Northern Virginia- Fairfax and Manassas
By: George Bitar, M.D. and Larry Lickstein, M.D.
Board Certified Plastic Surgeons
Toned and proportional thighs give a person a great deal of satisfaction and a healthy self-image. When the middle thighs rub together, or the outer thighs are disproportionate to the hips, a person can have significant grief. When someone loses weight, inherits bad genes, or simply ages, the inner thighs can sag, leaving the body contour with an unpleasant aesthetic appearance. Exercise may tighten the muscles and reduce the fat, but it will not be able to improve sagging skin that has lost elasticity. The best solution is an inner thigh lift.
The inner thigh lift operation has gained a lot of popularity in recent years due to gastric bypass surgeries and a large population of people who are left unhappy with the sagging appearance of the inner thighs. Outer thighs are usually not affected with the factors mentioned above, as much as the inner thighs. Also, outer thigh skin, in general, tends to have more elasticity, and is more forgiving than inner thigh skin. Therefore, an inner thigh lift is a more popular procedure. We address outer thighs with liposuction or with another operation, a lower body lift, which addresses sagging outer thighs, buttocks, and the abdomen.
An inner thigh lift is a straightforward operation with very high satisfaction among patients because it enables them to have more toned inner thighs, more self-confidence, more ability to exercise, and more fashion choices. The scar on the upper aspect of the inner thigh is well tolerated, given the benefits of this procedure.
An initial consultation is set-up where we discuss the inner thigh lift procedure, and whether you are a good candidate for the surgery. Your medical history is reviewed, and you will be asked to see your medical doctor for a physical check-up and a few labs to make sure you can undergo the surgery safely. You are given the opportunity to be seen by your own doctor to give the green light for surgery. You are asked to stop smoking, if you are a smoker, two weeks before and two weeks after surgery, for the surgery to be performed safely, and for you to have optimal results. You are given the opportunity to talk to patients who have had the same surgery you are considering. We will see you shortly after the surgery (in a day or two usually). You are seen regularly after your surgery. You are always welcome to come back for follow-up, even years after your surgery, free of charge.
Patients who are not happy with the way their inner thighs look may benefit from one of three procedures:
- Inner Thigh Liposuction: For people with good skin tone, good muscle tone, and excess fat of the inner thighs.
- Inner Thigh Lift: For people with loose muscle tone, excess thigh fat and loose skin in the upper aspect of the inner thigh.
- Extended Inner Thigh Lift: For people who have very loose skin, very loose muscles, and a large amount of excess fat extending from the groin to the inner aspect of the knee.
Inner Thigh Liposuction: This procedure is performed with a tumescent liposuction technique with minimal scarring, minimal downtime, and excellent improvement for the appropriate patient.
Inner Thigh Lift: The appropriate candidate for the thigh lift procedure is a patient who has loose skin, or loose skin and excess fat of the upper thigh. The way an inner thigh lift is performed is by resecting a crescent-shaped segment of skin and fat of the inner thigh extending from the mid-thigh in the back, to the mid thigh in the front, just below the groin crease. This will remove the excess skin of the upper inner thighs that rub together, and tighten the inner thigh. The resultant scar is usually hidden with clothes.
Extended Inner Thigh Lift: The appropriate candidate for the thigh lift procedure is a patient who has very loose skin, very loose muscles, and a large amount of excess fat extending from the groin to the inner aspect of the knee. This procedure is an extension of the inner thigh lift, described above. After the crescent-shaped skin is excised from the upper inner thighs, excess skin is excised along the inner aspect of the thigh tapering down to the knee. When the skin is removed, and the incisions are closed, the resultant scars are T-shaped or L-shaped, extending down to the knee. This technique leaves more obvious scars than the inner thigh lift technique, but its advantage lies in the ability to remove a significantly larger amount of inner thigh skin. Sometimes drains need to be placed under the skin with this technique, since the surgical area is larger, to manage any post-operative bleeding.
At the Bitar Cosmetic Surgery Institute, we take pride in making sure we provide for our patients the best surgical experience possible , anticipating problems or set-backs, and addressing them before they happen. This is a process that includes the pre-operative preparation, the actual surgery, and the after care.
General complications can occur with any surgery. Cosmetic surgery is usually a safe surgery performed on healthy patients and, as all surgeries go, is with low risk. What we do to even lower the risk of complications is to operate at a first class hospital with board certified anesthesiologists and nurses. To avoid post-operative complications, we advocate early mobilization –patients seen in our office one or two days after surgery- and active participation in their own post-operative care. When we create a partnership, the results invariably improve.
Bleeding after a thigh lift is rare. Before surgery, our patients are tested to make sure they don’t have any common bleeding disorders by their own physicians, and by lab tests. The use of tumescent solution before liposuction of the thighs, if it is performed during a thigh lift, minimizes bleeding. Also, at the end of the extended inner thigh lift operation, a drain is placed under the skin in each thigh to manage any early post-operative bleeding. In our practice the rate of significant bleeding is less than 1%. The treatment of a hematoma or a blood clot under the skin of the thigh is to open the incision and evacuate the blood clot. Typically this is a straightforward procedure.
The most important step in avoiding infections/wounds, in my opinion, is to perform the surgery at a first-rate surgical facility with board certified anesthesiologists and nurses. Patients are given the appropriate intravenous antibiotics coverage throughout the surgery. During the surgery, the skin surface of the patient is cleaned properly. After the procedure, my patients are prescribed a one-week course of antibiotics to minimize infection. As a result of these extra precautions, our rate of infection after a thigh lift is extremely rare. Conservative removal of skin is important for the results to be good, but also so that the skin is not under too much tension after the thigh lift. Small to moderate sized wounds in this procedure happen about 20% of the time, given the tension on the inner thigh incisions. Wounds will usually heal nicely with dressing changes and antibiotic ointment. Occasionally, we will do a scar revision to improve the aesthetic outcome of inner thigh lift scars, given that they heal under significant tension.
The way to minimize nerve injury is to resect a conservative amount of skin, thus creating minimal tension in the thigh, but yet achieving an aesthetically pleasing result. Occasionally, nerves can get stunned or bruised, and function may take a few days to weeks to return. Our rate of significant nerve injury in thigh lifts has been non-existent.
In women who have inner thigh lifts, if the incisions are made too close to the vagina, and the skin is closed only superficially, then the appearance of a “gaping vagina” may occur. This is an unsightly complication from an inner thigh lift procedure. In order to minimize the occurrence of this known complication, the scars need to be placed relatively distant from the vagina, and the skin needs to be sutured in multiple layers to avoid tension on the vagina. In my practice, we have not had this complication.
Smoking is an absolute contraindication in thigh lift. The carbon monoxide and nicotine in cigarette smoke causes severe reduction in blood supply to the skin and tissue during healing. This results in delayed wound healing, wound separation, death of the skin, and a higher risk of infection. Cotinine testing is performed in patients with a smoking history to ensure that they are safe when having this procedure.
Our office will provide you with a detailed post-operative instruction sheet that will be individualized to your needs. We usually see patients the day after surgery in one of our offices to make sure that everything is O.K., and that you are healing as planned. Multiple visits in the year after the procedure will ensure the best outcome possible.
For more information about this procedure call our office and speak to our friendly staff member at 703-206-0506.
Information on this web site is for information only. Do not use the information to diagnose or treat your plastic surgery or cosmetic surgery problems. Please contact your plastic surgeon with all questions and concerns.