Liposuction or Thigh Lift After Weight Loss?

I have gone from 22 stones to 14 stones over a course of 6 years. The skin on my inner thighs droops down. I was considering a thigh lift but after going for a consultation, the surgeon recommended a liposuction and said that with compression garments and massage, the skin should go back into place. I do have some stretch marks on my inner thighs so I am wandering, will my thighs look worse after liposuction? I am worried about having liposuction and then only discovering afterwards that I will still need to remove excess skin. What would you recommend I should do?


Doctor Answers 10

Liposuction Medial Size after Weight Loss?

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Thank you for the question and congratulations on your weight loss.

Liposuction of the medial thighs is a procedure potentially fraught with complications. The skin in this area tends to be very thin and patients tend to be more prone to have skin contour irregularities and unsatisfactory cosmetic results after liposuction of the medial thighs.  Based on your description of significant weight loss in the presence of stretch marks ( loss of elasticity) I would probably recommend that you don't have this procedure done.  Of course, nothing replaces direct physical examination  to determine whether a patient is a good candidate for procedure.

I hope this helps.

Sagging skin gets worse with liposuction

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Sagging skin after weight loss only gets worse with liposuction. Compression garments and massage do not lift or tighten the skin. Only a thigh lift can get rid of the excess skin and tighten your thighs. It is likely that the physician who suggested liposuction is not really trained in plastic surgery and liposuction is the only option that they have to offer you.  When the only tool you have is a hammer, the world begins to look like a nail.  Stay away from that doctor!

After Weight Loss, Excess Skin (NOT fat) is the Issue

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Unless you have excess fat, avoid liposuction.  Excess folds of skin ESPECIALLY in the inner thigh area are notoriously prone to sagging even in individuals with good skin tone.

A thigh lift of course involves more scars, but the results far surpass those of lipo.

Loose skin needs excision, not liposuction

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Plain and simple, loose skin needs to be excised as liposuction will not cause it to shrink well in my experience.  Time to visit another surgeon and make sure they are a real plastic surgeon, not someone else who only does liposuctiuon and thus wants to do it on everyone because that's all they can offer.

Thigh Lift More Suitable Most Likely

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Generally, after losing a lot of weight it can be difficult for the skin to tighten back up again. Liposuction may remove any stubborn fat deposits in your thighs, however it has been my experience that any obvious sagging present before surgery remains afterward, and can even get worse. As a result, a thigh lift would probably be better suited. Some of the stretch marks can also be removed, depending on where they are located. You will have more scarring, however liposuction will probably be insufficient in addressing your concerns.

For the treatment of loose skin in the medial thighs following weight loss, skin

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excision in the form of a thigh lift is usually necessary to achieve the desired result.  Typically, a good result from liposuction depends on the skin tightening up after the fat has been removed, much as the loose abdominal skin will tighten after pregnancy.  In the case of excess skin after weight loss, this elastic quality of the skin has already been compromised, and it is unrealistic to expect that you will get the necessary skin tightening from liposuction alone.  Removal of an ellipse of extra skin, tightening the distal thigh skin to the groin crease in multiple layers is the best way to achieve the smooth look you are looking for.  Although most patients are very satisfied with this approach, be aware of the scar in the groin crease, which is well hidden but not invisible. 

Michael H. Rosenberg, MD
Mount Kisco Plastic Surgeon

Just a stones throw

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We are not familiar with stones. However, after massive weight loss part of the problem is usually loose skin. Liposuction, by whatever means usually does not address loose skin to any significant degree. It is an option to perform the liposuction and wait to see how much skin shrinkage you get, then come back at a second stage and remove the leftover skin. This staged approach may allow your surgeon to limit the scarring that you would get from a primary thigh lift. Good luck!

Seek another opinion

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From what you describe - loose skin following weight loss - more weight loss or liposuction in this area may create more loose skin in the long run. It is always hard to recommend a procedure without an examination and their may be reasons for your surgeon to recommend the liposuction over removal of skin. Perhaps that is something he does more often and feels more comfortable offering this. You can always seek another opinion if you are unsure about the plan. Best wishes.

Charles Perry, MD
Sacramento Plastic Surgeon


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Congratulations on such a weight loss. Good job. It is difficult to answer your question accurately without a physical examination nor pictures. However, based on your history, I do not think liposuction alone will fix your problems. I believe that your skin has been stretched out too much from weighing 22 stones.  When you lost 8 stones, your skin tried to shrink around the fat that was lost from your inner thighs.  However, your skin has only so much you elastic qualities.  I do not believe by just removing excess thigh fat that your thigh skin will shrink wrap around your new thighs and you will wind up with smooth, smaller thinner thighs. Regardless of the expertise of your plastic surgeon, the type of liposuction machine used, and the type and length of compression used will significantly change the fact that you will probably need a medial thigh lift later.
With that said, it still may be worthwhile doing liposuction.  Some reconstructive plastic surgeons perform liposuction several months ahead of a medial thigh lift anyway. This allows for debulking of fat and may lead to a better medial thigh lift final result.
If I were you, I would do the leg liposuction and see what everything looks like.  Everyone is different and your results may be "acceptable" for you. However, based on your history, I believe your best results would be with a inner or medial thigh lift at a later date. Congratulations on your weight loss and good luck with your reconstructive plastic surgery.

Thank you,

J. Timothy Katzen, MD, FACS

Proceed with the thigh lift, lipo can be done later if needed

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If you are planning a thigh lift, you could always reserve that for after liposuction if your skin doesn’t retract enough after the procedure. The inner thigh is one area that is more prone to sagging than other areas. There certainly is a chance that you will have more irregularities or sagging then you want, after liposuction especially if you have a lot of stretch marks.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.