Can a bra line back lift help to contour the waist line? And can it be done alongside and arm lift?

Question

I had a tummy tuck many years ago after losing over 100 pounds. My waist still does not have a nice contour and part of the reason seems to be because I tend to carry a lot of weight on my mid back. although my skin is relatively thick, my back has many folds and seems lax. If I pull the skin up, it seems to make my waist look nicer as well. I also carry weight on my upper arms- the lower half has lax skin while the upper part just seems thick and very slow to change despite exercising.

Marc DuPéré, MD · Answer

Thank you for your question.Pictures would be nice and would help us to give you better answers.That being said, there is no doubt that a braline lift (part of the torsoplasty procedure) would help the midback rolls. But it depends how much and how many rolls you have and where exactly they are located. Many patients require both the braline lift and the lower body lift (an extension of your tummy-tuck procedure).There is a limit to lifting many back rolls without the lower body lift. Again, pictures would help.And yes, the Braline Lift can be combined with the armlift, and also with a breast lift.Look for an experience plastic surgeon as those procedures are still not common.Let us know if this information was useful.

Best regards,

Dr. Marc DuPéré, Toronto aesthetic plastic surgeon and body
surgeon

Best regards,

Dr. Marc DuPéré, Toronto aesthetic plastic surgeon and body
surgeon

J. Timothy Katzen, MD, FACS · Answer

A bra back lift also known as a horizontal torsoplasty could help with your waist and overall figure. Another option could be to get a vertical torsoplasty also known as an hourglass procedure where the incision goes from the armpit and down the side to either where the bra strap line is or down the side of the waist (if there is excess skin of the abdomen).

I specialize in reconstructive plastic surgery after weight loss.  If you have any more questions regarding horizontal torsoplasty or bra straplasty or bra-plasty please contact my office. Since the horizontal torsoplasty or bra straplasty or bra-plasty is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience performing the lower body lift. Do your research.  Make sure they have performed many of these upper body lift surgeries 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, horizontal torsoplasty or bra straplasty or bra-plasty plastic surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, 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 and RealSelf Hall of Fame.)

Carmina Cardenas, MD · Answer

Based on my 15 years of passion for body contouring I have found out that archiving a waist depends on many factors: our bone frame as the most important, if your bone is wide on your upper body, wide around the waist and narrow around the hips a tapeted waist will be more difficult to achieve but NOT impossible. For the ones who have a small upper body and wider lower body bone structure will be much easier to achieve a smaller waist. Then the saggy skin creates like a “tent” over the waist and then the fat a great cushion on top of the waist and finally a loose muscle (because of genetics, pregnancies or past obesity) will not allow to show the real or camouflaged waist. For the former reasons will be important to treat them all: tighten the skin, remove the fat and also create an internal corset with the  muscle. So we have to figure out which is the reason you have no waist. If it is the 3 BINGO!!! We may create a nice and tapered waist. So most likely you will need all of them.Be encouraged!!! Just be sure your surgeon is an expert on After weight loss surgery and a passionate for curves. Dr. Cárdenas

Thomas P. Sterry, MD · Answer

You are absolutely correct.  The upper back lift actually pulls redundant skin that otherwise can roll up on the waistline and smoothes it out.  This allows the true waist to show through.  I tell my body lift patients this all the time and remind them that without the upper back lift, they may not get the silhouette contour they want.Good Luck!

David Stoker, MD · Answer

I frequently perform bra line back lifts in the same operation that I also perform arm lifts.  The bra line back lift primarily reduces the folds of skin under the bra and just above the waist.  It is also very helpful for lateral chest rolls.  A breast lift is another procedure that I often combine with a bra line back lift for optimal results.

Alejandro J. Quiroz, MD · Answer

To answer this questions is important to
see some pictures.  If you desire is to
have a waist  line and more of an hour glass
shape we need to determine the postures of the abdominal musculature, the amount
of fat in the excess and quality of your skin to determine what would be the
procedure to give you the desire figure.

Camille Cash, MD · Answer

Congratulations on your impressive weight loss! An in person evaluation is needed to best answer your question.  From your description it sounds as though you would benefit from both skin removal and liposuction to better define your curves.  Visit with a board certified plastic surgeon near you to learn more.  I've included a video I hope you find helpful.

Matthew A. DelMauro, MD, FACS · Answer

Hello! Thank you for your question. 
Congratulations on your weight loss. 100lbs is amazing! 
Upper back lift surgery (sometimes called a bra line back lift) may be a good option to improve the shape, contour, and overall appearance of your upper back, mid back, and waist. This surgery also helps improve the appearance of back rolls in those areas. The surgery can be combined with arm lift surgery, but whether or not it is wise to do so depends on factors beyond the scope of this Q&A. So if you decide to pursue surgery it’s very important that you find a surgeon whom you are comfortable with and trust and who evaluates you in-person and tailors an individualized treatment plan for you and your aesthetic goals. Best of luck!
Matthew A. DelMauro, M.D.

Laurence Kirwan, MD, FRCS, FACS · Answer

Upper body lifts or bra-line lifts make a significant difference to the waist line, Depending on the amount of skin in the upper arm and its extension into the chest, a brachioplasty might be performed at the same time. Often, tissue taken from the upper body lift can be used to augment the breast. Take a look at a patient who had a combined breast lift and upper body lift on my web site. Consult with a Plastic Surgeon certified by the American Board of Plastic Surgery who is also a member of the American Society for Aesthetic Plastic Surgery and is experienced with this kind of surgery.

C. Bob Basu, MD, MPH, FACS · Answer

Based on what you have written and describe, you may benefit from an upper trunk lift and back lift.  This would include treatment for the arms, sides, and bra line (back) area.  But a phyiscal exam is needed to give you any meaningful advice.  Please see a board certified PS to learn more about your options.  Best wishes,Dr. BasuHouston TX