Kind of Scars to Expect from Medial Thigh Lift?

Hello, thank you for your question regarding a thigh lift.  I specialize in thigh lifts.  First, thigh lift are not really thigh lifts, they are more thigh reductions with a thigh lift that comes during the thigh reduction. however, we are stuck with the phrase "thigh lift". Anyways, basically, there are seven types of thigh lifts: crescent, vertical, modified vertical, T, modified T, spiral and the lateral thigh lift.  During a crescent thigh lift, an incision is made high in the groin--where the upper thigh meets the groin.  The upper, inner thigh is pulled upward.  A crescent area of upper, inner thigh skin and fat is removed.  During a vertical thigh lift, liposuction is performed and an incision is made from the groin to the knee. The inner thigh is pulled together in a vertical fashion like closing the curtains (not pulling the blind down, though).  An elliptical area of medial or inner thigh skin and fat is removed.  During a modified vertical thigh lift, the incision does not go completely to the knee.  Only the upper inner thigh is involved. This is ideal for patients who have "normal" knees.  The "T" thigh lift combines the crescent thigh and the vertical thigh lift.  During the "T" thigh lift, a "T" shaped area of inner thigh skin is removed.  The final scar is also in the shape of the letter "T".  The "modified T" thigh lift combines the crescent thigh lift with the modified vertical thigh lift.  During the spiral thigh lift, the buttocks are involved.  During a lateral thigh lift, an incision is made on the outer (not inner) thigh and extends from the top of the hip to the outer knee.  An elliptical area of outer thigh skin is removed.  All thigh lifts are performed under general anesthesia.  Recovery from a thigh lift is about three to four weeks.  In regards to your questions about inner thigh scar migration, this is more common during the crescent thigh lift, T, or modified T.  Scar migration is rare during the vertical thigh lift.  Inner thigh scars migrate because the weight and tension of the upper, inner thigh pulls on the groin scar. If the inner thigh scar pulls too much, the vulva or opening to the vagina can spread open.  NOT GOOD!!  One way to avoid this is to secure the upper, inner thigh to the pelvic bone and fascia.  I have developed and presented this inner thigh anchoring technique in several conferences.  Once the tension has been transferred to the pelvic bone, the upper, inner thigh scar cannot spread.  In regards to inner thigh scars getting wider and larger, this is rare. To achieve almost invisible thigh scars, the thigh must be closed in multiple layers with very specific suture types.  There must be minimal tension.  Wounds sometimes do occur.  When wounds occur, they are mostly due to the thigh lymphatic system.  Initially, the thigh lift scars may be lumpy, but over time, the lumps become smooth.  In regards to the fact that you have "never seen a healed picture of (thigh) scars because they're covered by garments and closed legs!)".  Well, I am happy to say, please visit my website.  I am very proud to say, in almost all my before and after patient pictures, the patients are naked allowing the scar to be seen. However, in plastic surgeons' defense, you do not want to be able to see the inner thigh lift when someone is facing you; everyone wants the thigh lift scar hidden.   It is my firm belief that post-operative scars must and should be shown to a prospective patient.  And "yes", all thigh scars do fade and flatten.  They will never disappear, but usually the scars are much better than having big thighs.  I hope this helps you in your quest for a thigh lift.   Please remember the thigh lift is not an easy surgery, and should be performed by an experienced plastic surgeon.  I hope that I have answered your questions about the different types of thigh lifts and the potential complications, such a scar migration.    If you have any more questions regarding the thigh lift, please contact my office. When searching for a thigh lift specialist, please seek an experienced, board certified plastic surgeon with significant expertise in thigh reduction surgery.  Demand to see before and after pictures of patients just like yourself on forums like RealSelf and their website.  Check out patient reviews of your chosen plastic surgeon on forums like RealSelf.  Thank you.  Sincerely, J. Timothy Katzen, MD, FACS, FICS, FASMBS. (Certified by the American Board of Plastic Surgery, member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, and International Society of Aesthetic Plastic Surgery, and fellow of the American College of Surgery, International College of Surgery, and American Society for Metabolic and Bariatric Surgery).

You ask a very important question about the thigh lift procedure. I feel that for the most part, the scar is the primary concern for many patients. Also, the healing and evolution of the scar is something that not everybody anticipates as they go into that procedure.
 In general, thigh lifts are done with one of two types of scars: the crescent lift, with a scar hidden entirely inside the groin crease, and the vertical lift, which has a scar running down the inner portion of the thigh. The extent and length of the scar is typically related to the amount of extra skin that must be removed.
 A very important detail that is important to point out is how that scar evolves over time.  a well placed scar within the groin crease can be virtually imperceptible over time. However, in some cases, the scar may not be exactly in the crease and can be visible. Additionally, a dreaded complication of thigh lift – especially the crescent thigh lift – is spreading or widening of the vulva as a result of excessive scarring. This can be both disfiguring and very uncomfortable. It can be difficult to treat. It is for this reason, that your surgeon must have extensive experience with the procedure and be very careful with scar placement and management.
Traditionally, the vertical scar along the inner portion of the leg has been dreaded by many patients because the scar can be so thick and red. I have found that with modified techniques, the extent of the scar can be absolutely minimized and its color and thickness treated with excellent postoperative scar management and possibly laser therapy.  With care and time, the scar can be VERY minimal and quitte acceptable to patients.  I agree with your comment that there are very few photos of the scar online. I will ask my office to put some up in my profile and we will try to share on our social media.
It is important to understand that with the thigh lift, it is common for small portions of the scar to open during the healing process. With good wound care, these will deal very well and are often a normal part of the process.
 Thigh lift is a very challenging and complicated procedure that requires skill experience and great patient care. It's critical that you use a surgeon who is certified by the American Board of plastic surgery and has extensive experience with the procedure.
I wish you the best,
Dr. Gabbay.

Your question serves to underline the fact that, as with most body contouring procedures, a medial thigh lift represents a trade off between redundant, inelastic skin, and sometimes long and visible scars.  For patients with just a small degree of skin laxity in the upper thigh, the scar can be confined to the groin area, and the skin tightening and vector of lift is mainly in a vertical direction. For any patient with a significant degree of skin laxity, there will need to be a vertical extension of the scar that will occupy a position roughly equivalent to the inseam of a pair of trousers.  However, the circumferential tightening that is achieved by this vertical extension of the scar can have a profound effect on the ultimate tightening and contouring of the thigh skin.The healing of scars is always an important issue for patients contemplating body contouring surgeries.  While anchoring the incision to the Colles fascia and ischial periosteum can help prevent scar widening and scar migration, perhaps the most important determinant of the quality of scar healing is the excision of just the right amount of skin, not too much, and not too little, and this can be tricky to determine in a patient with a great deal of skin redundancy, as the degree of apparent skin excess can vary with the position the leg assumes.  Beyond these considerations, other factors that affect wound healing include the patient's ethnicity, skin quality, and general health and nutritional status.  The good news is that some aspects of the appearance of the scars from a medial thigh lift can be improved by judicious employment of postoperative modalities such as steroid injections, silicone sheeting, and laser treatments.