I am so embarrassed by my flabby legs, cellulite and thick ankles. Can this be helped? (photos)

  A thigh and buttock lift may produce the most improvement, but I would have to discuss goals and expectations with you.Kenneth Hughes, MDLos Angeles, CA

It's not unusual for massive weight loss patients to develop loose, saggy thigh skin. This excess skin can cause a multitude of functional and aesthetic problems. For this reason, it's not unusual for patients to request surgical correction of this problem.A variety of surgical treatments are available to treat this condition. These procedures are tailored to meet the patient's aesthetic goals and address their anatomic findings.Your pictures demonstrate excess skin in both the transverse and vertical directions. Correction of this deformity will require a medial thigh lift. This procedure will require a groin incision which is extended along the inner thigh towards the knees. The procedure removes excess skin in multiple dimensions and significantly improves leg contour. It's associated with excellent clinical results and high levels of patient satisfaction.If you're considering a medial thigh lift, it's important to consult a board certified plastic surgeon with experience in this area. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

It is hard to evaluate the quality of your skin from your photographs.  This is the most important indicator of whether or not you would get improvement with liposuction.  Tightening the skin is a bit more elusive.  There are radiofrequency methods such as Vanquish and internal radiofrequency modalities such as ThermiTight that are showing promise.  Best to get evaluated to determine the best treatment for you.