Whether surgical or nonsurgical, these back beautifiers can remove excess fat, tighten loose skin, and restore uneven tone and texture.

Light + Energy Devices

According to Louisville, KY plastic surgeon Chet Mays, MD, depending upon the degree of skin laxity present, light and laser treatments can be effective to smooth skin and improve pigmentation concerns. “BroadBand Light (BBL) allows us to treat sun-damaged skin all over the body. Intense Pulsed Light (IPL) can help eliminate discoloration and improve skin clarity.”

Microneedling

To promote healthy, glowing skin, New York plastic surgeon Roman Rayham, MD says he is a fan of radio-frequency microneedling. “I recommend this to my patients because the microinjuries in the skin allow topical treatments, like hydroquinone cream for hyperpigmentation, to penetrate deeper. I also combine it with liposuction treatments so the skin is also addressed while we are sculpting the back.”

Radio Frequency

For those with excess fat around the bra line, first make sure that your bra fits properly, as an ill-fitting bra can create the appearance of back fat. For very moderate skin laxity or small pockets of fat, Houston plastic surgeon Christopher Patronella, MD says radio-frequency treatments like BodyTite are a good option. “I like to combine BodyTite with liposuction to achieve the best result,” he adds. “With radio-frequency heat to reduce fat, we also see some tightening of the skin by stimulating collagen and elastin production,” explains Dr. Mays. “We get the best results in my practice when we ‘stack’ these therapies, like TruSculpt 3D and ThermiSmooth, which both use heat technology.”

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CoolSculpting

“CoolSculpting plays a definite role in back contouring,” says Chicago plastic surgeon Peter Geldner, MD. “The results of surgical treatment are always more impressive than any nonsurgical method, but if you’re adverse to surgery and only have a small amount of fat to target, it will give a slimming result.” Dr. Mays utilizes the fat-freezing treatment as well. “Combining CoolSculpting and ThermiSmooth can help achieve better fat reduction and skin tightening. And as with all nonsurgical treatments, it can take three to six months to see the results, and many modalities require multiple treatments to see full results.”

Liposuction

The gold standard for fat reduction is also the gold standard for back contouring. “Most back sculpting procedures begin with liposuction,” says Dr. Geldner. “Skin excision can also be performed in some cases if needed. The exact location of the excision depends on where the excess fat exists: the bra line, flanks or a component of the posterior.”

“Liposuction is by far the most common procedure I perform on the back,” says Concord, CA plastic surgeon Eric Mariotti, MD. “If it is the lower back or hips, then standard liposuction is often sufficient. However, for the lower bra roll area and the upper back, the fat is oftentimes more fibrous and can be harder to remove. The addition of energy-based liposuction devices such as laser or ultrasound-assisted liposuction can also be utilized to remove more fat and have better skin retraction.”

To sculpt a new shape, Dr. Mays prefers power-assisted liposuction. “Once the fat has been separated and aspirated, I use my hands to smooth the fat in areas where contouring was performed. Sometimes, instead of discarding the aspirated fat, I will inject it back into the buttock region for a Brazilian Butt Lift to provide even more reshaping of the back.”

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