A technique for lipectomy used on rolls of fat in the back is presented. It is proposed that multiplanar and aggressive liposuction in this region exaggerates the feminine waist and results in a lifting effect on the fat rolls. It is proposed that suction performed in a vertical way creates a new vertical collagen framework that supports skin in an antigravitational manner. Fat from fat rolls is aggressively suctioned in a multiplanar way to obtain a very thin adipose flap. The direction of suction is always perpendicular to the axis of the fat roll. The location of the incisions is cranial or caudal to the fat roll. This means they are vertical or longitudinal to the body axis. All the patients showed a marked improvement in both the clinical and photographic evaluations. The percentage of correction to the waist curvature was 26%. Only 11% of the patients showed minimal cutaneous irregularities (residual fat and depressions). Fat removal by multiplanar liposuction accomplished in a vertical way on the back rolls produces excellent results. The improvement results from the thin cutaneous flap needing to redrape over a longer concave waist curvature. On the other hand, the cutaneous flap readapts better in a vertical way because the new vertical collagen framework supports skin in an antigravitational manner. With this technique, postoperative edema is minimized. Lymph vessels have the same vertical direction from top to bottom, and thus are less injured.
