Bra Line Lipectomy (Upper Back Lipectomy) After Weight Loss
Bra line lipectomy, also called an upper back lipectomy or bra line back lift, removes loose skin from the upper back through an incision placed along the bra line. It is the operation I use when rolls of redundant skin persist across the upper back after significant weight loss, an area that lower body procedures and liposuction alone cannot reach. For a full explanation of the procedure, read my comprehensive guide to bra line lipectomy after weight loss.
Is This the Right Operation for Your Skin Pattern?
Bra line lipectomy treats vertical skin excess of the upper back. This shows as 1 or more rolls of loose skin running across the back, sitting at or above the bra line. The rolls fold downward under gravity and often become more obvious when sitting or when wearing fitted clothing.
This pattern is common after significant weight loss, whether through bariatric surgery, medication or lifestyle change. The skin of the upper back is anchored by firm attachments to the underlying tissue, so the laxity gathers into distinct folds rather than draping evenly. That is also why liposuction (suction assisted lipectomy) alone does not correct it. The problem is redundant skin, not just fat, and skin must be removed directly.
An abdominoplasty (tummy tuck) or body lift (belt lipectomy) does not reach this area either. Those procedures treat the abdomen, flanks and lower back. If upper back rolls are your main concern, or they remain after lower body surgery, a bra line lipectomy is the operation that treats them.
You should be at a stable weight before considering this surgery. Whether the operation suits your skin pattern is assessed at consultation.
What the Operation Involves
- A transverse incision along the bra line, positioned so the scar sits beneath the bra strap or bikini band
- Direct excision of the redundant skin of the upper back
- VASER liposuction (ultrasound assisted lipectomy) as an adjunct where residual fat contributes to the rolls
- Layered closure to support the scar as it matures
- Operating time is typically 1 to 2 hours depending on the extent of skin removal
- General anaesthetic
- Performed at Maitland Private Hospital
- Day procedure or 1 night stay, decided case by case
- Drains are usually not required
Why Come and See Me for This Surgery
I am Dr Bernard Beldholm, a Specialist Surgeon (FRACS). My practice is focused on body contouring surgery for patients who have lost significant weight and for post pregnancy patients, so operations like the bra line lipectomy are part of my routine work rather than an occasional procedure.
I operate at Maitland Private Hospital, which has 24 hour nursing cover and an on-site ICU. I do my own ward rounds daily while you are in hospital.
Your first consultation with me runs for about 1 hour. A second consultation is always included at no cost, and it can be done remotely if travel is difficult. Telehealth is available for regional patients.
Follow-up is structured and included in the surgical fee: 2 weeks of intense follow-up straight after surgery, then reviews at 4 weeks, 3, 6 and 12 months. If upper back rolls are part of a wider pattern of skin excess, I can also discuss how this procedure fits alongside options such as the circumferential hybrid abdominoplasty, a technique I developed for patients with laxity extending around the trunk.
Risks and Recovery
This is major surgery on a part of the body that moves every time you reach, twist or lift, and the recovery reflects that. Common issues include swelling, bruising, temporary numbness around the incision, and scar tension across the upper back. Less common but recognised complications include bleeding, infection, seroma, delayed wound healing and wound separation, particularly where the closure sits under movement. The scar runs along the bra line and takes 12 months or more to mature. Most patients take 1 to 2 weeks off work depending on their role, with lifting and stretching restricted for longer. I cover the full timeline in my bra line lipectomy recovery article and the risks in detail in my bra line lipectomy complications article. Results vary between patients, and part of the consultation is working out whether the likely outcome justifies the scar and the recovery for you.
Cost and Medicare
Where you meet the criteria, MBS item 30169 (excision of redundant skin after significant weight loss) may apply to this procedure, which affects Medicare and health fund contributions. You will receive a written quote after your consultation, and I explain what is involved in my bra line lipectomy cost article.
Your Steps to Surgery
1. Get a GP referral
A referral is required before your consultation and is needed for any Medicare rebate.
2. Consultation
We spend about 1 hour assessing your skin pattern, medical history and nutritional status, and deciding whether this operation suits you. A second consultation is included at no cost.
3. Written quote
You receive a full written quote covering surgical, anaesthetic and hospital fees.
4. Prepare for surgery
Pre-operative blood tests, nutritional preparation and any medication adjustments are organised well ahead of your date.
5. Surgery
Performed at Maitland Private Hospital as a day procedure or with 1 night stay.
6. Recover with structured follow-up
2 weeks of intense follow-up straight after surgery, then reviews at 4 weeks, 3, 6 and 12 months, all included in the fee.