Crescent medial thigh lift - How much skin can you remove?

Question

When performing presurgical markings I know you open your legs to avoid removing too much skin during surgery. However, is there any danger in being slightly proactive and removing a little more than having your legs open allows for? Will you never be able to fully open your legs after? I figure the skin would eventually relax and allow for this or am I mistaken? I would like as much removed as possible to maximize the benefits of the procedure and am not worried about labia stretching (male).

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding the crescent medial thigh lift and how much skin can be removed. During a crescent thigh lift, an incision is made high up in the groin following the bottom of the underwear line. Tissue dissection is carried down the inner thigh, and a crescent area of upper inner thigh skin is removed. 
In my 20 years experience of performing crescent medial thigh lifts, usually, I can remove about four to five inches or about the width of your hand from most patients. In surgery, for the crescent medial thigh lifts, we base our skin resection on the elasticity of the skin and the resulting tension. Pre-operative markings assisting plastic surgeon, but do not fully commit a plastic surgeon to use the lower extent of the incision.Every patient is different in their markings. The problem with crescent medial thigh lift is wound dehiscence and opening. Wound breakdown is common with over-resection and early activity. I would not suggest removing too much skin. Even though your inner legs will relax if too much skin is taken with time, there is always the danger of wound dehiscence if too much thigh skin is removed. Therefore, in conclusion, I would go with your plastic surgeon’s suggestions on how much skin to remove. Pre-operative markings assist the plastic surgeon, but do not fully commit to the lower extent of the excision. Another key to the crescent medial thigh lift is anchoring the lifted thigh to fascia or periosteum along the pelvic bone. Anchoring the thigh prevents migration of the scar and sagging of the medial thigh skin with time. Thank you for your question regarding the crescent medial thigh lift and how much skin can be safely removed. When considering a crescent medial thigh lift or any type of thigh lift, seek an experienced, plastic surgeon who has performed hundreds of thigh lifts within their career. If you cannot find an experienced, plastic surgeon in your neighborhood, please consider traveling to another state. Good luck! If you have any more questions regarding medial thigh lift or thigh lifts in general, please contact my office. Sincerely, Dr. Katzen.

Kenneth Hughes, MD · Answer

The groin incision thigh lift can be very effective for the inner thigh, the posterior thigh, and even the buttocks if loose skin is present.  The flaps are anchored to some stronger tissue underneath to prevent migration, though it can still happen if tissues are particularly weak.

Paul C. Dillon, MD · Answer

A few things to consider:
Inner Thigh lifts can separate if the tension is too greatAt times, debulking is necessary through liposuctionA Vertical Incision may be required to achieve "tightening"Be prepared for the area to be tender after surgery (walking, going to the bathroom etc)Drains are usually placed"Tightness" has limits and usually the "Lift" does not make the skin near the knees and lower 1/3 of the thigh "tight".Prior skin laxity affects outcomeA history of smoking affects outcome.

Karthik Ram, MRCS, DNB · Answer

Hello thanks for sharing your query. The decision on how much of skin is excised depends on how much vertical lift is required and also based on quality of skin the tension present etc. Excising too much skin can increase complication, tension on wound and can lead to gaping of wound also the scar can migrate at a later date and be visible. You are right about the skin relaxing but you need to balance the risk with benefits. Consult a board certified plastic surgeon.

Ken Dolynchuk, MD · Answer

Great question! The upper medial skin excision is lmited by what is advanced in a vertical direction. You are correct in observing that this is the direction of maximal tension when spreading the legs. Hence the thighs are separated when marking these eclipses to minimize tension on the closure. If more skin redundancy is present the need for a vertical incision as well is incorporated into the plan. A”T” or “L” shaped scar is created. Hope this is helpful.

Vasdev Rai, MD · Answer

It is best to leave desins of surgery to surgeons who are actually going to do it.  There are multiple factors that are taken into consideration when surgey is planned and marked.

Crescent medial thigh lift - How much skin can you remove?

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