Thigh Lift after Massive Weight Loss
Dr. Peter Fisher is a renowned authority in plastic surgery following bariatric surgery and significant weight loss. He performs thigh lift after massive weight loss at his San Antonio, TX, practice to give you firmer, more attractive legs. Contact us today to learn more about how our innovative techniques are giving patients the results they deserve.
This is the least commonly performed procedure following weight loss, typically because:
- Most potential patients have heard that the results are not favorable.
- The incisions and subsequent scars are very long.
- Many potential patients feel that this area is covered and therefore proceed with other procedures first and never get to do the thighs.
Results are unfavorable when the incorrect procedure is done and when the patient's anatomy is not ready for this. If the thigh contains too much fat, just excising skin can, although not always, give a poor result. Deflating the thigh by liposuction prior to the thigh lift can enhance the results.
When thigh lifts are performed, I usually will do them with an upper body procedure and not at the same time as an LBL. I will, however, do a spiral thigh lift at the same time as an LBL.
- Longitudinal incision – 1. This incision is used when skin laxity extends all the way down to or even past the knees, sometimes to the ankle. There is vertical and horizontal skin laxity in this situation. If there is a lot of vertical skin laxity high on the thigh, an extension is then needed to accommodate this excess in an oblique direction adjacent to the labia in the groin crease as far laterally as needed. Sometimes the incision is run medially into the buttock crease as well.
- Spiral thigh lift – this is done for vertical skin laxity that is present only high on the thigh. It also helps define the buttock crease better and improves the shape of the lower buttock and posterior upper thigh, especially when ptotic (hanging). The incision starts at a point just lateral to the midpoint of the posterior thigh, then runs all the way around past the labia into the groin crease and up to the hip area. It can extend all the way along the top of the buttock to join the incision from the opposite side in the midline, helping elevate a ptotic buttock and or even auto-augmenting the buttock. Someone who has already had a tummy tuck and was happy with it, but not their thighs or buttocks, would get this procedure.
- Oblique thigh lift – This is rarely done, especially in massive weight loss patients, as it is only indicated in those patients who selectively have loose thigh skin high on their thigh and in the front.
Stop all anti-inflammatory drugs as well as vitamin E and any estrogen medications two weeks prior to surgery. The patient is seen in the office two to three days prior to surgery for final counseling, given their prescriptions, photos taken and markings applied. The patient is measured for a girdle which is then ordered. We suggest the patient rent a walker.
Numerous different incisions are used for this according to the severity and direction of skin laxity. A lot of patients will still retain a significant amount of fat in their thighs following weight loss. It is possible to “deflate” the thigh using liposuction at a surgical setting prior to the thigh lift. This allows for a better result, by being more aggressive with the skin removal, at a second surgical setting. This cannot be done when the thigh still has a lot of fat within.
When there is significant skin laxity, a vertical incision will always be needed. When this laxity is both in a vertical and transverse direction, an oblique incision in the groin, and sometimes in the buttock crease, is needed. When skin laxity is high on the thigh and vertically oriented, then an incision in the groin and buttock creases alone can be used. This is often termed a spiral thigh lift. This not only helps elevate loose posterior thigh skin, but also helps to better define and position the buttock crease and lower buttock contour. If skin laxity extends all the way down to the ankle, then the vertical incision can be taken all the way down to the ankle, keeping it on the inside of the leg.
The thigh lift is often done at the same time as one or more of the upper body procedures.
The patient is kept in the hospital at least one night and discharged when comfortable. When drains are used (for the longitudinal procedure only), they are taught how to empty, strip and record them. Our office supplies a measuring cup and recording sheet to you at the pre-operative visit. If appropriate, the girdle is placed now or immediately after the surgery. The nurse will call every two days to check on you, and you are encouraged to call with any concerns you may have.
Please contact us today to schedule a consultation with Dr. Fisher.
Dr. Fisher has been available to answer all of my questions and provide me with not only professional medical expertise, but also a much appreciated level of personal empathy. I would 100% recommend Dr. Fisher to anyone who is considering plastic surgery.Brandi