Will an extended tummy tuck, 360 lipo and J-Plasma help with back rolls and loose skin on back? (photo)

Question

I am 25 209lbs I’ve recently lost 35lbs and I have surgery scheduled in 40 days for an extended tummy tuck and 360 liposuction with j plasma. I have quite big back rolls all down my back and Im worried about loose skin once I get the liposuction. I was wondering if when I get my extended tummy tuck as the incision will run all the way round me, would it help with the loose skin on my back. As in pull it down ?

Warren Schutte, MD · Answer

Your extended abdominoplasty with lipo will not entirely fix excess skin and fatty tissue on your back. In my clinic, I typically do anterior (front) surgical work first, allow the patient to heal and then proceed with stage II on the posterior portion of the body (back). A bra-strap backlift with lipo is a very powerful technique to excise excess skin and lipo excess fat.

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding whether an extended tummy tuck, 360 liposuction, and J-Plasma will help with back rolls and loose skin. I appreciate your history and pictures. Based on your description, you have excess skin (cutis pleonasmus), loose skin (dermatochalasis), and excess fat (lipodystrophy) on your back, along with multiple back skin rolls and fat pockets.

If you proceed with back liposuction alone, it will remove the fat, but it will not address the skin laxity. In fact, liposuction may make the back rolls appear worse by deflating the fat but leaving the excess skin behind. Even advanced liposuction techniques such as VASER or radio frequency-assisted liposuction (like J-Plasma) will not adequately tighten this degree of loose skin.

The best surgical approach for treating back rolls and loose skin is either a horizontal torsoplasty or a vertical torsoplasty. A horizontal torsoplasty, also known as a bra strap plasty, involves an incision across the upper back, allowing for the removal of a large, butterfly-shaped area of skin and fat. This results in a smoother, flatter back. A vertical torsoplasty involves an incision from the armpit down the sides, removing an elliptical section of skin and fat. This technique hides the scar along the torso’s natural contour, but it may not provide as dramatic of a result as the horizontal torsoplasty.

Unfortunately, an extended tummy tuck or even a 360 circumferential lower body lift will not remove back skin or back rolls. The extended tummy tuck extends to the hips but does not address the back. The 360 body lift lifts the buttocks and outer thighs but does not pull down the back skin.

If your goal is to eliminate significant back rolls, I recommend discussing a horizontal torsoplasty (bra strap plasty) as part of your surgical plan. This procedure can be done simultaneously with an extended tummy tuck or a 360 circumferential lower body lift for the most comprehensive contouring.

I hope this helps answer your question, and I wish you the best in achieving your desired results.

Sincerely,
Dr. Katzen, MD

Daniel Barrett, MD · Answer

Dear desiyaht,

it is hard to tell for sure without an examination. GEnerally speaking, tummy tuck will address loose skin on the abdomen and sides but it won't affect loose skin on the back. In order to do so, you will need back lift. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Leila Kasrai, MD, FRCSC · Answer

There may be some improvement in the loose skin, but it would be limited to lower down on your back. It would be best to discuss your goals with your surgeon to avoid disappointment.

Wayne I. Yamahata, MD · Answer

No, your planned procedure will not significantly reduce the loose skin in your upper back. To improve this would require an upper back lift.

Gary M. Horndeski, MD · Answer

No, this will not be effective. You will need a back lift. This is usually done after the patient has undergone a breast lift. Unfortunately, you have not provided frontal views. However, the breast lift technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. J-plasma and liposuction will not solve your problem on your back.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Oliver Chang, MD · Answer

Hi desiyaht, just based off your photos (very limited) I see there is a need for some type of skin procedure for your back because you wish to have most of those back rolls go away. The extended tummy tuck will on address the front abdominal area (+/- your sides / flanks) and even if continued into the back (as a circumferential belt lift) - will not address the upper back rolls as shown in your photo. In my experience, aggressive liposuction plus J plasma would likely help with reduce your back issue but not remove any of the so called 'back rolls'. One way of tackling this might be to do the liposuction with J plasma, allow yourself to heal, enroll in a trainer program to be on a strict diet with aggressive exercises / weight lifting - to see how much you can shrink the rolls yourself after surgery - then a smaller back lift to complete the remaining loose skin. Unfortunately this is a tough situation for weight loss patients, losing the weight to become healthier in exchange for skin that doesn't want to tighten up without intervention. Hope this helps and consult with your surgeon all of your options. Good luck.

Connie Hiers, MD, FACS · Answer

No, the extended tuck will not change the back bra rolls. A back tuck can help excess skin in the flanks. A back tuck can be done for excess skin in the bar roll areas, but I would do liposuction with Renuvion first. You may not need or want such a back tuck later.

Camille Cash, MD · Answer

From the photo it would not be likely that the extended tummy tuck would be enough to address the skin laxity and rolls on the back.  You will likely need a back lift in the future to address that.  If you are intending to lose more weight I encourage you to complete that journey so that your surgeon will have the opportunity to maximize your results.

Jose Leon, MD · Answer

Hello, thank you for your question and the pics. Indeed,  plasma will help a lot with your rolls, the problem you should bear in mind is that there is no way to predict how much contraction will be achieved. but it's worth the try, maybe they won't be perfect but the outcome will be much better than without. But if you are 5'2" and 209 pounds, I suggest you loose 30 to 40 pounds, or you will end up with one or more blood transfusions, the amount of blood loss in this procedure while so high in weight is quite critical, my patients BMI is usually within 30 tops, and I haven't needed to give a blood transfusion to a patient in a really long time, just something to think about, good luck with your procedure

Will an extended tummy tuck, 360 lipo and J-Plasma help with back rolls and loose skin on back? (photo)

Answers (10)

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