Chapter 15 Liposuction of upper back/bra rolls
• Liposuction of the upper back and bra rolls can produce excellent outcomes, provided that attention is paid to patient selection and surgical technique.
• Positioning of the patient during surgery is important in order to achieve the best outcome.
• Wetting solution infiltration permits the procedure to be accomplished with the least amount of blood loss and minimizes surgeon fatigue.
• In our experience, there are minimal complications from performing liposuction to the upper back and bra rolls.
• Patients find satisfaction with their outcomes from this treatment, once swelling is resolved.
Anatomical Aspects
In liposuction the dense connective tissue is very important because it is thicker in the upper back region, especially in the grooves formed by the excess skin that can result from both genetic inheritance (Fig. 15.1), obesity (Fig. 15.2A and D), sagging senile (Fig. 15.3A, B) or post liposuction (see Fig. 15.2 C and F).
Another important feature is the loose connective tissue (Fig. 15.4B) that grips the skin and subcutaneous muscle (aponeurosis) in this region making it easier to rip of the whole skin and subcutaneous tissue without detaching it surgically during resection flaps (Fig. 15.4C and D).
Surgical Treatment
Planning – Demarcation
Liposuction of the upper back can be performed only by minimal incisions of 5 mm at each subsequent level of the armpits (see Fig. 15.1A and C).
Where it is planned, resection of skin incisions may be made in the flaps (see Fig. 15.4).
