Thigh Lift

Thigh lift surgery is surgery to remove the excess skin and fat from thighs that develops with ageing or significant weight loss. It tightens the remaining skin and improves the contour of the thighs. Afterwards many people are much more comfortable wearing styles of clothing and sportswear that expose the thigh due to the improved shape.

Indications for Thigh Lift:

• Loose skin on the thighs
• Loose skin and fatty tissue on the thighs
• Bulky thighs due to excess fat

Limitations of Thigh Lift:

• Thigh lift surgery does not treat the lower leg. It primarily addresses the thigh area.
• A scar along the inner side of the thigh is necessary to perform thigh lift surgery. This may need to run into the groin crease on occasion to gain the optimal result. Milder cases may be suitable for short scar thigh lift or in select cases liposuction alone. If this scar is an issue for you, then you should not have thigh lift surgery.
• Significant changes in weight can affect the long term results of thigh lift surgery. Therefore if you are considering thigh lift surgery after weight loss, it is best to be at a stable weight with no further changes in weight planned before undergoing the surgery.

 Thigh Lift Procedure:

Pre and post surgery clinical photographs of your legs will be taken. Thigh lift surgery is usually carried out under general anaesthesia (while you are asleep) with an overnight hospital stay. The surgery usually takes between 1.5 and 2.5 hours. If drains are used, they are removed the next morning before you go home. You will be asked to wear a support bandage or garment for 4 to 6 weeks afterwards.

Liposuction:

If required (usually required), liposuction is usually done first before the skin excision procedure. In select cases where the skin tone is good and the issue is excess fat alone, liposuction may be the only technique needed for treatment This is not common and usually liposuction is carried out in addition to the main skin excision procedure.   It is carried out through very small incisions where fluid is infiltrated and then a suction cannula is used to remove the fat. A narrow metal tube (suction cannula) attached to a suction pump is inserted through the very small skin incisions and used to remove the unwanted fat by moving it through the area to be treated under the skin. Most surgeons inject a local anaesthetic and adrenaline solution beforehand to help reduce pain and bleeding. Power or suction assisted liposuction is normally used.

Thigh Lift:

Thigh lift surgery is done via an incision running down the inside of the thigh from just below the groin crease to the inside of the knee. The excess skin and fat are removed and the remaining tissue and skin are sutured back together improving the contour and shape of the thigh. The tissue is not pulled overly tight as this gives an unnatural appearance and can cause problems with a stretched scar or it may be too tight for the internal tissues of the thigh and can cause problems with a sharp cut off appearance between the area of surgery and the knee and lower leg area which are not involved in thigh lift surgery. The thigh contour needs to blend naturally into the knee and lower leg for the best appearance afterwards.

Short Scar Thigh Lift:

In some people, the amount of excess skin is mild. They may be suitable for a short scar version of the thigh lift procedure where a shorter version of the main procedure scar is used, that does not run along the thigh as far down. It is important to understand that not as much tissue removal or not as significant a tightening or contouring effect can be achieved with a short scar thigh lift.

Combination Surgery:

Thigh lift surgery is often combined with other body contouring procedures. 

Post-Operative Course:

You will have bruising and swelling in your thighs afterwards which will peak at day 2 to 3 and slowly resolve over the weeks following this. Most of this will go in the next 4 to 6 weeks but swelling can persist for up to 6 months. You will have a scar running down the inside of your thigh to the inside of the knee. You often have some temporary numbness of the overlying skin.

You will need to wear a compression garment for 4 to 6 weeks postoperatively. This helps to provide support to the skin and to keep swelling controlled.

Recovery:

Most people return to work after about 2 weeks depending on the nature of their work. Exercise or strenuous activities need to be avoided for 6 weeks post surgery. Light activities can be resumed within 2 weeks and normal activities are usually unrestricted after 6 weeks.

Complications:

While most thigh lift surgeries go smoothly and patients are delighted with the results, as with any procedure there are some risks associated with thigh lift surgery.

