Hi Thriving9355, Thank you for your question about whether you are a candidate for a back lift or liposuction. Thank you for your history and pictures. Based on your picture, you have excess back skin and back fat. Back liposuction only removes back fat; back lipo does not remove back rolls or skin. If you only have back lipo, your back skin rolls will probably get worse, not better. You need a back lift to remove back skin and fat. A back lift goes by several names, including back reduction, upper body lift, back lipectomy, braplasty, bra plasty, bra lift, bra strap lift, and torsoplasty. There are two types of torsoplasties: vertical and horizontal. The vertical torsoplasty involves a vertical incision from the armpit down your sides. This incision from your armpit can extend to the top of the bra, the bottom of the bra, the bottom of your ribs, or even your hips. This incision pattern is completed on each side. The horizontal torsoplasty places an incision across your back. A large butterfly-shaped area of back skin and fat is removed from the central back in the back, and the back is lifted. The benefit of the vertical torsoplasty is that the scars are hidden when your arms are down by your side. Another benefit of the vertical torsoplasty is that it can give you an hourglass shape if the incision is carried down to the top of the hip. The vertical torsoplasty also tightens the abdomen by pulling the abdominal skin to the side. The disadvantage of the vertical torsoplasty is that there are two incisions. The advantage of the horizontal torsoplasty is that more skin and fat can be removed from the back than with the vertical torsoplasty. The disadvantage of the horizontal torsoplasty is the quite visible scar that runs across the back. Both procedures are performed under general anesthesia with a board-certified anesthesiologist. Both procedures require drains, which remain in place for approximately two weeks. Plan on a 2–3-week recovery. Both vertical and horizontal back lifts require you to lay on your back during your recovery. For your specific back lift or torsoplasty, I would highly suggest the horizontal torsoplasty. With a horizontal torsoplasty, you will eliminate more back skin and fat than with a vertical torsoplasty. Be sure your chosen plastic surgeon hides the horizontal back lift under your bra. Do not let them carry the incision above your bra. The horizontal back lift scar should be horizontal and across your back. The back lift scar should not be diagonal like the current rolls on your back. I hope I have convinced you that you need a back lift, not back lipo. Good luck. Sincerely, Dr. Katzen.