Hello, and thank you for your question regarding your thigh concerns and whether a thigh lift is your only option, since you're hoping to avoid thigh lift scars. Thank you also for sharing your history and photos—they're very helpful in understanding your case. From your pictures, you appear to have excess fat and loose skin extending from the groin all the way down to the knee, including the upper, middle, and lower thirds of the thighs. This combination of fat and skin laxity is often caused by massive weight loss, prior liposuction, genetics, or sun damage. While it may be tempting to consider less invasive options like liposuction alone, doing so would likely make the wrinkled, loose skin worse—not better. In your case, the most effective solution would be a thigh lift—specifically, a longitudinal vertical medial thigh lift. This procedure removes both skin and fat through an incision that runs from the groin to the knee along the inner thigh. During the surgery, liposuction is first performed on the anterior, lateral, and medial thighs to contour the area. Then, a large ellipse of skin and fat is removed to tighten the thigh. The procedure takes approximately 3 to 4 hours and is done under general anesthesia. Typically, one or two drains are placed per thigh and remain in place for 2 to 4 weeks, depending on your healing and drain output. Recovery usually takes about 2 to 3 weeks if you have a sedentary job, and up to 4 to 6 weeks if you’re more active. You’ll need to wear a medical-grade compression garment to help control swelling, minimize tension on the incision, and improve your scar’s appearance over time. I understand that the idea of a scar may be concerning. However, patients often find that trading the excess skin and tissue for a scar is well worth it. Most are extremely satisfied with their results and gain a significant boost in confidence and comfort. Other treatments like radiofrequency, microneedling, or Morpheus8 won’t be strong enough to meaningfully tighten skin or remove deep fat in this area. They may work well for minor skin concerns, but they simply won’t deliver the kind of transformation you're looking for. Ultimately, the decision is yours—but based on your anatomy and goals, the longitudinal vertical thigh lift offers the most reliable and effective outcome. I hope this explanation was helpful in understanding your options. If you have any questions regarding the thigh lift, vertical thigh lift, medial thigh lift, spiral thigh lift, crescent thigh lift, or thigh liposuction, please consult with a board-certified plastic surgeon who has extensive experience in body contouring after massive weight loss. Be sure they’ve performed at least 150 thigh lifts and can provide clear before-and-after photos. Take your time researching their credentials and reading verified patient 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.)