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?

J. Timothy Katzen, MD, FACS · Answer

Hello, Generous420962 from South Burlington, VT. Thank you for your question about a 35-pound weight loss, loose skin on the thighs, and which procedure would be best. Thank you for your history and photos. Regarding the thigh lift/reduction, there are 6 different types of thigh lifts: crescent, modified vertical medial, longitudinal vertical medial, complete medial, horizontal hip lift, and outer thigh lift. You have type 4 thighs with excess skin (cutis pleonasmus) and loose skin (dermatochalasis) on your inner thighs from the groin to the inner knee. The most effective way to address the issue is with a medial thigh lift from the groin to the inner knee. This is called a longitudinal vertical medial thigh lift. This procedure involves removing a large ellipical area of excess skin and fat from the inner thigh. A longitudinal vertical medial thigh lift is performed under general anesthesia and typically takes 3 to 4 hours. You should plan for a 3- to 4-week recovery period, keeping in mind that stairs must be avoided for the first 2 weeks. Surgical drains will be placed during the procedure and are generally removed 2 to 3 weeks post-op. To obtain an accurate assessment of what exactly you need, schedule a free virtual consultation. Most plastic surgeons offer free virtual consultations. I hope I have answered your questions about a 35-pound weight loss, loose skin on your thighs, and which procedure is best for your thighs. If you have any more questions regarding the thigh lift, thigh reduction, vertical thigh lift, medial thigh lift, spiral thigh lift, crescent thigh lift, or thigh lipo, contact an experienced plastic surgeon. Please seek an experienced, board-certified plastic surgeon with significant experience performing thigh lifts. Do your research. Make sure your chosen plastic surgeon has performed at least 100 thigh lifts. Be certain they have the before-and-after pictures to prove it. Carefully examine their before-and-after pictures and check their reviews on RealSelf. Sincerely, Dr. Katzen, MD, MBA (President of  the American Society of Bariatric Surgeons; Certified by the American Board of Plastic Surgery; Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery; and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

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)

Answers (4)

More Thigh Lift Questions

Sudden lipedema and EDS like connective tissue issues after HRT - is knee lift or mini thigh lift needed? (Photos)

Is labia distortion common with thigh lifts?

What can be done about my posterior thigh and butt area post weight loss? (Photo)

Skin still hanging almost 1 year post thigh lift - Do I need a thigh lift revision? (Photos)

80 pound weight loss. Are crescent or spiral thigh lifts an option for me? (Photos)

Lipedema - I have had two thigh lift surgeries and multiple sessions of liposuction. What other procedures would help? (Photo)

WE SEND PRETTY
EMAILS