Back lift: Bra-line lift vs jPlasty vs vertical Torsoplasty vs lipo only? (photos)

Question

I've lost 150 lbs and my weight has stabilized around BMI of 30-31. I've had extended brachio with LBL and for round 2, the brachio was revised with zPlasty +jPlasty, lipo & breast lift. jPlasty didn't smooth my back & side boob. That fat is so squishy & it looks bad when I'm wearing a properly fitting bra (I have been professionally sized many times). The widened jPlasty scar doesn't bother me much What procedure(s) should I look at for fixing ssues w/ back boobs & rear armpit spillage?

J. Timothy Katzen, MD, FACS · Answer

Hi, thank you for your question regarding what surgery would be best for your body whether it is a bra line lift vs J-plasty vs vertical torsoplasty vs lipo only. Based on your history and pictures, you have excess skin and fat of the infra-axillary or under armpit area, as well as across your back. Since you have excess skin, skin needs to removed.  Therefore, since liposuction does NOT remove skin, liposuction alone is NOT an appropriate suggestion.   To address the area underneath your armpit, I would suggest a vertical incision that extends from the armpit down past the inferior bra line. In your case, I am not sure exactly what went “wrong” previously or maybe your skin just stretched, but this area needs to be tightened in a vertical fashion. If a plastic surgeon were to pull this area down in a horizontal fashion (parallel to the bra strap line), this area will NOT BE corrected. In regards to your back, I would consider a horizontal torsoplasty or bra straplasty. This can be combined at the same time as the incision that extends from the armpit down past the inferior bra line. Therefore, in conclusion, your final incision will go from your armpit down to the inferior bra strap line, across your back (following your bra line) and then meet with the other vertical incision from your armpit down the side of your chest. I hope this helps with your decision making. Thank you for your question whether you should have a bra line lift vs J-plasty vs vertical torsoplasty vs liposuction alone.
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 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.)

Daniel Barrett, MD · Answer

Dear MomOfMia,
it is hard to tell for sure without an examination. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Kenneth Hughes, MD · Answer

Hello, thank you for your question. It seems like you can benefit from a back lift and liposuction, An in-person consultation is needed, I recommend you to schedule an appointment with a board certified plastic surgeon.

Carmina Cardenas, MD · Answer

It is wonderful what you have achieved after the weight loss!!!
As an expert in the After Weight Loss surgery, I must share with you that,  there are certain areas that we must identify and treat the excess of width as is arms and thighs. Excess of Length as is the back or abdomen or other areas that need to remove both vectors: width and length as is the lateral torso and sometimes the abdomen (needing the lower body lift-Fleur de Lis).  
So the “crescent” or “J” incision is for those who have developed a minor degree of saggy skin on the lateral torso but the back has no issues. 
In your case you will be a great candidate for the Back lift (brassiere line incision) which will end below your breast in order to create a smooth and tight back and convert the “J” in a vertical in order to remove the excess of width Of the lateral torso and also take advantage to move back a bit the current “J” scar to make it less visible. 
I have done it many times with great outcomes. 
Be encouraged!!! You will look astonishing!!!!
Dr. Cárdenas

Back lift: Bra-line lift vs jPlasty vs vertical Torsoplasty vs lipo only? (photos)

Answers (4)

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