Excessive skin after 83 pound weight loss - what would you recommend for droopy thighs and butt? (Photos)

Question

I have lost about 83 lbs and have lots of loose skin in my inner thighs, back of thighs and buttocks. I also have loose skin in my abdomen. I am most focused on how droopy my thighs and butt are and was wondering what procedures might be an option for me. My BMI is 24.5 right now - should I try to lose more body fat before a procedure?

Serdar Bora Bayraktaroglu, MD · Answer

Combining a 360 lower body lift with a medial thigh lift creates a cohesive, comprehensive transformation for post-weight loss sagging. A lower body lift addresses the abdomen, flanks, and buttocks simultaneously, lifting droopy glutes while flattening the front. A medial thigh lift targets inner-leg laxity. Depending on safety limits and your recovery goals, these can be performed together or staged 3 to 6 months apart to ease healing. Staging reduces physical trauma and maintains better mobility. Consult a board-certified plastic surgeon to determine which approach best suits your anatomy and lifestyle.

J. Timothy Katzen, MD, FACS · Answer

Hello anonjy in Sun City, FL, Thank you for your question regarding excessive skin after an 83-pound weight loss and what you would recommend for droopy thighs and butt. Thank you for your history and your pictures. Congratulations on your weight loss—that is a tremendous accomplishment. Thank you for providing your medical history and photographs. The first step is to carefully analyze your pictures to determine which procedures will best address your concerns. Based on the photographs you submitted, your buttocks and hips demonstrate cutis pleonasmus (excess skin), dermatochalasis (loose skin), cellulite, and striae (stretch marks). From the limited abdominal photograph, you appear to have excess skin, excess fat, and stretch marks around the umbilicus. You would do best with a 360 circumferential lower body lift. The 360 circumferential lower body lift includes an abdominoplasty (tummy tuck), rectus muscle repair (rectus diastasis repair), and lifts/reductions of the mons pubis, hips, and buttocks. The 360 circumferential lower body lift will remove excess skin and fat from the abdomen, hips, and upper buttocks. The 360 circumferential lower body lift will flatten the stomach and lift the buttocks so that the rolls of skin under the buttocks disappear.  
Regarding your thighs, you have type 4 thighs. You have moderate skin laxity, moderate striae, moderate wrinkles, and moderate lipodystrophy from the groin to below the inner knee. The best treatment for type 4 thighs would be a longitudinal vertical medial thigh lift/reduction. During a longitudinal vertical medial thigh lift/reduction, a vertical incision is made from your groin down the inseam of your thigh. The incision would extend slightly beyond your medial (inner) knee skin fold. Often the 360 circumferential lower body lift and the longitudinal vertical medial thigh lift/reduction can be performed at the same time. Both procedures are performed under general anesthesia. Allow a 3 to 4 week recovery period. To obtain an accurate evaluation of your anatomy and discuss the procedures that would best achieve your goals, a consultation would be best. Most board-certified plastic surgeons offer free virtual consultations, allowing you to receive a personalized treatment plan from the comfort of your home. Your BMI is acceptable for surgery. However, if you can lose more weight before surgery, that would be ideal. If you have any more questions regarding the lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, belt dermolipectomy, thigh lift, thigh reduction, vertical thigh lift, medial thigh lift, spiral thigh lift, crescent thigh lift, or thigh lipo, please contact an experienced plastic surgeon. Since the body lift is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience performing the lower body lift. Do your research. Make sure they have performed at least 150 circumferential lower body lift and thigh lift/reduction surgeries and have the before-and-after pictures to prove it. Carefully examine their before-and-after pictures and check their reviews on RealSelf. If you cannot find an experienced, lower body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen, MD, MBA, FACS, FICS, FASMBS (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, and International College of 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.)

Michelle Zweifler, MD · Answer

With significant weight loss, it is not uncommon to see some deflation with loose skin and skin sagging especially in the abdomen, buttocks and thighs.  A lower body lift, address the abdomen, outer thighs and buttock with removing excess skin, repositioning tissue and restoring contour.  The thighs are often addressed with a medial thigh lift.  There are scars with these procedures and it takes time to heal.

Tyler Sbrocchi, MD · Answer

Hello, this is an excellent question and congratulations on your weight loss. Most commonly we perform a thigh lift for loose skin around the thighs as well as a circumferential body lift which will help with the abdomen contour and the posterior body or buttock lift to help address and deflation and sagging to the buttock area. These commonly can be performed at the same time as well. As long as you at at your goal weight and your weight has been stable for several months you do not necessarily need to lose any additional weight. As always it is best to schedule a consultation in person in order to do an exam and determine which procedures are best to achieve the goals you are looking for, good luck!

Yasemin Aydinli, MD · Answer

Congratulations on the weight loss. For loose inner and back-thigh skin a thigh lift is the standard option, and for sagging buttocks and outer thighs a lower body lift can address several areas at once. A BMI of 24.5 is a good starting point; what matters most is that your weight stays stable for a few months, and you do not necessarily need to lose more unless there is a specific fatty area you want reduced. One important point: when we are considering multiple or combined procedures like these, your age, your blood test results, and your overall health status become very important in planning the surgery safely. For that reason, and to allow faster and complication-free healing, I would not recommend performing a thigh lift and a tummy tuck at the same time; staging these procedures rather than combining them is the safer approach.

Excessive skin after 83 pound weight loss - what would you recommend for droopy thighs and butt? (Photos)

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