What procedure removes back fat folds, extra skin, bra strap fat... etc.? (Photo)

Hi Cici,Congratulations on your massive weight loss. Thank you for your pictures and brief medical history.Your complaints about excess skin and fat on the back are not uncommon. Fortunately, there is a very good surgery that can treat this areas.  First of all, you are quite correct in that you have excess skin and fat of the upper back. Liposuction can remove some of the excess fat.  However, liposuction cannot remove excess skin. You will need the excess back skin surgically removed.  Liposuction alone will not successfully treat your upper back.  Based on your brief history, limited photos, and not a thorough physical examination, I would suggest a torsoplasty.  A torsoplasty removes excess skin and fat of the upper torso. There is a horizontal torsoplasty and a vertical torsoplasty.  In a horizontal torsopasty, an incision is placed across the upper back, under the bra strap line.  It is called a horizontal torsoplasty because the eventual scar is parallel with the floor.   During the markings made before surgery, a significant amount of time is spent in the placement of the incisions. This is done to optimize scar placement and have the back scar concealed postoperatively under a bra. This is the surgery that I would suggest for you.   In a vertical torsoplasty,  an incision is made on each side from the armpit down towards the upper hip.  This removes excess skin and fat in a football shaped fashion from each side. The benefit of the vertical torsoplasty is that the scar is more concealed than the horizontal torsoplasty which runs across the back.  With the vertical torsoplasty, when your arms are down by your sides, the scar is typically concealed. The horizontal and vertical torsoplasty procedures are performed under general anesthesia. The procedure takes between two and four hours depending on the amount of excess skin and fat that needs to be removed.Both the horizontal and vertical torsoplasty can be combined at the same time as a arm lift.I hope this answers your question regarding upper back lift treatment options. If you have any questions, please not hesitate to contact my office at (310) 859-7770. Sincerely, Dr. Katzen

I would suggest that a combination treatment - of mid and upper back liposuction, together with the skin resection known as a bra-line lift ("upper body lift") would help the shape of your trunk area.  The scars for this surgery are horizontal across the mid-back, and are typically hidden by the fabric of your bra.

Hello Cici,Your condition is very common actually after weight loss. I recommend an Upper Back tuck. The scar would be placed exactly on the bra line. This would remove all extra skin on the upper back and lift the drooping skin creases. Additional procedures would be required on the arms and waistline. 

Thanks for your great question Cici. I like to look at the root cause of a patient's problem. In the pictures you provided, it looks like there are three issues. One is the excess fat, next the excess skin, and finally tight, tethered skin folds on the flanks. Unless each of these is addressed you will not have as good a result as possible. The bottom line is that to effectively treat these you will need an excisional procedure which will leave you with conspicuous scars. However, the ultimate shape should be worth the trade-off. Liposuction as an adjunct will help too. I can't really see your arms in the photos so I'm not sure if they should be included as well. Good luck and I trust you will achieve the results your looking for.BRK

Thanks for the question Cici.  I tell my patients that the only way to reliably tighten loose skin is to take a piece out.  So we are trading a scar to tighten the skin.  In this area we typically try to place the scar under the bra: a "bra line back lift" .  For patients that have loose skin in the back and are willing to accept the scar, this can be a good procedure.  If you can grab skin, pull it up manually and the problem is corrected ( a "lift test" then this can work well.  It is important to see a board certified plastic surgeon who peforms these types of procedures to get an opinion.  If the problem is not loose skin but only fat, then procedures such as cool sculpting or liposuction can be helpful.