Procedures / Body

Thigh lift/ reduction

Even after significant weight loss, some patients are left with redundant thigh skin and fat. Like the arms, the thighs can be a very difficult area to target with exercise and diet. Furthermore, sometimes the amount of excess thigh fat can prohibit patients from exercising. Excess thigh skin can also cause rubbing and chaffing. This constant rubbing can lead to chronic skin rashes and can predispose to leg boils and other chronic skin infections. Large thighs can interfere with finding clothing that fits appropriately. Large legs can also hinder sexual relations and personal hygiene.

Even after extensive diet, exercise and even gastric bypass, often the only solution is surgical reduction. After massive weight loss, there are several different types of thighs can develop. Patients may have a “mild” amount of excessive skin and fat in the upper inner thigh. Patients may have a “moderate” of excess thigh skin and fat that extends half way down the inner thigh. Patients may have “severe” excess skin and fat that extends to the inner knee. Patients may also present with “extreme” excess thigh skin and fat; these patients have excess skin and fat along the inner and outer portion of the thigh and to the ankles. In consultation, Dr. Katzen will determine which type of leg you posses and which incision may best suit your needs.

Incisions: crescent, modified T, medial, staged liposuction

Just like the arm lift/reduction, the amount of excess skin and fat determines the length of the incision. If excess thigh skin and fat are “mild” then a crescent incision may be the best way to treat the area. The crescent thigh incision is placed in the groin. The groin is where the pelvis meets the upper thigh. In the front, the incision follows the lower bikini line. As the incision extends posteriorly, the incision creeps between the thighs and courses under the buttock. A wedge or crescent area of upper thigh skin and fat is removed. The inner thigh skin is freed and lifted; the incision is then closed in several layers with sutures. The resulting scar is “hidden” in the groin and is usually easily covered with most types of underwear. This crescent thigh technique is best suited for patients who have excess skin and fat in the upper inner portion of the thigh. This procedure is also well suited for patients who want to hide their thigh lift scars.

If the amount of inner thigh skin and fat is “moderate”, then a modified T incision may be the best incision. This incision utilizes the above crescent thigh lift incision but has a perpendicular incision that exends partially down the inner leg. This inner leg extension follows the inseam of a pair of pants. Dr. Katzen purposely places the thigh incisions in this fashion. This is done so when others look at a patient’s thighs, the resulting scar is “hidden” in the inside or inseam of the leg. The modified T incision extends as far as is needed to remove unwanted excess thigh skin and fat. Typically, the modified T extension measures 5-6 inches. This technique is best suited for patients who have excess skin and fat in the upper half of the inner thigh.

If the amount of thigh skin and fat is “severe”, then a medial thigh incision may be indicated. This incision goes from the groin to the knee. Similar to the modified T incision, the medial thigh incision is placed like the inseam on a pair of jeans or pants. As with other body areas, an individual’s amount of excess skin and fat determines how long this incision needs to be. If one has excess skin and fat below the knee, the incision may need to go below the knee in order to have that skin and fat removed. The medial thigh lift is best suited for patients who have excess skin and fat throughout the entire inner leg with extension of skin and fat below the knee.

Unfortunately, after massive weight loss some patients do not lose any fat from their thighs. These patients are left with a significant amount of excess skin and fat both on the inner and outer portion of their legs. These patients are best served with a staged procedure. This means that they will need two or more procedures to reach their goals. Typically, Dr. Katzen recommends liposuction first for these patients. Depending on the severity of the leg, several liposuction surgeries may be required. After one or two months and after the legs have healed from liposuction, a formal medial thigh lift is performed.

The Consultation

Dr. Katzen will examine your thighs. Together you and Dr. Katzen will discuss what bothers you about your legs. If the upper inner thigh bothers you, a crescent incision may be appropriate. If the inner knee bothers you, a medial thigh lift may be beneficial. During your consultation, Dr. Katzen will review the benefits of each type of thigh lift. Rarely, medical insurance covers medial thigh lifts. However, depending on your insurance carrier, your leg lift may be a covered benefit. You and Dr. Katzen can also discuss this during consultation.

The Procedure

Most thigh lifts take about 3 to 4 hours. Dr. Katzen performs this procedure with a board certified anesthesiologist in a board certified surgery center or hospital. Before the surgery, markings are placed were the incisions are planned. Both legs are then sterilized and draped. Once the patient is completely asleep, incisions are made. Dissection is carried through the thigh tissue and excess thigh skin and fat are removed. The incision is closed in several layers with sutures. At the end of surgery, a compression garment will be placed to minimize swelling and flatten scars. Typically, you will spend 1 to 2 hours in the recovery room. After the recovery room, you will be allowed to go home or go to a recovery center where a nurse will watch you. Dr. Katzen will see you several days later and the bandages will be changed. Dressing will be changed daily and the garment should be worn for several weeks. After surgery, your legs will tight and they will feel swollen. Over time the swelling subsides. Depending on work type, most patients are able to return to work approximately 3 to 4 weeks after the thigh lift procedure.