HI Ybanks89, Thank you for you your question regarding a back lift. Thank yo for the pictures of your back. basically, there are two types of back lifts: vertical and horizontal. The vertical back lift is also called the vertical stealth back lift. In your case, the incision goes from the arm pit down the sides and extends to the top of your hip bone (superior iliac crest). An elliptical area of skin and fat is removed. Usually, the vertical stealth torsoplasty scar is hidden when your arms are by your sides. The horizontal torsoplasty is also called a bra strap torsoplasty or upper body lift. This scar goes across the upper back. In most cases, the horizontal torsoplasty gives a better back lift, but the scar is much more visible. Usually, it's a trade off between the better lift and a more visible scar vs. not as good a lift and a more hidden scar. In your case, you would get the best result with a scar that goes across your back like a bra strap torsoplasty or upper body lift. However, if you cannot live with the back scar from a bra torsoplasty, I get it. many patients cannot tolerate that scar. if that is the case, please proceed with the vertical stealth torsoplasty. Thank you for your question regarding the back lift. I hope I have answered your questions regarding the difference between the vertical and the horizontal torsoplasty. If you have any more questions regarding the backlifts or torsoplasties, please contact my office. Sincerely, Dr. Katzen.