Management of Back Rolls

The excisional management of back rolls has become more common as the population with massive weight loss grows. The direct excision of upper back skin excess is frequently an extension of anterior chest surgery and may be performed as a single circumferential procedure or in several stages. In a woman with massive weight loss, rather than disposing of this back tissue, it may be deepithelialized and rotated anteriorly onto the chest for autologous augmentation, yielding the double benefit of reducing the back and also providing well-vascularized tissue perfused by intercostal artery perforators to fill the deflated breast.