we should analyze your pictures to determine the best procedures.  From your pictures, you have cutis pleonasmus (excess skin) and dermatocholosis (loose skin) without stretch marks (stria) throughout your entire back.  You have two significant rolls of excess skin and fat on each side below your bra strap.  Unfortunately, your back rolls are too significant for just liposuction with J-Plasma or skin tightening.  You need a back lift to remove excess skin on your back.  There are many names for a back lift, including: back lift, bra strap lift, bra plasty, bra straplasty, upper body lift, upper back lift, vertical torsoplasty, and horizontal torsoplasty.
Most experienced, board-certified plastic surgeons would suggest a horizontal back lift in your case.  The back lift is also called a horizontal torsoplasty. or bra strap plasty.  During the horizontal torsoplasty, an incision is made under the bra strap line and extends to the center of your back.  Tissue dissection is carried down your back, and a large butterfly area of upper and middle back skin and fat is removed.  Then the middle and lower back are pulled to this horizontal line under the bra strap.  Thus, the middle and lower back rolls are eliminated.  If you cannot deal with an incision across your back, you may consider a vertical torosplasty.  During a vertical toroplasty, an incision is made from the axillae down the side of the chest.  A large elliptical area of skin and fat is removed from the sides of the upper, middle, and lower back.  Your back rolls are eliminated by pulling them to the sides.  The benefit of the horizontal back lift is that the most back skin and fat is removed compared to all other techniques.  The disadvantage of the horizontal toroplasty is the scar. The benefit of the vertical back lift is that the scar is somewhat concealed when your arm is by your side.    The disadvantage of the vertical toroplasty is that not as much back skin and fat are removed compared to the horizontal toroplasty.  Basically,  liposuction with J plasma/skin tightening will not significantly help because you have too much back skin and fat.  If you can handle the scar, go with the horizontal toroplasty.  If you cannot handle to upper back scar, proceed with the vertical toroplasty.  
I hope that I have answered your question regarding whether you need a back lift or can you do liposuction with J plasma/skin tightening.  To get an accurate assessment of what exactly you need, schedule a free virtual consultation.  Most plastic surgeons offer free virtual consultations.  If you have any more questions regarding the back lift, bra strap lift, bra plasty, bra straplasty, upper body lift, upper back lift, vertical torsoplasty, or horizontal torsoplasty, please get in touch with an experienced plastic surgeon. Since the back lift is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience performing the torsoplasty. Do your research.  Make sure they have performed at least 50 toroplasties and have the before-and-after pictures to prove it.  Carefully examine their before-and-after pictures and check their reviews on RealSelf.   If you cannot find an experienced, upper-body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen, MD, MBA, FACS, FICS, FASMBS (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.)

Thomas Trevisani, MD · Answer

In person exam is essential . Based on limited photo- it appears that you present with excess skin - that can be removed surgically. Liposuction alone will not address excess skin. I suggest that you consult with an experienced Board Certified PS

Oliver Chang, MD · Answer

Based off your photos - you have a lot of skin laxity on the back both sides - also likely contributed by the multiple times of liposuction (lipo tends to make skin looser, not tighter esp in the back). Back lifting will give you improvement - which in exchange for a long scar across the back where you wear your bra. Recommend to tone your back a lot - back exercises, lifting, pilates - and to lose weight build more lean muscle - that's the only other way to tone up the skin a little more but your best bet is to cut skin to tighten. If you are ready for the scar, you are ready for the procedure. Seek out a few consultations and proceed with the surgeon that fits you.

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