Would skin tightening or lipo help with the sagging appearance behind my thighs? (Photos)

Question

I had previously went from 175lb to 90lbs and am now 135lbs. i included picture because i don’t really know how to describe it but the area behind my thigh, right beneath my butt seems so sag. i was wondering was procedure would help minimize the appearance of the sagginess.

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. Helps reduce appearance of Cellulite by helping aid the production of collagen and tightening the skin. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

Thank you for sharing the details and photos—it really helps to understand what you’re describing. From your description, it sounds like the sagging you’re noticing behind your thighs is mostly excess or lax skin, rather than excess fat. This is common after significant weight fluctuations like what you’ve experienced.

Liposuction primarily removes fat, but it does not tighten loose skin. So if the sag is mostly skin, liposuction alone may not improve the appearance and could even make the skin look looser. On the other hand, skin tightening treatments—like radiofrequency, ultrasound, or energy-based devices—can help mildly to moderately improve skin laxity. However, for more significant sagging, surgical options such as a thigh lift are usually the most effective way to smooth and contour this area.

It’s also worth noting that combining modest fat reduction with skin tightening can sometimes give a better overall result if there’s both residual fat and skin laxity. Maintaining healthy hydration, skin care, and muscle tone can support the results but won’t fully reverse loose skin.

So, in short: liposuction alone likely won’t fix the sag, non-surgical skin tightening may offer mild improvement, and surgery would give the most noticeable and lasting change if the sag is significant.

Citrus Aesthetics - San Diego · Answer

First, congratulations on your weight loss, that’s a huge accomplishment. After significant weight fluctuations, it’s very common to see laxity in the area just beneath the glutes (often called the gluteal fold or posterior upper thigh).
In most cases like yours, the issue is skin laxity and volume redistribution, not excess fat alone. When skin has been stretched, collagen and elastin fibers can lose strength. Once weight is lost, the skin doesn’t always fully retract, especially in areas where gravity naturally pulls downward.
Here’s how I think about this:
Liposuction alone is usually not the solution if the primary concern is loose skin. Lipo removes fat, it does not tighten skin. In fact, if there isn’t much excess fat, removing more volume can sometimes make laxity appear worse.Skin tightening treatments can help, depending on severity. Energy-based devices (radiofrequency or ultrasound) stimulate collagen remodeling over time. These are best for mild to moderate laxity.In cases of more significant skin redundancy, surgical skin excision (such as a thigh lift) is the most definitive option, because it physically removes excess skin.
At our practice, I always emphasize a multi-modality approach. That might include:
Strategic energy-based skin tighteningCollagen-stimulating injectables in select areas (when appropriate)Muscle tone optimizationAnd in some cases, collaboration with a board-certified plastic surgeon if surgery is truly indicated
The key is proper assessment. We evaluate:
Skin qualityDegree of true fat excess vs. skin laxityMuscle toneScar tolerance and downtime preferences
There is rarely a one-size-fits-all answer. The safest and most natural outcomes come from customizing a multi-modality approach rather than defaulting to liposuction alone.
I would recommend an in-person consultation where tissue quality can be physically examined that’s essential in determining whether non-surgical tightening will be sufficient or whether surgical intervention would provide a more predictable result.
Aesthetic treatments should always be discussed with and performed by a trained, licensed, and medically certified aesthetic provider. The recommendations above are for educational purposes only and do not replace an in-person consultation, examination, or personalized medical advice.

Would skin tightening or lipo help with the sagging appearance behind my thighs? (Photos)

Answers (3)

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