Background: Body contouring in the post-bariatric surgery patient has focused predominantly on the resulting tissue excesses of the abdomen, breasts, and arms. The back, however, has not received the same attention and, although the skin folds on the back may sometimes be improved by addressing the previously mentioned areas, the result is usually unsatisfactory and leaves the patient with significant residual excess.
Methods: The senior author (B.S.) has developed a classification system and surgical treatment for the excess back tissue that eliminates these folds.
Results: Modifications of the senior author's techniques of mammaplasty/mastopexy and circumferential abdominoplasty, in addition to direct excision, are used to improve the contour of the back.
Conclusions: Contouring of the back roll deformities seen in post-bariatric surgery patients requires a systematic approach. With this approach, the authors have been able to achieve uniform patient satisfaction with low morbidity. Although patients are left with additional scarring, this tradeoff is accepted by nearly all patients for the dramatic improvement in body contour.