Skin laxity on the back is primarily a skin problem, with fat a secondary issue. This is important because if you address a skin problem with the wrong tools you actually worsen the laxity. A mild level of laxity can be addressed with liposuction plus Renuvion J Plasma. Mild meaning one soft roll where if you pinch and pull the skin, it snaps back readily. In my hands, Renuvion provides about 20 to 30 percent tightening, which can be reasonable for borderline individuals. Anything beyond that, especially when you pick the skin up and it tents instead of snapping back, should never involve liposuction. Lipo only removes the skin's sole supporting structure and allows the skin to sag over what is underneath. An upper body lift (bra line back lift) should be performed instead. A scar is left just under the bra line which will be covered with your bra strap. Loose skin is directly excised and no tightening gadget anywhere on the globe mimics cutting out loose skin. This is determined with an in-person test in which skin is pinched and pulled and not determined with one still photograph as here. #StayBeautiful, @RealDrWorldWide