Upper Body Lift After Weight Loss

After major weight loss, loose skin rarely stops at the waist. Across the back it gathers into rolls that a bra band or a fitted shirt makes obvious; at the side of the chest it runs out towards the armpit; and in men the chest can deflate and sit lower than it did. An upper body lift removes that excess from the upper trunk in one operation.

• Why the upper trunk changes
• Are you a candidate
• The operation
• Combining procedures
• Recovery
• Scars
• Risks
• Cost and Medicare
• Where Dr Kumar operates
• Common questions

Why the upper trunk changes after weight loss

Skin that has been stretched over a long period loses much of its elastic recoil. When the fat beneath it goes, the skin does not shrink back to match. On the back, the skin is tethered more firmly at some levels than others, so the excess gathers into horizontal rolls between those points — typically one at the bra line and one lower, above the waist.

The pattern differs between men and women. Women tend to notice the rolls above and below the bra band and the tissue spilling from the side of the breast towards the armpit. Men more often notice a chest that has flattened and dropped, with loose skin continuing around the side of the chest wall onto the back.

How much excess you are left with depends on how much weight you lost, over what time, your age and your skin quality. How the weight came off — surgery, weight-loss medication or diet and exercise — matters far less than whether it has now stayed stable. Training builds muscle beneath the skin, which helps shape, but it does not remove skin that is already in excess. More on back rolls after weight loss.

Is an upper body lift right for you?

An upper body lift is worth considering when:

It suits less well where the looseness is confined to the breasts or chest. In that case breast surgery or chest contouring alone is the better operation, with a shorter scar. If you are still losing weight, the right advice is usually to wait until it settles.

Medical conditions such as diabetes need to be well controlled first, and nicotine in any form substantially increases the risk of wound problems. Dr Kumar’s team can arrange preparation with an Accredited Practising Dietitian and a DEXA body composition scan where it will help plan your surgery. Nutrition before skin removal surgery.

What the operation involves

The operation is done under general anaesthetic at Westmead Private Hospital and takes about two hours on its own, with an overnight stay. Before you consent, Dr Kumar marks the lines on you and shows you exactly where the scar will fall.

The excess skin and fat are removed as a horizontal band across the back, extending around the side of the chest as far as the looseness goes. The deeper tissues are supported and the wound is closed in layers so that the tension sits beneath the skin rather than on the scar itself. Drains are placed to remove fluid in the first days, and a compression garment is fitted before you wake.

Where breast surgery is done at the same time, the scar in the breast fold is continued sideways into the back incision so that the two join, which allows the side of the chest to be tightened as one unit. In men, the chest component is planned with the back excision so the contour runs smoothly from front to back.

Combining an upper body lift with other procedures

Breast surgery. In women, an upper body lift is frequently combined with a breast lift after weight loss, because the incisions meet and the side-of-chest tissue is best corrected with the breast. It is usually the most efficient plan.

Male chest. In men, it is commonly combined with male chest contouring, addressing the deflated chest and the back rolls in one operation.

Arms. An upper body lift does not correct the upper arm. An extended arm lift addresses the arm and the tissue continuing onto the chest wall. Whether it is done at the same operation or as a separate stage depends on total operating time and safety, and Dr Kumar will advise on that for you.

Why not with a lower body lift. An upper body lift pulls skin upward; a lower body lift pulls it downward. Done together, each works against the other and the result is worse than either done properly. They are staged, usually three to six months apart, and the area causing the most functional trouble — more often the lower trunk — usually goes first. How staged body contouring is planned and how many operations you will need.

Recovery, week by week

When	What to expect
In hospital (overnight)	Drains and compression garment in place. You will be up and walking with help early, which reduces the risk of clots. Pain is managed with regular medication.
Weeks 1–2	Recovering at home. Drains come out once the fluid output falls. Sleep propped up or on your side rather than flat on your back, and avoid reaching overhead. Short, frequent walks.
Week 2	Most people return to desk-based work. Physical roles take longer. Time off work after body contouring.
Weeks 2–6	A gradual return to most everyday activities depending on effort and the areas treated. The garment is worn for six weeks. No heavy lifting.
Weeks 6–12	The garment comes off at six weeks. Activity builds up, with full clearance — including heavy lifting and full training — at around twelve weeks for most patients.
Months 3–18	Swelling settles and the scar matures, from red and firm to flatter and paler.

The nurses who prepare you for surgery are the same nurses who see you at every post-operative review, and follow-up continues to twelve months. The full recovery timeline after skin removal surgery.

Scars

The scar runs horizontally across the back and continues around the side of the chest. It is positioned to sit under a bra band, swimwear or a garment line, but it is long, and you should expect to see it.

Back skin is thick and under tension with every movement of the shoulders and trunk, so scars here widen more readily than abdominal ones. That is the honest trade for removing the rolls. Scars take twelve to eighteen months to mature, and Dr Kumar’s team will show you how to care for yours as it does. Numbness close to the scar is common and usually improves over months. How the scars settle and scars in men after body contouring.

Risks and complications

All surgery carries risk. The risks Dr Kumar will discuss with you include:

Nicotine, poorly controlled diabetes and low protein intake all increase the risk of wound problems, which is why preparation matters. Read more about the risks of surgery.

Cost and Medicare

The initial consultation with Dr Kumar is $400, with a Medicare rebate of approximately $88 where you have a GP referral. A GP referral is required to see Dr Kumar. Surgical fees are quoted individually after your consultation, in a written itemised quote. The hospital provides its own quote after checking your health fund, so your final quote shows whether your fund covers you.

Medicare item 30169 covers removal of redundant non-abdominal skin for functional problems following significant weight loss — at least five BMI points — where weight has been stable for at least six months, for one or two non-abdominal areas. Functional problems means recurrent rashes, infection or skin breakdown in a fold, or interference with daily activities, rather than appearance. Surgery for appearance alone is not covered. Breast surgery done at the same operation is assessed against its own item numbers.

Dr Kumar’s practice offers an in-house instalment plan. The full Medicare criteria, what skin removal surgery costs, health fund cover and paying for surgery.

Results

The aim is a smoother back and upper trunk without the rolls that catch on clothing, with the excess at the side of the chest removed. The final shape takes several months to show as swelling settles, and the scar keeps improving for up to eighteen months. Further substantial weight change will affect the result. Individual results will vary. Before and after photographs of Dr Kumar’s patients are in the gallery (18+).

Where Dr Kumar operates

Dr Kumar consults at Westmead, Penrith and Orange, and performs body contouring after weight loss at Westmead Private Hospital. You can send photos first so Dr Kumar’s team can advise before your consultation. Body contouring for regional NSW patients. For an overview of every operation, see body contouring after weight loss.

Common questions