Thank you for your question regarding how scarless lifting is possible, particularly after fat removal procedures like liposuction or thigh lifting. The term "scarless lift" is often a marketing term and can be misleading. In reality, every surgical procedure that removes skin or tightens underlying tissues will leave a scar. In some cases, surgeons may use smaller incisions hidden in natural creases (such as in the groin or underarm) or perform procedures endoscopically to minimize visible scarring, but no true lift can be performed without any scarring at all. For example, in thigh lifts, excess skin is physically removed, and the skin is sutured together to create a tighter contour. The scar may be placed along the inner thigh or groin crease to make it less noticeable, but it still exists. Internal sutures (deep or dissolvable stitches) help support the lift and promote longer-lasting results, but skin elasticity plays a role in how well the tissue “snaps back.” After massive weight loss or aging, the skin often loses the ability to retract fully, so skin removal becomes necessary for true lifting. If only fat is removed (e.g., through liposuction) and the patient has excellent skin elasticity, some degree of natural retraction may occur—but this isn’t a lift, and results will vary greatly depending on the patient’s age, genetics, and skin quality. In these cases, there may be no visible scar beyond the small puncture marks from liposuction, but again, this is not technically a lift. To determine which technique is best for your goals, it’s important to consult with an experienced, board-certified plastic surgeon. They can evaluate your anatomy, skin quality, and expectations to create a safe, realistic plan that balances aesthetics and scar placement. Sincerely, Dr. Katzen (President of the American Society of Bariatric Plastic 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 Surgeons, American Academy of Cosmetic Surgery, and RealSelf Hall of Fame.)