Can my thigh dent be fixed safely? (photos)

Question

I am apprehensive about fat grafting because my thigh dent is located to a large vein or artery, and I am afraid of a fat embolism. Will the fat be able to survive after fat grafting if I continue to work out with leg weights. Would a silicon implant fill out that area. I've never seen or come across anyone with my specific condition.

Robert M. Tornambe, MD · Answer

While physical exam is optimal, from your photos, it appears that you would be an excellent candidate for fat grafting to correct the problem. I have successfully corrected many similar Lipo contour deformities referred to me over the years. The chances of fat embolism are very low, even with the vein nearby, as it can be marked and avoided. You can return to vigorous physical activity about 2 weeks postop. Forget about silicone implants for this problem. Seek out an experienced board certified plastic surgeon with experience correcting Lipo contour irregularities. Good luck!

John A. Millard, MD, FACS · Answer

Yes, this can be fixed!  I use a five step process in my practice and others techniques may vary, but the principles are the same,  The dent is caused by a combination of fat deficit and connective tissue contraction. Both need to be addressed to achieve the best results.  In my practice I would firs use an ultrasound image machine to study the scar tissue un there if the indentation.  This same ultrasound image technique would then be used fro targeting of the connective tissue for selective cutting by the VASERSmooth.  Next, superficial liposuction with the VASER would help release the overlying skin to allow it to re-drape better. After this I would use an instrument called a "Disruptor" to expand the scared connect tissue area.  I would then fat graft the area under ultrasound and finally use an instrument called a fat integrator to more evenly distribute the fat.  There are several different ways to skin a cat to fix you dent.  Would just make sure that your plastic surgeon has both a plan and experience with his or her techniques in this regard.  Good luck!

Khashayar Mohebali, MD, FACS · Answer

Fat grafting is a much safer and better solution than implants into your thigh.  The area looks safely away from major arteries and veins and fat would give you the best chance of a natural result.

Curtis Perry, MD · Answer

First the area of the depression is quite far away from any large vein or artery and this should be no risk of coursing an embolism from the procedure performed by a competent surgeon. Once the fat from the grafting procedure takes is there permanently. So you should have no worry performing vigorous exercise after you have allowed a period 2 to 3 weeks for the healing of the grafted tissues. Fat is entirely natural your tissue and is what was there prior to the creation of the defect. So it is the ideal reconstruction material in your situation. Properly performed grafting is going to give you the best blending into the surrounding areas. As the size of defects get larger it is not uncommon to require a touch up procedure 3 to 4 months after the initial procedure to achieve the best contouring results.Silicone injected into that l large a defect would very likely become lumpy and very firm.Good luck

Barry L. Eppley, MD, DMD · Answer

I have and treated such thigh dents before, almost always after a traumatic injury. Fat grafting is much better long-term than silicone implant and you have two choices. Injectable far grafting would be the first option and is done with a blunt cannula for injection so there is no risk of intravascular injection. The second option is an actual enbloc dermal-fat graft which is placed through a small incision in the central aspect of the dent. It requires a harvest site and it is best if you have a c-section scar to use for it.

Steven Wallach, MD · Answer

What was the cause of your dent?  That is important to know. Fat can be placed in some defects if an adequate blood supply can be obtained in the region.

Samir Shureih, MD · Answer

Ideally would like to know the cause of the dent in the thigh, how deep. Fat grafting is the ideal rout to fill the dent, may require multiple fat grafts to get the right contour.Using the blunt cannula and expertise in fat grafting would lessen the risks involved.

Vincent P. Marin, MD, FACS · Answer

From your photos, it appears that you have a contour deformity on your thigh. Traditionally, this is best corrected with a fat grafting procedure. Although fat embolism is a risk of this procedure. it is very uncommon. Using blunt cannulae to inject the fat also significantly reduces the risk of this. You should see a board certified plastic surgeon in your area to get a formal opinion through an in-person consultation.Best of luck,
Vincent Marin, MDSan Diego Plastic Surgeon

Can my thigh dent be fixed safely? (photos)

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