Hello, and thank you for asking whether you could get a thigh lift with incisions under your butt and groin area to remove loose thigh skin. Thank you for your history. Conceptually, it is possible to have a thigh lift, also known as thigh reduction or thighplasty, with an incision placed high in the inner groin and underneath the buttocks. The incision you describe is well-known to experienced plastic surgeons specializing in weight-loss patients. The thigh lift incision pattern you describe is called a crescent or spiral thigh lift. Some other plastic surgeons call the crescent thigh lift a mini or hidden thigh lift. The benefit of the incision is that the scar is hidden. The disadvantages of this procedure is that not much upper inner thigh skin is removed, possible risk of scar migration down the inner thigh, labral spread, and opening of the introitus or entrance to the vagina. If you only have a mild defect in the upper inner thigh, the hidden groin incision may be your best option. However, it is impossible to say if the surgery would be adequate in your case without pictures or a physical examination. So, pictures would be helpful, but a thorough physical examination is in order. You are correct in that liposuction would likely cause loose skin in your condition due to your age and description of the skin type of your thighs. A more reliable thigh lift is an incision partially down the inner thigh from the groin. Some patients need this incision extended from the inner thigh to the knee. This is the most common thigh plasty, or thigh reduction surgery. Usually, liposuction is included in thigh lift surgery. In your case, consider initially thigh liposuction, and then at a later date, a thigh lift from groin to inner thigh for maximum results. The benefit of staging the procedure is that more thigh skin can be removed, and the risk of wound dehiscence or opening is decreased. Good luck. I've answered your question regarding whether you could get a thigh lift with incisions under your butt and groin area to remove loose thigh skin. If you have any questions regarding thigh lift, thigh reduction, vertical thigh lift, medial thigh lift, spiral thigh lift, crescent thigh lift, or thigh lipo, please get in touch with a thigh reduction expert's office. Thighplasty surgery is difficult. Thighplasty revisions are even more difficult. 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. Make sure they have the before and after pictures to prove it. Please carefully review their before and after pictures and check their reviews on RealSelf. Sincerely, Dr. Katzen. (Plastic Surgeon, President of the American Society of Bariatric Plastic 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 and RealSelf Hall of Fame.)