Let's Talk Lipo: Bra Roll Liposuction

Let’s Talk Lipo

This week is the fourth in my series on liposuction and the focus is liposuction of the bra roll. This is a common procedure that women seek and is liposuction of the upper back. In this edition we will cover:

• Ideal candidates for bra roll liposuction
• Anesthesia requirements
• Surgery day details 
• Technique and limitations
• Recovery and how to optimize your outcome

Let’s Talk Lipo: Bra Roll Liposuction

Most women are well acquainted with the struggle of the bra roll. The “bra roll” is back fat that lives under your bra band. The reason the bra is blamed for this fat is because when you tighten your bra clasp it acts as a corset causing spillover of the fat above and below the bra band. I think many of us have had that moment when we are in a dressing room, wearing a bra that is probably too tight, and become frustrated with the fit of clothes over a lumpy bra roll. Well I have great news for you, liposuction plus a properly fitted bra can eliminate the bra roll in the right patient! 

Ideal Candidates

If you have been reading my newsletter series on liposuction you can probably guess some of the features of the ideal candidate by now. It all comes down to skin quality and degree of skin excess. In general liposuction alone is not a great option for massive weight loss patients because of the amount of skin excess. If you are within 20 pounds of your ideal weight and have good skin quality this procedure may be a great fit for you! The safe candidate that has the best chance at a fantastic result without suffering harm should meet the following requrements: 

• The patient should be in overall good health and fit for surgery
• The patient is within 20 pounds of their ideal weight
• The patient has focal fatty deposits and minimal skin excess along the bra roll
• The patient has healthy, thick skin with elasticity and few to zero stretch marks

Anesthesia Requirements

General anesthesia is used for liposuction of larger areas including bra roll liposuction and other back liposuction. Our anesthesiologist will put you to sleep and keep you comfortable with your airway protected during the procedure. This allows us to keep you maximally comfortable and your airway protected while I work hard creating your new shape. 

Surgery Day Details

On surgery day you will present to our practice at Highland Park Plastic Surgery Center where we have a private, state certified operating room. You will be the only patient having an operation during your scheduled surgery time and will have the undivided attention of the entire team. After surgery you will spend some time in our recovery room and then will go home the same day to recover in the comfort of your home. 

Incisions, Technique, and Limitations

The incisions are small and on average 4-5mm - just big enough to insert the liposuction cannula. The number of incisions depends on your frame and fat distribution but on average three incisions are needed.  I hide the incisions in the bra roll and in other discrete areas such as the armpit crease. 

I use the SAFELipo technique that I described in my newsletter #14. If you missed that newsletter I encourage you to go back and read it for details on how liposuction is performed. 

The back has different anatomy compared to the abdomen. The skin is thicker and the fat denser. Because of these anatomy differences the bra roll is much more forgiving and has a lower risk for contour deformities compared to the abdomen. 

Recovery and how to optimize your outcome

Pain: liposuction usually requires pain medication for the first 2-3 days, and after that can be managed with over the counter meds as needed. I will provide you with a muscle relaxer if indicated to help you relax and to improve your sleep.

Diet: your recovery will be optimized if you are eating the appropriate protein requirements for your body, limit salt intake to a moderate amount, and hydrate.

Garments: you will be placed in foam at all times for 6 weeks and a compression garment at all times for 8 weeks. You may purchase a spanx-like compression garment that you prefer during this time as long as I approve it. Commitment to compression is the greatest method to optimizing your outcome.

Activity: walking is encouraged immediately after you have recovered from anesthesia to prevent blood clots. In general, walk often and rest often. At the two week mark you should be able to take long brisk walks, at 4 weeks increase your cardio exercise and by 6 weeks you will be released to full activity. 

Results

As with all liposuction, final results take time to reveal themselves because of swelling. Over a period of 6 months with strict compression garment use you will see your body transform. Final results are expected by 6 months but you will see changes along the way. If you gain weight after liposuction this will affect your outcome. You can have recurrence of your bra roll and/or disharmony of your figure if you gain weight after liposuction.  

If you are wondering if bra roll liposuction is the right procedure for you call and schedule a private consultation with me. I would be thrilled to evaluate and educate you regarding options to achieve your goals!

As always, here's to choosing how we age, on our own terms!

Dr. Lindsey Tavakolian, MD MPH