The upper body lift

A body lift allows the treatment of significant cutaneous sagging fat after a large amount of weight loss.

People who ask for back bulges to be corrected generally ask for treatment by liposuction. However, these bulges are not usually due to excess fat but rather to excess skin requiring skin excisions, which is where an upper body lift is used.

For patients who have lost a large amount of weight, the body has undergone a radical change after losing several dozen kilos. However, the satisfaction of slimming, which is very beneficial for health, is tarnished by significant tissue sagging, which can often lead to significant functional discomfort and aesthetic issues, requiring a change to your body image.

The surplus sagging fatty tissue is spread around the entire circumference of the body and will require complete circular re-tensioning.

The upper body lift removes excess skin and fat from the upper body:

• Back: upper back bulges

• Sides: lateral thoracic bulges

• Front: sub-mammary bulges.

At the same time, it is possible to correct the other areas that have been affected by weight loss, including the breasts, arms, and armpits.

Removing excess skin allows the re-tensioning of different areas and excess fat is eliminated in two ways:

• Fat is removed from under the skin in one block;

• The fatty excess is removed by liposuction even outside the area of skin resection.

This sagging skin and fat can cause discomfort in daily life (irritations in the folds of the skin, sweating, mycosis or eczema, difficulties in wearing certain clothes and bras, postural discomfort, back pain,...) but also a source of a feeling of failure in dieting. This is because the sagging persists despite weight loss and makes any efforts seem to be in vain, discouraging patients. This means they are exposed to the risk of the yo-yo phenomenon by gaining weight after having lost it.

Conversely, the operation can be motivating because your dieting efforts are rewarded by an overall slimmer figure.

This new sense of harmony is a balancing factor and boosts self-confidence, both when naked or clothed.

The main use for the upper body lift is to correct significant skin slackening and fat after massive weight loss.

There are two types of cases, depending on the significance of sagging skin and fat:

• When sagging is very significant and also affects the central area of the back, the scar will be completely circular so it is hidden by the bra.

• When sagging does not affect the central area of the back, an upper body lift can remove excess cutaneous fat with an almost circular scar that stops a few centimetres from the middle of the back, which is hidden by the bra.

In addition, after massive weight loss, patients are anxious to make sagging tissue taught again. However, it is better to wait until your weight has stabilised for a few months and you are not too far from your desired shape and weight.

Each person arrives with a request for correction of a particular defect that is particularly troublesome to them. The objective of the operation will be to correct this defect as a priority by assessing whether it may be appropriate to correct other associated defects to have a well-balanced, natural result that meets expectations.

So, depending on the insights gained during the first consultation, the operation could possibly be combined with another procedure, notably liposuction, a breast lift with or without breast augmentation using prosthesis or by lipofilling (injecting your own fatty tissue collected during the body lift), an arm lift, including the underarms, and a lower body lift. These can be carried out during the same operation or at another time, depending on the associated operation

During the first consultation, it is essential that you openly express what bothers you and what you would like to improve. Do not be afraid to ask any questions, including expressing your fears and expectations. Everyone has a different body shape, psychology and expectations. These are not the same and there is no standard to apply.

After you have explained your motivations, I will examine you and offer one or more solutions, taking into account your expectations, your anatomy, respecting your identity and the natural aspect of your appearance.

During the first consultation, I will evaluate the technique to use, the scar location for tightening the tissues, the areas to treat by liposuction and, if necessary, by lipofilling (injecting your own fatty tissue collected during the body lift).

So you can visualise the desired result, I will show you photos of surgical results from cases similar to yours so you can understand the objective of the procedure.

It is essential that you and I have a good understanding when deciding to operate and to determine the technique to use from those I can offer.

I will then give you all the information on the techniques proposed along with the information sheets from the Société Française de Chirurgie Plastique Reconstructrice et Esthétique (French Society of Plastic, Reconstructive and Cosmetic Surgery), as well as a detailed estimate of the costs for the options chosen. You will then be able to move your project forward and get ready for a second consultation when you will be able to ask any additional questions to help you make a decision and prepare for the operation.

This operation is long and tiring and the anaesthetist will need to see the patient long enough in advance to prepare for the operation and be able to carry out all the necessary examinations to check for a good state of physical health and no type of deficiency.

You will need to remove body hair from the areas that will be operated on, if necessary, a few days before the operation.

