Joseph Hunstad, MD, a plastic surgeon in Charlotte, NC, has developed the Bra Line Back Lift procedure, which eliminates the bumps, bulges, and loose skin on the back caused by aging, sun exposure, or massive weight loss.

“The Bra Line Back Lift is a procedure that eliminates the rolls and folds along the line of the bra that are bothersome to women,” Hunstad says. “During the procedure, the entire amount of tissue that is lax, resulting in rolls and folds, is removed and replaced with a high-quality fine line scar that falls within the confines of the bra line or bikini top of a swimsuit. It is a meticulous procedure that literally gives lifting and rejuvenation to the entire back from the waistline to the neck.”

Before surgery, Hunstad instructs patients to wear their swimsuit or bra, and he marks an outline to guide his incisions.

During the procedure, which normally lasts about 1 hour, Hunstad cuts across the patient’s back and removes the extra folds of skin—as much as 10 inches—and sutures the remaining tissue back together.


To date, the Bra Line Back Lift procedure has been performed on 20 patients.

A study published in the October 2008 issue of Plastic and Reconstructive Surgery reported that patients who underwent the procedure experienced minimal complications. At about 2 weeks postsurgery, they were allowed to increase their activity levels based on their discomfort.

The study concluded that the procedure can be used to contour the middle and upper back—removing all of the back rolls and folds. According to the authors, placing the scar within the patient’s bra line helps conceal it—even when the patient uses a two-piece bathing suit.

“This is an exciting new procedure that gives patients concerned about this area of their body a possible new option to discuss with their plastic surgeon,” says James Wells, chair of the ASPS Public Education Committee.

According to Hunstad, patients who are good candidates for this procedure are women—usually between their 30s and 60s—who experience laxity and excess tissue on their sides, beneath the bra line, and across the back. Hunstad says that the only reason a man would need this surgery is after losing a significant amount of weight.

Complications associated with this procedure have been minimal, Hunstad says.

“The only complication I have seen to date is a suture abscess requiring suture removal, and on one occasion a slightly widened scar requiring scar revision. No hematomas, wound dehiscence, or infections have been seen. Patient response to the procedure has been uniformly excellent, with an extremely high level of satisfaction. One patient who has undergone a number of procedures stated that this was the ‘best procedure I’ve ever had.’ “

The downtime associated with the Bra Line Back Lift is minimal. Patients can shower the next day and resume normal activities within 72 hours following the procedure.

Any postop regimen? Discomfort associated with the procedure is relieved with pain medication. Hunstad warns patients to not stretch the incision by putting excess tension on it. He also recommends that patients use Scar Guard to quicken the healing of the scar.

The cost of the procedure ranges from $7,500 to $10,000, and it is not covered by insurance.


Beverly Hills, Calif-based aesthetic surgeon Fardad Forouzanpour, MD has invented the Umbilical Locator, designed to help plastic and aesthetic surgeons locate the umbilicus (belly-button) during abdominoplasty procedures.

During traditional abdominoplasty, the plastic surgeon makes an incision into the abdomen, and then manipulates the skin, tissue, and abdominal muscle. The manipulation of the abdomen often requires relocation of the belly button.

See also “Sculpting Realistic Expectations” by Michael S. Kluska, DO, FAACS, FACOS, in the June 2008 issue of PSP.

The placement of the umbilical incision is one of the most difficult parts of the surgery because the surgeon has no way of knowing where the belly button once was.

The Umbilical Locator is a small, plastic, shaped disk that is sutured to the original location of the belly button. After completion of the abdominoplasty, the surgeon is able to feel the Umbilical Locator beneath the skin, remove it, and create a new belly button in the correct location.

“The Umbilical Locator is a simple tool/device that allows for easier localization of the Umbilicas through the skin after mobilization of the redundant tissue,” Forouzanpour says. “By using the Umbilical Locator, proper location of the Umbilicas is identified, in order to create a more aesthetically pleasing umbilical shape at an anatomically correct position.”