Management of excessive laxity of the abdomen, breasts, arms, thighs and buttocks following
massive weight loss has received much attention, however little has been written about the surgical approach
to the back rolls and folds. “Back rolls” can range in a number from one to four on either sides of the
midline. In post-bariatric patients, the excess tissue must be excised. Liposuction is rarely indicated because
the skin and subcutaneous tissue remains in excess in these patients. In addition, back tissue is dense and
fibrous, making it less amenable to liposuction. Post-bariatric contouring of back-roll deformities requires an
approach that allows for direct excision of the two lower folds (lower thoracic and hip rolls) during the
circumferential lower body lift procedure and of the two upper folds.
Keywords: Back rolls, festoon curtain deformity, back contouring.
