Thigh lifting is the most arduous and high-risk surgery among body contouring procedures. In the overall plan for reconstruction after massive weight loss, it is usually reserved for last. For patients who have heavy, draping folds of skin excess in the thigh areas, it is the only effective alternative for long term improvement. It is also the only alternative for severe cellulite, wrinkling and other unsightly irregularities in the thighs.
Thigh lifting and reduction can involve one or more incisions in the inner thigh areas. The incision that follows the groin crease anteriorly and then continues into the buttock fold posteriorly is required for the lifting component. For some patients, the thigh lift is all that is required, and the incisions can be concealed with modest underwear or swimwear. Reduction of the thigh requires an incision on the inner aspect of the thigh continuing to or below the inner aspect of the knee.
Dr. Lindsey usually tells his patients that a 60 – 70% improvement in the thigh contour is realistic. For the best results, staged procedures are generally required, meaning that additional tightening and skin removal can be done 6 months later. This is due to the intrinsic healing properties of the lower extremities and thighs which are inferior to the healing properties of the torso or face. The patient must be willing to accept the fact that perfection is not possible with this type of plastic surgery, and that residual redundant skin and laxity are required in order to avoid complications such as wound separation or dehiscence.
Early ambulation and mobilization are a must with this type of surgery as with others. A custom fit compression garment is also required which extends from the ankle to the waist. This is for comfort and protection during the healing process. The compression is paramount during the healing period to prevent swelling which in turn offloads tension on the sutures. The lower extremities should be elevated above the waist when the patient is not walking. Unlike other body contouring procedures, thigh surgery requires prolonged compression support up to 6 months.
Small to moderate wound separations occur in almost all patients undergoing thigh lifting and/or reduction. This may delay return to work or home duties. Typically these wound problems are managed with Epson salt sitz baths in the bathtub at home for 30 minutes twice daily followed by application of saline wound dressings.
Thigh lifting and reduction are considered major procedures, and time off of work may be 2 weeks or more depending on the healing process.
Although arduous, thigh lifting and reduction are very gratifying. There is improved comfort and mobility from the removal of the skin excess, improved hygiene, and improved appearance.