Thighlift

What is a Thighlift?

Thigh deformities are usually associated with saddlebag and droopy and fat buttock. Aging skin is like skin after weight reduction, which needs to be excised and pulled tight to give a youthful appearance.

Thighlift is a recently well – known body contouring surgery. It improves the contour and shape and generally reduces the size. The goal of the thigh lift is looking good in standing posture without skin distortion. It was originally performed as part of a total body lift surgery and in recent years has gained popularity as a stand-alone procedure. Inner thigh lift usually benefits those who experience pain due to chaffing of the inner thighs.

A Thighlift offers comprehensive correction of skin sagginess and soft tissue excess with wrinkles and folds in the thigh area, usually following pregnancy, massive weight loss, post liposuction and advancing age. The lower body lift improves the outer thigh; the medial thighplasty raises the inner thigh.

Thighlift is a surgery to reduce the skin redundancy and adipose volume and thereby improve the contour and shape of the thighs, leaving the scar along the creases, as hidden as possible. The procedure involves removing amount of skin and fat, on both sides symmetrically, initially horizontally and if necessary vertically.

Sometimes isolated loose inner thighs, requires only medial Thighplasty. Liposuction will often compliment the result of the Thigh lift.

In a weight stable patient only a lift procedure is sufficient, in an overweight patient a 2-staged procedure may be necessary (1st stage liposuction, 2nd stage thigh lift)

Types

Horizontal Medial Thigh lift (inner thigh lift) –  a horizontal crescent of inner thigh skin and fat is removed (only lax skin around the inner part of the thigh is excised)

Circumferential Thigh lift – front, inner and back and side skin excisions are done. The scar starts from groin and runs along the upper medial thigh and posterior lower buttock thigh crease.

Vertical Medial Thigh lift – excision of inner thigh is done. This type is recommended when there is severe deformity of the skin and fat, from the back of the groin to the inner knee. A wide band of skin excision along the entire length of the thigh from the inner portion of the knee to the back portion of the labia is done.

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Indication and Contra-indications

Indications

• Loose skin with stretch marks (thigh area)   
• Massive skin folds with fat bulge (thigh area)

Contraindications

• Weight fluctuations
• Low immunity
• Low hygiene
• Infection around the area

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Special instructions

In most cases, the scar is extended and permanent. Although, it can be hidden in the bikini line, one must carefully weight the benefits of the surgery against the associated scarring before deciding to undergo this surgery.

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Surgery

Anaesthesia and Hospital stay

It is performed under a combination of sedation and local anaesthetic. In some cases a combination of local and general anaesthetic is considered.  One night stay at the hospital is recommended.

Incision site and scar location

The horizontal scar is usually hidden usually along the bikini line. Scar position usually varies depending upon the location, the amount of fat and skin to be excised and the tension created during closure.

Surgical Procedure

The surgery usually takes an hour.  Adequate amount of excess skin with fat will be removed via variable incisions. The excision of skin is done according to the line of vector to reduce tension. Horizontal crescent of inner thigh skin fold is removed by artfully extending the excision along the pubis. Very large excess skin sometimes needs vertical excision creating a vertical scar (from groin to knee). The inner fascia is then sutured. The skin closure is done meticulously without undue tension. Suture strips and bandages are applied.

Post – Operative Instructions

• Pain for week managed with pain killers
• Movements within limitations
• Antiembolic stocking to reduce chances of DVT.
• Gentle massage to reduce swelling
• Major case needs longer stay.
• Swelling of the feet and ankles due to fluid retension.
• Occasionally drains nned to be inserted
• Drainage and aspiration necessary occasionally
• Compression garment 1 month.
• Scar takes 3 months to heal, strengthen by the end of 1 year.
• Sometimes scar management necessary – injection, gel sheath, scar revision
• Ultrasound therapy to reduce swelling and increase rate of healing

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Recovery and Combination Procedures

Post-oerative care

Support pressure garments, to reduce swelling and seroma collection, are recommended for 4 weeks. Gentle walking is advised to prevent venus thrombosis. It is important to keep the leg elevated whenever stationary, to reduce swelling. Massage to reduce lymphatic edema is recommended. As the skin will initially be very tight while standing and walking, it is advised to avoid excess over stretching of the legs.

Follow-up schedule

2 weeks, 4 week (suture removal), 3 months, 6 months, 1 year

Recovery

Bruising takes 10 days to resolve, swelling takes up to 6 weeks to subside. Numbness around the scars will slowly improve over a year. Patches of permanent numbness is possible. Minimal movement for 1 week, normal walking can be resumed at the end of 2 weeks. Most normal activities can be resumed at the end of 4 weeks. No physical training or strenuous exercises for 3 months. Depending on the type of work (desk job) you may be able to return to work in 2 weeks.

Combination procedures

• Associated liposuction
• Abdominoplasty
• Girdle lift
• Buttock lift
• Branchioplasty

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Results – Longevity and Limitations

Longevity of results

The results of the surgery are not permanent. The longevity depends upon skin quality, weight fluctuations and life style factors. In some cases with good management the results can last for a lifetime.

Limitations of end results

• Unevenness, dimpling and asymmetry
• Loose skin deformity is diffuse, so recurrence is possible.
• In the case of massive correction it may require a staged procedure