Worried about skin wrapping around your bra line?

Young woman showing manucure hands. Closeup view. Female underware. Undress bra self. Remove lady back clothes

Many women are uncomfortable wearing form-fitting clothes because the skin either above or below the bra line creates folds that distract from the aesthetics of a woman’s back. Unfortunately, it can happen at any age. Special underwear can hide the problem, but who wants to wear tight underwear in the warmer months?

Reasons: the skin of the back and shoulder must adapt to a wide range of movements of the shoulder girdle. When the arms are raised above the, the skin in the posterior superior axillary region must be stretched to avoid restricting this movement. Over time, our skin begins to enlarge and increase in surface area, especially in the posterior axillary fold, narrowing to the tip of the shoulder blade. The skin below the axilla and laterally along the ribs do not require expansion, but a transition line or fold may develop and become more pronounced under the influence of gravity, causing a shearing effect on the skin above. The appearance is enhanced by the restrictive band of the bra crossing this area, thus creating the dreaded “roll of bra strap fat”.

Anatomy varies greatly depending on skin type and quality, body mass index (BMI), and age. In some cases, the skin folds are very tight, without a lot of excess fat, but the problem is excess skin. People with a higher BMI may have a large amount of fat deposited in this area. At the other extreme is the massive weight loss patient who has very little obesity but has a lot of inelastic, bloated skin that hangs over the bra. Each type of patient requires different treatment methods to achieve a satisfactory result.

Treatment options

  • If you have a small increase in back fat with deep tight folds, the treatment is:
  • aspiration lipectomy with the addition of an energy source or VASER-assisted aspiration lipectomy (ultrasound energy),
  • or power aspiration lipectomy, which is a mechanical rotating blade effect built into the cannula,
  • or the method of pulsating heat and water, which destroys the interstitial fibers surrounding the fat.

All of these approaches work by disrupting the connective tissue between the back and the dermis of the skin in combination with the inflammatory response of the surgical cannulae, allowing the skin to re-drape / redistribute to tighten the back and conform to the new contour.

Young woman closing her bra

Non-invasive body contouring procedures, such as cryolipolysis (CoolSculpting), do not have a mechanism for destroying fibrous inserts in the skin from the deeper fascia, so no elimination of dense fold lines will occur.

If you have an elevated BMI and increased levels of skinfold obesity, you will also benefit from the above methods of adding energy sources with liposuction, but a greater degree of fat removal is required. Increased fat volume requires more cell removal. However, care must be taken to avoid overresection, which can result in loose, hanging skin on the back.

For the massive patient with weight loss or someone who has a large amount of loose skin with or without added fat, a skin resection technique is often incorporated into Brachioplasty to correct sagging upper arm skin.

If your bra line or excess fat is detracting from the overall aesthetics of your back, you need a board-certified plastic surgeon to thoroughly evaluate your situation to determine the right treatment option so you can feel more confident in your skin.



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