What to Do for Remaining Flaccidity of Butt/thighs Post Lower Body Lift?

I had a lower body lift and inner thigh lift (groin incision) 5 wks ago and while the TT portion looks great I have significant loose skin on the thighs front and back and sagging buttock folds...would gluteal implants take up much slack? I have no body fat to use for grafting. Or do I need a second butt lift? And/or another thigh lift using an inner thigh incision running from groin toward knee? MD says he took 12-14cm of skin all the way around. Is there a limit to how much can be taken?

Doctor Answers 5

Lower body lift and looseness

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There is always residual laxity after a lower body lift this is related to your overall skin quality. Remember if it is too tight, you can not bend and the scar may stretch or even pull apart.  The pull is always better near the closure. The further away you are the less it helps.  You  may need direct excision on the buttock crease, or implants.

New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Residual Looseness of lower Buttocks AFTER Lower Body Lift

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Although you must look a lot better than you did before your body lift, I agree that you still have looseness and sagging of the buttocks. I cannot comment on your thighs since this single photograph does not address that area.

Residual sagging is the result of insufficient skin removal as well as poor fixation and damaged skin which gives after the surgery resulting in collapse and sagging.  I would wait 4-6 months to allow both the inflammation and probably further sagging to declare itself. You then may benefit from a "Butterfly" type buttock lift which would greatly lift the buttocks and smooth the folds you are bothered by now. If you did have any areas of fat by then, grafting the lifted buttocks would beautifully enhance the appearance and "turbo charge" the result of this Buttock Lift.   Good Luck.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Residual sagging of butt/ thighs after lower body lift

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Congratulations on having undergone a 360 lower body lift with crescent medial thigh lift. It is difficult to answer this question without more pictures or a thorough physical examination. However, I will try to answer this question as best I can.

I can only assume you had a successful 360 lower body lift. Therefore, I would not suggest another buttock lift. If you want a larger buttock and since you mentioned you do not have any fat for fat transfer, I would recommend insertion of submuscular gluteal silicone implants. Buttock augmentation with implants will help to give more projection to the buttocks and “take up” some of the sagging buttocks skin. If you do not necessarily want a larger buttock, another way to get rid of the buttock skin, is to place an incision in the infra gluteal fold. This incision is placed where the posterior thigh meets the buttock. The incision is placed in the crease and the buttock skin is pulled down. This technique should remove any slack or “shrinkles” on the buttock.

The thighs are another matter completely. If you are considering an inner thigh incision or medial thigh lift to remove excess buttock skin, this will not work. If however, you were seeking to remove excess skin and fat from the inner thigh, I would suggest a medial thigh lift. In this surgery, an incision is made from the groin to the inner knee. Excess thigh skin and fat are removed. The excess thigh skin is pulled toward inner knee. The resulting incision goes from the groin to the knee.

Good luck with your weight loss journey. If you have any questions, please contact my office.

Dr. Katzen

J. Timothy Katzen, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 254 reviews

Residual sagging and looseness after lower body lift!

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You are 5 weeks post-op, and your single photo shows what must be nice improvement from your lower body lift. However, I understand your being bummed about seeing looseness at this early stage after surgery. It appears that additional surgery may help to a degree, but your skin's own innate laxity (lack of collagen and elastic fibers--usually genetic, and sometimes obesity-related) makes additional excisions all prone to the same early and recurrent loss of tone. Buttock implants carry too high a risk of infection, IMHO, but there are good plastic surgeons who do this operation and accept these risks. I would neither fat graft nor augment your buttocks.

Rather, I would wait for 6 months to see just how much everything settles, softens, and stretches before making any adjustments or considering  a surgical plan. For now, enjoy looking (much) better, and don't obsess about the rest!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

What do do about lax skin after thigh lift?

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Lax skin after thigh lift may be due to inadequate skin resection(unlikely in your case),lack of adequate skin fixation to a fixed point on the inner thigh(unlikely), or inherent skin laxity due to loss of skin elasticity. It sounds like your problem may be due to loss of elasticity of your skin itself and therefore additional surgery may not successfully correct this problem.

I have had success with the skin tightening mode using Slim Lipo.  Smart Lipo should be effective as well. I use the Slim Lipo1240 wavelength to impart laser energy to the sub-cutaneous areas. The result is tightening of the skin by collagen shortening as a result of specific heating of the connective tissue. It takes about two to three months to appreciate the results and the technique may have to be repeated to maximize the effect.

Joel B. Singer, MD
New York Plastic Surgeon

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.