Image: plastic surgery results
American Society of Plastic Surg
Does your back need a nip and a tuck? A new procedure called the bra-line back lift is like a facelift for your flipside. Here, it's pictured as a before-and-after.
By Health writer
updated 9/18/2008 8:30:15 AM ET 2008-09-18T12:30:15

After gastric bypass surgery and the subsequent tummy tuck, Tracy Wilkinson became obsessed with an area of her body she’d never before worried about: her back. The 100-pound weight loss left her with droopy folds of excess skin that bulged beneath her bra line.

“I felt like I had another pair of breasts under my arms,” says Wilkinson, who’s 67 and lives in Covington, Va. “It made me feel not-human. I didn't feel attractive with all that loose skin.”

Enter the bra-line back lift, a new procedure designed to eliminate those bumps and bulges caused by loose skin — sort of like a facelift for your back. Wilkinson was treated by Dr. Joseph Hunstad, a Charlotte, N.C., plastic surgeon who created the procedure and penned the small study that appears in the October issue of Plastic and Reconstructive Surgery.

“It completely eliminates the rolls and folds on the outside of the chest and the back,” says Hunstad. “Even women who are really fit can have a lot of skin laxity; they have a bulge above or below the bra. And that's what this procedure corrects: It takes all that laxity and eliminates it.”

Not to be confused with lipo
This surgery doesn’t remove back fat; that’s still best eliminated by liposuction. The bra-line back lift is designed for patients with saggy skin caused by aging, sun exposure or massive weight loss, like in Wilkinson’s case.

“You know, you just think, ‘Oh if I can just lose the weight’ — well, that brings a lot more things to the surface, because there you are with all that stuff hanging off you,” Wilkinson says.

Buying beautyHunstad so far has only treated women — 20 total, including the seven in the study. Aging and sun exposure doesn’t cause as much skin looseness in men as it does in women, so Hunstad expects the only reason a man would need this surgery is after losing a significant amount of weight.

But men wouldn’t benefit from one of Hunstad’s favorite parts of the procedure: The scar can be hidden under a bra or bathing suit. Before surgery, Hunstad instructs patients to wear the skimpiest swimsuit or bra they’d ever dare to wear, and he marks an outline to guide his incision.

During the one-hour surgery, he cuts across the woman’s back and removes her extra folds of skin — he’s taken as much as 10 inches of skin from a patient — and sutures the remaining tissue back together.

A trend in the making?
Since he started performing the procedure seven years ago, Hunstad has seen a slow but steady increase in women professing their disgust over back rolls. Interactive: How the body ages

“It's funny — more and more women are starting to be bothered by this area,” Hunstad says, “and I think it's ‘cause our clothing is more and more revealing — and all of a sudden they're like, ‘Ew.’”

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But at $7,500 to $10,000 a pop —  none of which is usually covered by insurance — and a scar that stretches across the back, this surgery isn’t for everyone, says Dr. Richard D’Amico, president of the American Society of Plastic Surgeons.

“There are lots of people who have back bra-line rolls of fat and a little bit of extra skin that can be very satisfactorily treated with just liposuction, with a scar that’s hidden in the armpit. So we want to be careful for who we prescribe this for,” says D’Amico, whose cosmetic surgery practice is based in Englewood, N.J. “The population that’s most likely to benefit from this is massive weight-loss patients.”

D’Amico sees the new technique as a “completion” procedure: After a tummy tuck, breast lift, thigh lift and arm tuck, then a patient might consider the bra-line back lift. “This is a piece in a bigger puzzle, and it’ll likely be the last procedure done,” D’Amico says.

After her tummy tuck and back lift, Wilkinson, for one, says she doesn’t plan to undergo any future plastic surgeries.

I look like a normal person now, and feel that way,” Wilkinson says. “That was the motivation for getting this done — to feel like a normal person and not feel ashamed.”

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