Alternatives to back bra lifts with horizontal scars? (photos)

Hi "Iwantmyhourglasscurves",Thank you for your question and your pictures.I have many patients in my plastic surgery practice with your same complaint. These patients have excess back skin and fat, however,  they do not want an incision that extends across their back.  Though the horizontal back lift can lead to significant elimination of back skin and fat, there is a more visible scar associated with the horizontal torsoplasty or bra strap lift.What I offer my patients, and what I would suggest to you, would be a "vertical torsoplasty." I also call this the "hourglass procedure". The incision extends from the axilla or armpit down the sides. Sometimes the vertical torsoplasty or hourglass procedure incision extends from the armpit to the bra strap line, or lower rib cage or sometimes to the top of the hip. The skin of the back is then pulled forward, tightened, and removed. An elliptical or football shaped area of skin and fat is removed from the sides. This results in significant reduction in the back skin and fat rolls and creates more of an hourglass figure.  The benefit of the placement of this incision for the vertical torsoplasty or hourglass procedure is that when your arms are by your sides, the scar is concealed. In addition, if you wear a low back or bare back dress, the scar is not visible as it would be for a horizontal torsoplasty or bra strap incision.  Sincerely, Dr. Katze

While I completely understand your reticence for scars, ultimately, I think you would be disappointed in any liposuction or Vaser procedure alone.  You may have some adherence of loose skin to the new contour but it would be minimal at best.  These procedures will help reduce the volume of fat but will not address skin laxity to the degree that would be optimal.  A mid back lift may be something you might consider in the future if you can warm up to the scar.  In my experience this scar does heal very well and it does a great job of smoothing out the bulges on the back.  Best of luck to you.

It is really difficult to give you absolute advice without examining the quality of your skin and tissue.  Typically, liposuction of the upper back has to be done carefully since it can cause further skin laxity.  Back skin laxity is dimensional.  It can be vertical laxity in and up and down direction or horizontal.  The main operation for vertical back skin laxity is a bra-line upper body lift which you do not want.  Alternatively, in 2008, we described the J-upper body lift in teaching courses.  Since then this procedure has become well-established.  The J-upper body lift works well for mild degrees of upper back laxity.- like yourself.  To see pictures of this, please visit our extensive upper and lower body gallery.

Thanks for your question. By looking at your pictures, I think you will benefit with liposuccion (assisted by ultrasound) on back and hips and if there is an excessive amount of skin, then removing it as in a lover body lift. Most importantly is having the recommendation by a board certified Plastic Surgeon. Best wishes

If you haven't undergone laser liposuction sculpting then I would proceed with this. It will thin out the fat later and result in less fullness. The folds and shadows will be less. A backlift would then follow if your goals were not totally achieved. 

Thank you for your question and photos.  While your skin is somewhat loose, there is a significant amount of fat in the back region.  Your skin laxity is not enough to justify and upper body lift or axillary excisional treatment.  I would recommend aggressive liposuction of the back to get rid of the excess fat.  The skin will contract some and give you significant improvement without large scars.   Best wishes.

Liposuction may be a good first step in tyring to get some improvement with minimal scarring. If, however, after lipo the skin deflates more, you may then benefit most from the bra line lift scar. Be sure to see a board certified plastic surgeon for consultation.Good luck!

Unfortunately there are no shortcuts to good results. You simply have too much skin and no amount of liposuction, laser or not, is going to give you adequate tightening. The only answer to best results is remove the skin, thus the scars. If you do lipo first, as suggested, you are still going to need the skin tightened and will simply have wasted all that money on the liposuction, in my opinion ( the skin excision also takes off all the fat, not just part of it like liposuction).