Most patients who have a thigh lift procedure have undergone a significant weight loss; many of these have had some form of bariatric surgery to lose their weight while others have accomplished it through a combination of diet and exercise.
Medial Thigh Lift
The first thigh lift, or thighplasty, surgeries attempted to hide the scar in the groin crease in front and in the buttock crease in the back. While this procedure is still occasionally performed, the results are generally confined to the upper inner thigh area only and is generally referred to as a medial thigh lift. Most patients who have lost a lot of weight have a lot more excess skin than just the upper inner thigh and need a much more extensive procedure. In addition, this type of thigh lift can result in a blunting of the normal fold between the upper posterior thigh and the buttock as well as cause problems with sitting as the scar sits directly over the bone that we normally sit on.
Standard Thigh Lift
Those who have a lot of excess skin require a much bigger procedure to affect the entire front and inner thigh. The procedure removes an ‘L’ shaped segment on skin with the shorter limb running along the groin crease and the longer limb extending from the upper inner thigh down to and sometimes past the knee. The length of the scars are determined by the amount of skin to be removed, which is generally dependent on how much weight was lost in the thigh area.
Drains and Sutures
One drain is typically placed in each thigh and is removed in 3-5 days while wraps hold the bandages in place until the drains are removed; at this time a compression garment is worn for at least another two to three weeks. We generally use only buried sutures and sometimes buried absorbable staples so that no stitches need to be removed and to reduce the severity of the scars.
Some liposuction can be performed at the same time, particularly on the inner thigh where some of the fat tends to persist, as it is often resistant to weight loss. After the fat is removed, the skin is undermined, the excess is excised and the skin is pulled upwards and inwards to rejuvenate the appearance of the thigh. In cases where there is a lot of residual fat despite significant weight loss, it may be advisable to perform the liposuction first as a separate procedure and delay the thigh lift to a later date.
Patients who have lost a lot of weight are usually considering other procedures in addition to thigh lifts. If liposuction of the thighs is recommended as a separate procedure, it can be done at the same time as a tummy tuck, breast lift or arm lift. Combining multiple procedures helps to cut down on overall anesthesia and facility costs as well as reduces recovery time and time off work or lost vacation time.