Liposuction Below Bra Line Area?

I am considering liposuction of the infra-scapular back area, located just below the bra strap. Is this a risky procedure, as I understand it is challenging as it has more dense fibrous tissue? I have a fat roll that creases on the sides of my back around that area. What is the success rate for this type of procedure, cost estimate, recovery time/activity? Thank you.

Doctor Answers 10

Liposuction of the Bra Fat and Back

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There are many who believe that liposuction is not a difficult technique but I tend to be humble about the technique in general. There are many fine details that can make the difference between a good result and a magnificent result. In general, the bra fat on the back is enveloped by very fibrous tissue and the fat is generally tightly adherent and fibrous. I would recommend liposuction with ultrasound to shrink the skin and improve aspiration of the fat. Also, positioning is important as the position of the arms during surgery can affect surgical results and overall results.

Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Careful pre-op analysis required

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Your surgeon and you should examine your anatomy both with and without a bra, and also with your arms at different degrees of elevation to see whether skin elasticity or excessive skin is a potential issue. If you elevate the arms and there is still a roll, you might have excessive skin and require excisionrather than just liposuction. Also if the roll presents only with your arms down, it might be more of a situation of the soft tissues gathering due to the ligamentous attachments that need to be released rather than localize fat deposits. In general, it is an area that is more difficult to liposuction but also to produce excellent results because it is often secondary to dynamics effects such as soft tissue movement, position of the arms, and bra fit. Having said that, it is possible to get improvement with the right combination of surgical manuveurs.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Liposuction in the back or lateral chest areas

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Your best best is to consult with a board certified plastic surgeon on this issue. This is a very tricky anatomic area.

The area you describe contains vital nerves to give sensation to the breasts, the arm, to lifting of the arm, and to preventing winging of the scapula through nerve damage, or a pneumothorax, collapse of the lung. Surgeons certified by the American Board of Plastic Surgery have the correct training to prevent or treat these potential problems.

Cosmetic surgeons likely have zero experience with any of the nerve or chest operations, or surgery on the brachial plexus listed above in their training.

Any doctor can use tumescent technique; and most plastic surgeons performing frequent liposuction procedures are adept with it as well as with many other techniques as well.

This is a wonderful procedure, as long as it is performed safely. An artistic surgeon will balance the looseness of the skin with the fat to be removed, know how to perform the whole spectrum of procedures including those for excess skin, and achieve the best balance for the patient.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 194 reviews

Liposuction can be very beneficial in this area

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The upper back rolls can be treated with liposuction. It can be more challenging due to the fibrous nature of the fat, but certainly possible to get a very good result. See an excellent plastic surgeon in your area that will examine you and determine if you are a good candidate for liposuction. Some patients think that liposuction is the answer and realize that a surgical excision is actually better given the amount of excess skin. It really varies from individual to individual, and only a good plastic surgeon can give you the correct options.

In terms of local versus general, i do not think that there is any difference in outcome. It is mainly a matter of preference for you and for your surgeon.

In terms of which liposuction to use, that too is patient and surgeon specific. I prefer ultrasonic liposuction since the fat can be emulsified (softened) and more easily removed. In addition, the skin will have some contraction (tightening). Laser liposuction has similar advantages, but the safety is not well-established.

Down time for liposuction to this area will likely be 7-10 days. Cost varies widely depending on your location and your surgeon. Good luck.

Sirish Maddali, MD
Portland Plastic Surgeon

Liposuction of this area is not hard.

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In our experience in New York, liposuction of this area of the back is usually very successful, and the fibrous tissue does not present a problem. How it's done is important. We recommend performing the liposuction up and down rather than side to side, in order to flatten the rolls. Also, you have to be in just the right plane.

The recovery is quite easy: patients go back to work in 4 days and exercise in 10 days. Fees vary too widely to give you a useful idea. Also it is unusual for a patient to have just this one area treated, so there is typically a combination fee.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Liposuction Removes Below-Bra Fat

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Tumescent liposuction is a surgical procedure that takes a great deal of skill and expertise to perform well. The fat under the bra area does tend to be more fibrous and may require additional methods such as ThermiTight to get an optimal result. Non-invasive techniques such as Thermage, which uses radiofrequency energy or Ulthera which uses ultrasonic energy may also tighten the skin in this area. Vanquish or CoolSculpting are two other non-invasive ways to eliminate the fat and may actually be all you need. Recovery time varies by technique chosen but will probably be about a couple of weeks of swelling and/or soreness. Results are usually visible after three to four months. Please consult a board-certified dermatologist to find out which fat-removal method is best for you.

Mitchel P. Goldman, MD
San Diego Dermatologic Surgeon
4.9 out of 5 stars 26 reviews

Liposuction is effective for this area.

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Dear Ann,

This area is much more fibrous than the abdomen. However, it can benefit from liposuction. This area can be approched with a number of liposuction methods.  However, the safest method continues to be tumescent liposuciton perform under local anesthesia. 

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Laser lipo is an alternative for liposuction under the bra line

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You are corect that under the bra line is a difficult area to achieve good results with liposuction.

I have found that using SlimLipo laser lipo has made it easier for me to treat this area with increased fibrous tissue resistance to the lipo cannula. The other benefit of the laser lipo is the skin tightening effect of the laser.

You need to find an experienced board certified plastic surgeon who is comfortable treating this area.

Liposuction of the bra area and back

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Liposuction of the back is generally harder due to increase fibrous tissue. However the excess fat around the bra area is easily removed with liposuction. The main problem relies in the skin excess, mild to moderate skin excess could retract following liposuction. Large amounts of skin could be hard to retract and might require specific removal.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Liposuction and bra strap rolls

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 Liposuction of the rolls along the bra strap can be very effective.  Yes, it can be more fibrous but there are many techniques to treat this area.  Different cannulas, different techniques can all treat this area effectively.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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.