Back liposuction applies to individuals with localized fat in the upper and lower back. Liposuction of the back can decrease fullness in the upper back by reducing subcutaneous fat and can result in skin retraction, particularly with power-assisted ultrasound liposuction (U-PA)L. Liposuction of the upper back is an excellent complement to the arm, breast lifts, while liposuction of the lower back will complement the abdomen, buttocks, and thigh lifts. Liposuction of the upper and lowers back secondarily unmasks and enhances the buttock region as well. The sacrum often has a fatty deposit that responds well to liposuction and helps contour the buttock. Liposuction of the back is not a procedure frequently applied to massive weight loss patients who have achieved a body mass index of less than 30. Their issue is more skin redundancy and lax tissue than subcutaneous fat.