The cosmetic surgery procedures you may never have heard of: bra line backlift

Fat is a funny thing. We all know that it can creep up on you, particularly as we get older, but fat cells can also be deposited unevenly and often in the most unlikely of places. Many of my Leamington cosmetic surgery patients – particularly my female patients – exercise regularly and work hard on achieving a flat tummy or taut thighs, but get downhearted when they check out their back view in the mirror and see rolls of fat and skin below and above the bra line. This excess skin can make a woman appear heavier than she actually is.

Tissue on the back is of a slightly different composition to elsewhere on the body. The skin is much thicker, there is minimal ‘deep’ fat and the superficial fatty tissue is much more dense and fibrous, all of which makes it very difficult to shift this problem with exercise or diet.

Also, if your weight has fluctuated over the years, then this will have increased the amount of fibrous tissue and you will usually have developed skin laxity that appears as ‘rolls’ on the back.

Recently, I wrote about one of the less well-known procedures I offer clients called a trunk reduction; this week I’m reviewing another, more unusual, cosmetic surgery procedure known as the bra line back lift.

I perform the procedure under a general anaesthetic; first, following a careful preoperative mark-up, an incision is made all the way across the upper back and into the upper armpit area on each side. The back skin is then separated from the underlying muscles down to the lower back area, before it is pulled tightly upwards, the excess removed and the skin closed with dissolvable stitches. This produces a smoother contour to the back area.

The trade-off is the scar extending across the upper back from armpit to armpit. Scars on the back tend to fade less well and may also stretch in response to normal bending movements, so that they are not a completely fine line.

However, at pre-planning, the best position for the scar in regard to the standard bra strap line is considered and marked accordingly to try to minimise visibility and the majority of my patients are comfortable accepting the scar in exchange for a much-improved body contour.

The cosmetic surgery procedures you may never have heard of: trunk reduction

Reflecting the ever increasing rise in plastic surgery in the UK, the internet has become a vast resource of information – often excellent, but sometimes misleading or sketchy. I find that many prospective patients that arrive for a consultation at my Leamington plastic surgery practice are fully conversant in the pros and cons of breast augmentations, tummy tucks and liposuction, but it can also mean that they have fixed ideas on which procedure is best for them.

I offer a range of cosmetic surgery procedures and sometimes a patient may require something less straightforward to achieve the results they are hoping for. Here I look at some of the less well-known cosmetic surgery procedures I offer.

The tummy tuck or abdominoplasty is a very popular procedure and many men and women arrive for a consultation at my Leamington cosmetic surgery practice believing that this is the procedure for them.

For some, excess skin and fat continues round onto the flanks and into the middle of the back. Unfortunately, this is a common side effect of losing a great deal of weight. The remedy is a trunk reduction.

What does this involve?

The surgical procedure involves a careful mark-up before surgery and, during surgery, includes all the essential steps for an abdominoplasty. So, the incision on the front runs horizontally across the top of the pubic area and, staying low, out onto each side. This allows access to the tummy muscles all the way up to the lower chest area so that these can be tightened up if they have weakened and spread, following pregnancy or excessive weight gain, for instance. Excess skin and fat is then removed low down and the tummy button repositioned as necessary.

With the patient on his or her tummy, I focus on the pre-marked area and make the incision from the point low on each side, continuing across the upper buttocks to meet in the mid-line low in the lumbar region of the back. Excess fat and skin are removed and the entire surgical wound is closed with dissolvable stitches. In practice, the ‘face-down’ part of the operation is generally done first.

The benefits of a trunk reduction

Most patients want smoother, tauter contours and, although they may have fixated on a particular problem area, such as their paunch, it is my responsibility to highlight areas of skin and fatty excess which will be made much more obvious on the low flanks and back if just the tummy tuck is done and to advise on the surgical procedure most likely to achieve overall satisfaction, even with the trade-off of a more extensive scar.