• Swelling and bruising. This will peak around day 2 to 3 post surgery and will gradually reduce after that. Most of the swelling is usually gone by 6 weeks but occasionally lasts longer than expected.
• If you have a tendency to bruise or bleed easily or take medications such as aspirin that make you more prone to bleeding, this may be a higher risk for you. It may be necessary to stop some medications in advance of surgery. Occasionally there is more bleeding than expected from the incisions or bleeding under the skin forming a haematoma. A return to theatre may be needed to deal with this.
• If an infection occurs, you will be treated with antibiotics and occasionally a return to theatre is needed to washout or further treat the wound.
• Slow healing. This may be due to one of the problems mentioned in this section such as infection or sometimes some areas are slower to heal than others or due to overdoing it after surgery. This is usually managed with dressings in the clinic.
• Wound dehiscence or opening up of part of the incision. This will slow healing and can happen if the tissues are pulled tightly together or if an infection, haematoma or seroma occur. If it occurs, it generally heals over time but may leave a poorer scar than expected e.g. widened or with a contour dip.
• Clots in the legs (deep vein thrombosis) can form due to the length of surgery and reduced mobility after the procedure. They can sometimes travel to the lung (Pulmonary embolus (PE)) and this can be very serious. While in hospital, you will receive blood-thinning injections and be asked to wear compression stockings. You should continue to wear the stockings for 2 weeks after discharge from hospital.
• Numbness or sensitivity of the skin of the thigh due to bruising or damage of the sensory nerves in the area. This is usually temporary but can persist as patches of numb skin on the thigh.
• Seroma. After surgery, the body naturally produces a certain amount of fluid as part of its reaction to surgery and attempts to heal the area.  Sometimes this fluid can build up underneath the skin after the drains have been removed and require drainage in the clinic with a fine needle. This may need to be repeated until it stops being produced.
• Suture spitting. The sutures used are normally dissolvable. Sometimes parts of these sutures can take longer to dissolve than anticipated and can cause some irritation and spit out.  Any remnants can be removed in the outpatient clinic and the area should heal well after that.
• Poor scar formation which may be tender, raised, lumpy, stretched, red or slow to settle
• Scar migration. At the time of surgery, the incision placements are planned for optimal effect and to be as discrete as possible given the nature of the surgery. Sometimes over time, the scar can gradually migrate lower in the thigh due to the effect of tissue tension and gravity. This may result in a more visible than expected scar in some styles of clothing and swimwear.
• No-one is perfectly symmetrical and we all have differences between the two sides of our body. These differences persist after surgery but are usually small enough that they are not overly visible and do not require any treatment. Occasionally further treatment is required to address a significant asymmetry following thigh lift surgery.
• Residual loose skin.  Sometimes due to the particular extent and distribution of skin laxity that is present, a small amount of residual loose skin is present after thigh lift surgery. This should be significantly less than that present preoperatively but can still be a source of disappointment afterwards.
• Visible scarring. While every effort is made to place the thigh lift scar in as inconspicuous a location on the inner arm as possible, the scar will run the length of the inner thigh and may be visible from certain angles and in certain styles of clothing.
• Bulge at the knee just below the operated area resulting in a visible “cut-off” point between the reshaped thigh and the unoperated lower leg
• Distortion or pull on the vulva.  Although thigh lift incisions are carefully planned before surgery to minimise the risk of this happening, on occasion a tight thigh lift scar can cause a pull effect on the external female genitalia causing a distortion or gaping of the vulva.
• Lymphoedema where fluid drainage channels in the leg are disrupted by the surgery and therefore the leg tends to swell to a varying degree
• Disappointment with the result. Sometimes after undergoing thigh lift surgery, patients are disappointed with the result. This may be due to one of the problems described above occurring or due to unrealistic expectations of the surgery e.g. mild asymmetries, visible scarring or less than expected definition of the thigh area.  It is important that you discuss your expectations in advance of the surgery so that you can understand what to expect from the surgery and so this situation is avoided as much as possible. (Additional costs may be incurred for further procedures.)

 Longevity of Procedure:

Thigh lift surgery has a high success rate and is considered an excellent procedure for contouring the thighs. The improvement in your thigh contour is apparent early on although it is 6 to 12 months before the final result can be seen. The results are usually very long lasting.

The natural ageing process of the body continues regardless of surgery and so may over time alter your body shape leading to recurrence of loose skin. Significant changes in weight can also affect the longevity of thigh lift surgery.

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