Hello blue_ice in San Antonio, TX, Thank you for your question regarding the best procedure to address loose skin of bilateral medial thighs due to striae. Thank you for your history and photos. Regarding the thigh lift/reduction, there are 6 different types of thigh lifts: crescent, modified vertical medial, longitudinal vertical medial, complete medial, horizontal hip lift, and outer thigh lift. You have excess skin in the upper inner (medial) one-third to one-half of the thigh. On your medial (inner) thighs, you have cutis pleonasmus (excess skin) and dermatochalasis (loose, lax skin). The most effective treatment for excess skin of the inner thighs is a thigh lift (medial thigh reduction). Based on your examination, the procedure that would provide the best result is a crescent thigh lift. During a crescent thigh lift, the incision is placed within the infragluteal fold, where the buttock meets the back of the thigh. The incision is then extended forward into the groin, following the natural crease between the pubic region and the labia as well as the crease along the upper inner thigh. Positioning the incision within these natural skin folds helps conceal the resulting scar. A critical component of this procedure is securing the elevated tissues by anchoring the incision to the pelvic periosteum, the thick connective tissue covering the pubic bone, using permanent sutures. This deep fixation is important for keeping the tissues in place over time and easing the tension on the skin closure. Anchoring the repair to the pelvic periosteum significantly decreases the risk of one of the most important potential complications of a crescent thigh lift: downward migration of the scar and soft tissues. Without adequate fixation, the scar may descend along the inner thigh over time, resulting in widening of the labia (labial spreading) and enlargement of the vaginal opening (introitus). Securing the repair to the underlying pelvic structures substantially reduces the risk of these complications and helps maintain the surgical result. An alternative procedure for treating excess skin of the inner thighs is a modified longitudinal vertical medial thigh reduction. During this operation, a vertical incision is made from the groin and extends down the inseam (medial aspect) of the thigh, continuing beyond the lowest area of excess skin. This approach is particularly useful for patients with significant excess skin extending farther down the thigh. However, the primary disadvantage of this technique is that the resulting vertical scar is more visible than the scar associated with a crescent thigh lift. Stretch marks have caused your skin to be of poor quality, which limits your non-surgical options. Good luck. I hope I have answered your question about the best procedure to address loose skin on the bilateral medial thighs due to striae. To get an accurate assessment of what exactly you need, schedule a free virtual consultation. Most plastic surgeons offer free virtual consultations. 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. Make sure 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.)
