In the United States a group of plastic surgeons carried out a surgical study designed to tighten the upper and middle back region. The procedure, called the bra-line back lift, removes excess rolls and fat from the upper mid back region, enabling patients to wear formfitting clothes comfortably. The study authors state that, as the scar is conveniently placed on the bra-line, it can be easily disguised by wearing a bra or even a two piece bathing suit.American Society of Plastic Surgeon’s (ASPS) official medical journal, Plastic and Reconstructive Surgery.® It was carried out on 7 women between 2001 and 2007. The women’s age ranged from 36 to 67 years, with an average of 54 years.
The Operation
The lift was performed on women by first making preoperative markings of the bra outline, followed by marking the soft tissue to be removed. After the incisions, resection of the excess tissue and skin is performed, sometimes requiring an area of skin up to 8 or 10 inches wide to be removed. The superficial fascial system (SFS) is then closed under high tension. The operation takes approximately one hour. According to the authors, a drain is not usually required for this procedure. A drain was used on one occasion due to an increased body mass index.
Post Operation
Women were advised to avoid heavy lifting, vigorous activity, excessive bending, lifting their arms above the head and immersing the area under water. After two weeks, the women could slowly increase their activity depending on how they felt, but avoiding actions which caused too much tightness or discomfort.
The results
Results were monitored after a period ranging from 8 to 67 months (averaging a 22 month follow up). One patient needed to have her scar revised due to a fall at home one week after the procedure. Within a year of the operation, one woman chose to undergo revision as she perceived scar widening and remaining laxity or droopiness. According to the study, there was uniform positive feedback about the lift. No cases of infection, hematoma, seroma or tissue necrosis were present.Back fat and folds occur as a consequence of weight fluctuations, substantial weight loss and due to natural ageing. The study authors stated that tightening of the sagging upper and mid back fat and skin was previously performed through lifting procedures which involved concealing the final scar at the waist. However insufficient tension could be applied during these techniques in order to have any significant effect on the upper mid back rolls. The study concluded the bra-line back lift is safe and effectively contours the middle and upper back.
Candidates
The authors indicate that the procedure is not intended for persons who have all round skin and tissue sagging following significant weight loss. It is intended for fit patients in order to treat isolated upper and middle back soft-tissue sag. The chairman of the ASPS Public Education Committee, James Wells, states “as with all new procedures that are not yet widely practiced, patients need to choose an ASPS Member Surgeon who has a comprehensive understanding of how bodies change over time, the impact of environment and lifestyle and the know-how to develop the best treatment plan for the best result”.Currently, there are no statistics as to how many of these procedures have been performed in the United States. In 2007, there were more than 19,500 lower back lifts performed according to the ASPS. At this stage, the Australian Society of Plastic Surgeons does not collect statistics on the number of plastic surgeries performed in Australia. If you wish to consult a surgeon about treating your upper and middle back fat and rolls, always ensure to seek advice from a qualified plastic surgeon who is a member of the Australian Society of Plastic Surgeons.
The study was published in the October, 2008 issue of
Procedures
