Male Upper Torsoplasty Surgery Guide

After significant weight loss, particularly following bariatric surgery, some men are left with excess skin across the chest, back, and sides. An upper torsoplasty is a surgical procedure designed to remove this redundant skin and improve the upper torso shape.

When the surgery is extended completely around the upper body, it is referred to as a circumferential torsoplasty.

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Causes of Excess Chest and Back Skin

Excess skin develops when the skin has been stretched beyond its ability to retract. After major weight loss, the skin may appear loose and folded. Contributing factors include:

  • The amount and speed of weight loss
  • The length of time spent overweight
  • Age and natural skin elasticity
  • Genetic factors
  • Nicotine use
  • Prolonged sun exposure
  • Distribution of body fat

Why Addressing Excess Skin May Be Considered

Redundant skin across the chest and back can cause:

  • Skin irritation, sweating, and rashes in skin folds
  • Difficulty maintaining hygiene in affected areas
  • Physical restriction of movement when excess skin is significant
  • Skin breakdown from repeated chafing

What is an Upper Torsoplasty?

An upper torsoplasty surgically removes redundant skin and, in some cases, fat from the upper torso.

  • If limited to the back and sides, it may be described as a bra line torsoplasty
  • If extended all the way around the torso, it is known as a circumferential torsoplasty

The Role of Suction-Assisted Lipectomy (SAL)

Suction-assisted lipectomy (SAL) may be performed during torsoplasty to refine the outcome. While the main purpose of torsoplasty is skin removal, SAL can:

  • Reduce localised fat deposits on the chest, flanks, or upper back
  • Improve transition between treated and untreated areas
  • Address persistent fat that remains after weight loss

SAL does not correct redundant skin and is used only as an adjunct to excision.

Potential Benefits of Upper Torsoplasty

Potential outcomes of the surgery may include:

  • Reduction in redundant skin across the chest, back, and sides
  • Reduction in skin irritation and chafing
  • Improved ability to maintain hygiene in skin fold areas
  • Improved ease of movement when excess skin is reduced

Considerations and Limitations

Points to keep in mind include:

  • All surgery carries risks
  • Scars are permanent, although they usually fade with time
  • Time off work is required during recovery (often 2–3 weeks)
  • Temporary activity restrictions are necessary during healing
  • Health insurance rarely covers the surgery except in selected post-weight loss cases

Who is a Candidate?

Men may be suitable candidates if they:

  • Have achieved and maintained a stable weight
  • Are in good overall health
  • Have redundant skin in the chest or back regions
  • Do not smoke, or are prepared to stop before and after surgery
  • Understand that scars are a required part of skin removal procedures
  • Can commit to the necessary recovery period

The Surgical Procedure

  • Conducted under general anaesthesia, usually taking 3–5 hours
  • Incisions are placed along the chest crease, bra line of the back, or circumferentially if needed
  • Excess skin is excised and the remaining tissue repositioned
  • The nipple–areola complex may be repositioned if required
  • Suction-assisted lipectomy (SAL) may be combined to refine fat distribution
  • Incisions are closed and supported with dressings or compression garments

Recovery After Surgery

  • Hospital stay: Usually overnight, sometimes longer
  • Pain: Present in the first week; managed with prescribed medications
  • Mobility: Walking is encouraged from day one to reduce the risk of blood clots
  • Work: Light duties may resume in 2–3 weeks; longer if physically demanding
  • Exercise: Heavy lifting or strenuous activity should be avoided for 6–8 weeks
  • Showering: Usually possible after 24–48 hours, but prolonged soaking should be avoided until wounds heal

Results Timeline

  • Initial changes are visible soon after surgery, though swelling and bruising are expected
  • Most outcomes stabilise within 3–6 months
  • Final results and scar maturation may take 12–18 months

Risks and Complications

Potential risks include:

  • Infection
  • Seroma (fluid accumulation)
  • Haematoma (blood accumulation)
  • Wound healing problems
  • Blood clots (deep vein thrombosis or pulmonary embolism)
  • Nerve changes, including altered nipple sensation
  • Anaesthetic complications
  • Hypertrophic or keloid scarring
  • Possible revision surgery

FAQs

What do the scars look like?
Scars vary depending on the surgical plan. They are usually placed horizontally across the upper back or circumferentially if more extensive skin removal is required.

Does suction-assisted lipectomy replace skin removal?
No. SAL addresses fat but does not remove redundant skin. Torsoplasty is required to address excess skin folds.

How long do scars take to fade?
Scars may take 12–18 months to mature, often becoming flatter and lighter over time.

How long do the results last?
Results are generally long-lasting if body weight remains stable. Skin ageing will continue naturally.

Does private health insurance cover torsoplasty?
Cover is limited and generally applies only under strict post-weight loss criteria with higher-level hospital insurance.