Attn: All Doctors That Specialize in Post Massive Body Contouring - What Can You Do for my Thighs? (photo)

There is a great difference in the doc you may choose for a "mommy makeover" vs. those that specialize in Post Massive WL patients. Out of the latter subset, I see many impressive results on those that a) lost <100 lbs or b) did not carry majority of weight in thighs. I have lost 200 lbs. My thighs and calves are a surgery challenge. I have come to the conclusion that I will most likely need a two stage procedure - a long thigh lift + an extended Medial + whatever you can suggest for calves.

Doctor Answers 6

Thigh Lift

Hi Onedimsim. Fantastic job on the weight loss. You actually look good considering you lost 200lb. I have seen pts look much worse than you. Why bring this up. It tells me 2 things. Your weight was well distributed and your skin tone is fairly good. I know you wanted to talk about your legs but as I specialize in post bariatric contouring and have to bring up your truncal laxity, as this is intimately connected to your thighs. I have not seen your back but suspect you have atrophy ( loss of fat and other tissue ) of your buttocks which are sagging as well. Depending to what extent I suggest having 2 surgeries.

1. A lower body lift with a spiral thigh lift and any suctiong of the thighs that may be needed. A butt auto augmentation and hip augmentation if needed can be done at the same time. All of this will lift your lateral thighs and upper medial thighs as well as lifting and as mentioned augmenting the buttocks and completely contouring the abdomed.

2. 6 months later a longitudinal thigh lift if necessary could be done excising excess skin down to the ankle. This would take care of the circumferential laxity of the thigh and calf.

You need to see a ps who does these procedures almost exclusively.

Good luck


San Antonio Plastic Surgeon
4.9 out of 5 stars 51 reviews

Massive weight loss thigh lift surgery medial thigh lift

Dear Onedimsim,
Congratulations on losing 200 pounds!  That is quite an accomplishment.   Since you did not include a picture of your thighs and calves, I will try my best to answer your question.
The majority of my practice involves massive weight loss patients. This means most of these patients have lost at least 100 pounds.  I have performed surgery on patients with much smaller legs than you and I have performed surgery on patients with much larger legs than yourself.
For your legs I would suggest a two step procedure. The first procedure would be liposuction of the anterior, inner (or medial), posterior thigh, and calves.  The recovery from this procedure should be approximately 2 to 3  months.  This will allow the swelling to go down and the skin to shrinkwrap around the remaining fat in your legs. You should take 2 to 3 weeks off work.  You will need to wear a compression garment for at least two months or more.
The second surgery would involve an incision in the inner or medial thigh.  This incision would extend from the groin to the inner knee.  Typically, liposuction to the calves fixes the problem. However, you may require an incision from the inner knee to the inner ankle.  This is rare; however, for someone who has lost 200 pounds, this maybe required.  
As this is a complex surgical procedure, please seek a board-certified plastic surgeon with a significant amount of experience in massive weight loss patients. In addition, since your weight loss is so extreme this should be covered by your medical insurance. Please find a board-certified plastic surgeon who is willing to submit this to your insurance company. Good luck on your weight loss journey and congratulations on losing so much weight.

J. Timothy Katzen, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 194 reviews

Body Contouring After Weight Loss

Every area of the body is affected following massive weight loss (MWL). Patients who have succeeded with massive weight loss can benefit from: facelift (rhytidectomy), breast lift (mastopexy), arm lift (brachioplasty), tummy tuck (abdominoplasty), buttock lift (total lower body lift), and thigh lift (thighplasty). These procedures are often done in a staged fashion (in multiple surgical procedures). There are many different approaches to grouping these procedures together. In general, multiple extensive simultaneous procedures should only be performed in centers with significant experience in body contouring. One approach for the massive weight loss patient is a "top down" approach: begin with mastopexy + brachioplasty in the first procedure; perform a total lower body lift (belt lipectomy or circumferential abdominoplasty with buttock lift) in a second procedure; in a third procedure, address the thighs with a thigh lift. Minor revisions may be required, and in these procedures, targeted liposuction--perhaps to the knees and calves--could be performed. Body contouring following massive weight loss is not without risk: deep vein thrombosis (DVT) is of particular consideration and lovenox/heparin shots are required. Make sure that you are in optimal health and at an ideal weight prior to surgery in order to maximize your outcome potential.

Adam J. Oppenheimer, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 189 reviews

The Management of Thigh Skin Sag

It's not unusual for massive weight loss patients to develop significant amounts of loose, saggy skin. This can affect almost any area of the body. For this reason, it's not uncommon for patients to require multiple procedures to correct these anatomic deformities.

Your history and pictures suggest significant amounts of skin sag of the buttocks, lateral thighs, posterior thighs and medial thighs following massive weight loss. Correction of this problem will require staged procedures to adequately address the entire circumference of your thighs.

In your particular case, I believe that performing a lower body lift as an initial maneuver would offer significant advantages. This procedure would remove lower back skin while simultaneously lifting the buttocks, lateral thighs and posterior thighs in an upward direction. This procedure would significantly improve the contour of the lateral and posterior thighs, but would only have a minimal impact upon the medial thigh.

For this reason, a medial thigh lift would be necessary as a secondary procedure. This operation could be performed six months after the original procedure. This procedure would remove excess skin in both the transverse and vertical dimensions. The operation utilizes an incision along the groin crease which is extended downward along the inner thigh towards the knee. It dramatically refines and improves thigh contour. It's associated with excellent clinical results and high levels of patient satisfaction.

If you're considering thigh lift surgery, it's important to consult a board certified plastic surgeon with experience in this area. This surgeon should be able to formulate a treatment plan that addresses your anatomic deformity and achieves your aesthetic goals.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Lateral / inner thigh lift after weight loss

An inner/ lateral thigh lift can be combined with an abdominoplasty to improve the contour of your thighs and remove excess skin.   The biggest problem with a thigh lift is longevity.  The weight of the thighs can tend to pull the scars down.  There are techniques that have been developed over the years to attempt to solve this problem.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Attn: All Doctors That Specialize in Post Massive Body Contouring - What Can You Do for my Thighs?

                      I perform dozens of thigh lifts a year.  An extended medial thigh lift may be the procedure for you.  An exam would be necessary to confirm.  Find a plastic surgeon with ELITE credentials who performs hundreds of body contouring procedures each year.  Look at website before and after photos and decide which surgeon can give the results you desire.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.