You will be prescribed a specific post-operative support belt and a suitable bra to wear, which you will need to buy. These must be brought on the day of the operation to be worn at the end of the operation.

No medications containing aspirin or anti-inflammatories can be taken within 10 days of the procedure.

For general anaesthetic, you will have to fast strictly for 6 hours before the operation (do not eat anything, chew gum, eat sweets or smoke).

Tobacco consumption should be stopped or reduced as much as possible during the month before and month after the procedure. Tobacco can cause scarring problems.

Your stay in hospital will generally be 2 to 3 days.

The operation lasts about 4 hours.

The operation is performed under general anaesthetic.

Before you go to the operating theatre, in your room, I will go over the precise goals with you as we agreed during the consultations. You can then always make recommendations and ask any questions. I will then draw the lines and marks on your skin to guide the operation and the lines of the incisions.

The incision is circular and is in a place where it can be hidden by a bra.

The length of the scar will depend on the excess skin to be removed:

• When sagging is very significant and also affects the central area of the back, the scar will need to be completely circular.

• When sagging does not affect the central area of the back, an upper body lift can eliminate any excess cutaneous fat with a scar that is almost circular but stops a few centimetres from the middle of your back.

The final reshaping of the figure is carried out through liposuction to remove residual fatty surpluses.

The stitches are placed within the skin’s thickness (inverted and intradermal stitches), which means they are invisible. These stitches are absorbable so they do not need to be removed. Staples are sometimes used to complete the internal stitching, if necessary.

For optimal healing and better long-term results, it is important to deeply stitch the fascia superficialis (fibrous structure located in the subcutaneous fat), which should be secure to support the re-tensioning of tissues. This will prevent excess tension on the skin, which would have an adverse effect on the quality of healing and tissue maintenance.

At the end of the operation, a compression bandage is applied to the scar, a specific thoracic support belt for post-operative support and a suitable bra are fitted.

During the night and the days following the operation, there may be a painful sensation of tension in the area that was operated on, including aches and pains, which may impede your mobility. These pains are moderate in a resting position and may require analgesics that are given through a drip during hospitalisation or are taken as tablets at home. These post-operative pains will diminish and disappear within a few days of the operation.

Swelling (oedema) and bruising are generally moderate and it takes about ten days for them to disappear almost completely.

As the stitches used are absorbable, they do not need to be removed. Placed internally within the skin’s thickness (intradermal overlock), they are invisible. Any staples are removed within a week of the operation to avoid leaving a mark.

You will need to take 3 weeks off work in most cases.

• A chest support belt and bra should be worn day and night for 1 month.

• Every time you shower, clean the scars with an antiseptic, and, if necessary, treat them with ointment in the weeks and months following the operation to improve the quality of healing.

You will need to attend a follow-up consultation about a week after the procedure, then after 1 month, 3 months, 6 months, and 1 year.

• You may resume sporting activities as soon as any painful discomfort has subsided.

• Walking is strongly recommended in the days following the operation because muscular activity promotes drainage of tissues that have been operated on and limits the risk of phlebitis.

• You are advised against prolonged standing still.

• The recommended rest position is lying on your back or side with your legs slightly bent.

• Exposure to the sun: No exposure as long as there are traces of bruising, even when slight. Then, exposure is allowed using a sunscreen with a maximum sun protection factor.

The result is particularly spectacular due to the amount of excess skin and fat removed.

The result of reshaping the figure is immediately visible despite post-operative oedema and will continue to improve in the weeks and months following the operation.

In the long term, tissue sagging is permanently corrected and the majority of patients do not need another operation.
The excess fat removed cannot return because the fat cells do not multiply. If you gain weight, this will be harmonious over the whole body.

To complete the result of the upper body lift and to balance the thoraco-dorsal region, it is often useful to combine this with reshaping the breasts and armpits.

In addition to the aesthetic improvement, this procedure has a beneficial effect on personal well-being and weight control and makes physical activity more comfortable.

Read the information from the French Society of Plastic, Reconstructive and Cosmetic Surgery.

The cost of the operation will depend on the procedure to be carried out, the duration of the operation, the type of anaesthetic and any hospital charges.

This procedure does not currently qualify for reimbursement by Social Security.

A detailed estimate is given to you during the first consultation following the options you have chosen. You then have a minimum legal period of 15 days to consider your options and move your project forward.

The first consultation costs €50. The follow-up consultations before and after the operation are free.