Thigh lift scars and recovery - what can be expected?

Question

Hi all. Considering a thigh lift but worried about a few things so all help would be appreciated: 1. Is an infection or wounds splitting inevitable? 2. How do you go to the loo for a no.1 and 2 and how do you clean after so as not to get an infection ruin? My doctor wants dry wounds (no showers) for a week minimum so this is beyond me 3. I want a short vertical scar from groin to mid thigh rather than all the way to the knee) bc I am not ready for a full scar. I have seen 7 doctors so far and all of them said it’s guaranteed that the groin scar will migrate so I need to be prepared for that. I am therefore considering only the vertical scar (not groin). They all said it’s possible but may leave a small dogs ear (I think that is what it’s called). Any thought on this? Pros and cons? 4. For those who do have groin scar migration and is now showing under panty line- how conscious do you feel? 5. Doesn’t the compression garment actually irritate the wounds? Doesn’t the garment run against healing wounds when you pull it up, even if you try to be careful? Thanks in advance (best doctos visited : EFitzgerald, Mo Akhavani, Paul Tulley, Nikiforos Kranidiotis, London and Nicosia)

Serdar Bora Bayraktaroglu, MD · Answer

Wound complications: Splitting and infection are not inevitable. Strict rest and minimizing skin tension keep these risks low.Bathroom hygiene: Use a peri bottle with warm water to gently rinse after using the toilet, then pat dry with sterile gauze. Never rub or wipe.Vertical-only scar: Skipping the groin incision avoids scar migration, but leaving excess tissue at the top can cause a slight puckering ("dog ear"). This is easily revised later under local anesthesia.Compression friction: Layer non-stick gauze pads over your incisions underneath the garment to prevent chafing during wear and removal.

Zoran Potparic, MD · Answer

After consulting 7 surgeons you have too many unanswered questions? Unfortunately, without series of good photos or better, in person consultation, it is impossible to give you good advice. However , one thing is clear, well anchored  groin scar, when combined with vertical scar, does not drop in time. Good luck.

J. Timothy Katzen, MD, FACS · Answer

Hi GTP, Thank you for your question regarding thigh-lift scars and recovery and what can be expected.  
As you know, there are 6 different types of thigh lifts: crescent, modified longitudinal vertical medial, longitudinal vertical medial, complete medial, horizontal hip lift, and outer thigh lift. The crescent thigh lift is a thigh lift centered in the panty line. The concept is acceptable however, the crescent thigh does not remove much fat and has significant complications like scar migration, labial spread, and opening of the introitus. A critical step in a crescent thigh lift is securing the incision to the pelvic periosteum, the strong connective tissue layer that covers the pubic bone. Permanent sutures are used to anchor the crescent thigh lift scar to this stable structure, significantly improving the long-term durability of the repair. This specialized technique helps reduce one of the most important risks associated with a crescent medial thigh lift by minimizing downward tension on the incision. As a result, anchoring the scar to the pelvic periosteum decreases the likelihood of labial spreading, widening of the vaginal introitus (vaginal opening), and downward migration of the scar along the inner thigh. Proper fixation of the scar is an essential component of achieving both a functional and aesthetically pleasing result while maintaining the natural contour of the groin and upper inner thigh. Another highly effective option for treating excess inner thigh skin, loose thigh skin, and skin laxity is a modified longitudinal vertical medial thigh lift, also known as a modified vertical medial thigh reduction. During this procedure, a vertical incision is placed along the inseam of the thigh, beginning in the groin and extending downward beyond the lowest area of excess skin but not to the knee. A longitudinal vertical medial thigh lift extends to the knee. This approach allows for the removal of a substantially greater amount of loose thigh skin than can typically be achieved with a crescent thigh lift, making it an excellent choice for patients with significant skin redundancy extending farther down the thigh. The primary disadvantage of the vertical medial thigh lift is that the resulting scar is more visible because it extends along the inner thigh, whereas the scar from a crescent thigh lift is largely concealed within the groin crease. A modified longitudinal vertical medial thigh lift is performed under general anesthesia and typically requires approximately three to four hours to complete, depending on the amount of excess thigh skin being removed and whether additional body contouring procedures are performed simultaneously. Most patients should plan for a recovery period of approximately three to four weeks before returning to daily activities. During the first two weeks after surgery, stair climbing should be minimized to reduce tension on the incisions and promote optimal wound healing. Surgical drains are commonly placed to prevent fluid accumulation beneath the skin and are generally removed two to three weeks after surgery, depending on the amount of drainage. Careful adherence to postoperative instructions helps optimize healing, minimize complications, and improve the final contour and appearance of the thighs.
To answer your specific questions, a thigh lift incision opening is not "inevitable"; however, the incidence is about 30%. Urination will be managed with a bladder catheter for 7-10 days. For bowel movements, you will need to take the garment off and hover over the toilet with a toilet riser. Urine is sterile, so it will not cause an infection. Wiping after a bowel movement is handled with a handheld shower head or bidet. Most plastic surgeons do not have you bathe for 7 to 10 days or longer depending on your healing. If you want a short vertical scar (modified longitudinal vertical medial thigh lift), you run a higher chance of dog-ears or excess skin and fat at the end of the incision. If you have the incision to the knee (longitudinal vertical medial thigh lift), you will have less of a risk of a dog ear compared to a modified longitudinal vertical medial thigh lift. The "consciousness" of a migrated crescent thigh scar is patient-dependent. The garment can definitely cause friction on the incisions and lead to wound breakdown. Therefore, the thigh-lift garments need to be carefully tailored and modified so such issues do not happen. I hope that I have answered your question regarding thigh-lift scars and recovery and what can be expected. I hope that I have answered your questions regarding the thigh reduction. 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.)

Thigh lift scars and recovery - what can be expected?

Answers (3)

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