35 pound weight loss - loose skin on thighs. Which procedure? (Photos)

Question

Hello, I’m a 52 year old woman who’s lost about 35 pounds in the last year. I’m 5’5” and weigh about 115 and have been stable for about 6 months. I’ve truthfully never loved my thighs. I work out 5 days a week, eat healthy, non-smoker, take vitamins, collagen and creatine. I am now just sad to have muscle covered by loose skin. I’m not expecting perfection, nor do I want it, that would seem strange at my age. But I’d love to lose some skin. I had a breast lift and implants 12 years ago and understand scarring. Mine are well healed and virtually invisible. For some reason I’m struggling with the thought of having a scar from groin to knee. This is something I’d love to do, my family supports and I have the ability to take time off to heal. I’m also willing to travel for the best results if necessary. I’m in New England. Thoughts?

Jacob Carlson, MD · Answer

First off, congratulations on your weight loss! That is awesome.
Based on the information your provided, your BMI is 19.1. With that is mind, I think you are correct in saying that what you are seeing is mostly "loose skin" and not a significant excess of underlying subcutaneous or fatty tissue. To determine the best surgical approach to address the loose skin, I usually ask my patients (and obviously assess them in person when I see them) what area of loose skin bothers them the most.
Your description of a scar from the groin to the knee is consistent with a Longitudinal thigh lift. These are good at addressing excess skin and tissue that is present AROUND the thigh. The longitudinal thigh lift doesn't do a great job of LIFTING up the skin around the knee region, but it does do a good job of tightening the skin around the leg circumferentially. This option is obviously more invasive than the Crescent thigh lift, but it does a better job of lifting the skin up at the inner, front, sides, and even some on the back of the thighs if needed.
If most of the laxity is on the upper inner thigh, a Crescent thigh lift would place the scar in the groin crease and underneath the buttocks to lift up and tighten the skin on the inside of the thigh, roughly from the level of the mid-thigh to the groin. This option doesn't do much to the skin around the knee or the front of the leg.
Some patient need a combination of of the Longitudinal and the Crescent thigh lifts to address laxity in both of the skin around the leg and on the inside of the thigh.
Another option that some surgeons perform is called a Spiral thigh lift. The Spiral thigh lift is essentially an extended version of the Crescent thigh lift. The scar is placed in the groin crease, extends back underneath the curvature of the buttocks (infragluteal fold) near the inner thighs, and also extends up around the top of the buttocks from the sides.

Zoran Potparic, MD · Answer

It is very likely, based on these photos, that a thigh lift would be a good procedure for you. However, there is a significant underlying cellulitis contributing to skin laxity. You can expect that tightening of the skin will improve this condition to a certain degree, but not completely eliminate it. Good luck

Gerald Minniti, MD, FACS · Answer

Only a skin removing surgery will accomplish your goals well. The majority of the 'lift' is actually not vertical in direction, but horizontal/circumferential. The incision runs from the inner knee to groin, then up either side of the pubis towards the inguinal ligament (the bottom of your abdomen near the upper edge of your pubis).

35 pound weight loss - loose skin on thighs. Which procedure? (Photos)

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