Generally, speaking surgeons, do not do white undermining during skin removal procedures over the back. this means that only skin laxity in the general area where the skin excision is done will be incorporated or affected from the procedures. Unlike a tummy tuck where the skin tightening can go all the way from the incision up to the rib cage, this effect does not happen on the back. If you need an extended tummy tuck and schedule an extended tummy tuck. If you need it back lift, then schedule a back lift.Are you currently working with a plastic surgeon? If so, your surgeon should spend the time to explain what age procedure can, and cannot accomplish for you. If they haven’t, then consider consulting with a few more plastic surgeons. The following are some general guidelines to find the best provider. To find the best provider, I suggest patient schedule multiple in person consultations with experienced plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who have similar body or facial characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures. Being shown a handful of preselected images, representing the best results of a provider’s career is insufficient to get a clear understanding of what average results will look like in the hands of each provider. There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs. Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body/face to use as reference when reviewing before and after pictures. The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery. Best, Mats Hagstrom, MD