American Society of Bariatric Plastic Surgeons (ASBPS)

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Back Lipectomy or Torsoplasty or Upper Body Lift

A back lift, back reduction, back lipectomy, or torsoplasty is a plastic surgery procedure whose primary goal is to remove excess rolls of back skin and fat.  Often, after massive weight loss, there can be an accumulation of excess back skin and fat. Sometimes this skin and fat collection is isolated or localized to the lateral chest above the bra strapline. Sometimes, the excess is more severe, and the excess skin and fat extend as an apron across the entire upper back. Depending on the severity of the excess skin and fat, there are different types of torsoplasties. If you have minimal skin deformity and excellent skin contractility, you may just need back liposuction. If you have more extensive excess back skin, you may require a partial vertical torsoplasty. During the partial vertical torsoplasty, an incision is made from the armpit down the chest's side to the lower portion of the bra strap or inframammary fold. Suppose you have a significant amount of excess torso skin and fat. In that case, the partial vertical torsoplasty incision may need to be carried to the top of your superior iliac crest or hip bone. If the excess skin and fat extends throughout your upper back, you may require a horizontal torsoplasty. During a horizontal torsoplasty, an incision is made across your back. This is also described as a braplasty or a bra-straplasty. Whether it is a vertical or horizontal torsoplasty, the torsoplasty may or may not be covered by your insurance, depending on your insurance's quality and unique anatomy. The torsoplasty takes approximately three to four hours to complete. The torsoplasty is performed under general anesthesia on an outpatient basis. After your torsoplasty, it will be essential for you to wear your garment. The garments will help to reduce the swelling. Garments should be worn for a minimum of six weeks.  The recovery after a torsoplasty is approximately two weeks.  Two weeks after your torsoplasty, you can return to a sitting job.  You can return to a physically active job at approximately four to six weeks. After your torsoplasty, you can return to light physical activity at approximately three weeks and heavy gym activity at approximately six to eight weeks. Most of the swelling is gone after about eight to twelve weeks after a torsoplasty. Different patients have different pain levels; however, most patients will require pain medications for the first five to seven days.  Usually, drains are involved and may stay in for approximately one to two weeks. You can have sexual relations approximately two to three weeks after the torsoplasty. You do not necessarily need massages; however, you may require lymphatic massages if there is swelling. Once your torsoplasty incisions have healed, you will be expected to apply silicone gel creams to minimize the scarring. 

     

Before: Torsoplasty                            After: Torsoplasty

(Courtesy of J. Timothy Katzen, MD)

     

Before: Torsoplasty                            After: Torsoplasty

(Courtesy of J. Timothy Katzen, MD)