Vertical Thigh Lift Usually Necessary with Massive Weight Loss

Thigh lifts are one of the more difficult procedures performed by plastic surgeons. The lower extremity typically has loose skin on the medial aspect making liposuction difficult and generally patients with major weight loss will have laxity of the anterior and medial thigh. Resection of tissue in this area is in a challenging anatomic area with lymphatic tissue and vascular tissue which can cause complications. Additionally the scar location cannot be totally hidden. Patients frequently will grasp the upper portion of their thigh and pull upwards mimicking the appearance they are hoping to achieve. Unfortunately the surgical equivalent of this is much more difficult and the tension transmitted by pulling of the thigh is never achieved as well with surgery. A vertical thigh lift involves an incision from the groin down to the knee. It can be combined with liposuction. It almost never achieves the same degree of tightness that patients hope for and pushing the limit by excising more tissue can lead to worse scarring. The skin of the medial thigh is very thin and does not allow for multiple layered closure which takes tension off resulting in sometimes unfavorable scarring. This patient lost 140 pounds after a duodenal switch. She had an abdominoplasty, brachioplasty and in a staged fashion had a vertical thigh lift which helped significantly in the very loose lax skin Of her thighs. Of course she had a scar which eventually does fade but never disappears.