MEDIAL THIGH SURGERY
As with other body areas, the shape of the thigh depends upon each individual’s fat deposition pattern, subsequent fat loss pattern, body weight, and the quality of the skin-fat envelope. Some individuals have good thigh contour despite weight fluctuations. Other individuals show a significant amount of skin laxity following weight loss. And another group of individuals store and maintain a large volume of fat in their thighs; which doesn’t change much, even with substantial weight loss.
Several approaches to excisional contouring of the medial thigh exist, depending upon the amount and location of tissue laxity. An isolated medial thigh lift is reserved for mild-to-moderate laxity problems, limited to the upper inner thigh, where there is limited horizontal excess. Because the majority of skin laxity occurs at the junction of the anterior and medial thighs, the resection pattern is performed more anteriorly and the excision does not extend into the buttock fold posteriorly. The use of Colles fascia (the deep superficial fascial roll) as the central anchor for the medial thigh lift has produced more consistent long-lasting results, decreasing the risk of problems commonly associated with the earlier skin-suspension medial thigh lift. When more extensive problems exist in the anterior thigh and inguinal areas, the resection can be extended (anteriorly) to the anterior superior iliac spine producing a high-lateral tension abdominoplasty effect with only a medial thigh lift. The medial thigh lift procedure can be combined with deep liposuction for additional contouring. Attempting to lift the lower inner thigh via a medial thigh lift incision is usually unsuccessful, since the lifting force cannot be translated over such a long distance. In most patients, anteromedial thigh laxity is caused by descent of relaxed lower abdominal and inguinal tissues after pregnancy or weight loss. Attempting a medial thigh lift before the support tissues of the lower trunk are lifted, often leads to an unfavorable aesthetic result. A high-lateral tension abdominoplasty should precede medial thigh lifting for moderate-to-severe medial thigh laxity.
In patients with generalized trunk and thigh relaxation (usually the result of significant weight loss), the maximum vertical relaxation occurs along the lateral body contour.
The thigh tissues then fall downward and inward, spiraling down along the thigh. When medial thigh laxity and loss of skin tone is significant, a medial thigh lift will not be sufficient to reduce this excess and laxity; especially in the lower inner thigh. A vertical thigh reduction is necessary for eliminating medial thigh excess in most massive weight loss patients. The horizontal and vertical skin excess present in most massive weight loss patients cannot be completely addressed with horizontal scars alone, because most of the thigh tissue excess is horizontal (circumferential). It is always been best to eliminate the lateral thigh laxity and descent before approaching any medial thigh laxity and skin excess. These patients should therefore have a lower body lift or belt lipectomy prior to vertical thighplasty.
Patients who, despite significant weight loss, continue to have large fatty medial thighs may consider a staged preliminary liposuction procedure to deflate the medial thigh; a medial thigh plasty may then be performed later.
If you would like to schedule a consult to discuss whether a thigh lift is right for you, please call our office at 414-443-0033.
- Drains may be placed beneath the skin to reduce post-operative fluid accumulation. At discharge you will be given instruction regarding incision and drain care, and how you may bathe.
- Some patients may be admitted to the hospital for an overnight stay.
- Patients return to the doctor’s office at approximately 1 and 2 weeks, and 1 and 3 months, after surgery.
- Bruising resolves within 2-3 weeks after surgery. Initially, patients may be quite swollen in their lower extremities. Residual swelling may take 6 months or more to resolve. Numbness can remain for 1-6 months.
- Sutures may need to be removed 1-3 weeks after surgery. Other sutures are dissolvable and will release on their own.
- Patients are required to begin walking the same day of surgery, and ambulation may increase as tolerated.
- Avoid strenuous activities for approximately 3 weeks after surgery. Your doctor will instruct you when you may begin a gradual return to activities. Patients usually return to unrestricted activity by 6 weeks after surgery.
- Time off work depends upon your job requirements, but will be at least 1-2 weeks after surgery