Can gaping labia after medial thigh lift improve with time or will it only get worse? (Photo)

Thank you for your question.  From your photos it is clear why you are concerned.  You have the result of an inexpertly performed medial thigh lift.  The scar should have been higher, in the crease, and the closure should have included a layer of sutures anchoring the skin to what is called Colles fascia.  Had that been done then you would not be experiencing the spreading of your vulva.  It is not likely to get better on it’s own.  As a matter of fact, gravity and tension will only pull the scar farther down.  I recommend that you have a revision by a surgeon who has experience with this procedure and uses the Lockwood technique.  

Thank you for your question regarding gaping labia after a medial thigh lift, what can be done to improve the situation, and whether it will worsen. It is too early to tell anything; you are only five weeks out of surgery. You must wait. During the waiting period, most of the scar tissue should relax. I would suggest compression garments and deep tissue massage, one to twice daily, to break up the scar tissue. During the procedure, the scar should be anchored to the peritoneum or the layer above the pelvic bone to minimize scar migration and labial spread. It is doubtful that you'll need a revision, but it can usually be done if it is needed. However, I would not rush into a revision. I would wait at least six to eight months after your initial surgery. This gives enough time for the scar to mature and allows for an accurate dissection. Good luck. I hope this situation resolves independently and you don't need further thigh surgery. However, if you do, remember crescent thigh revisions can be performed. Good luck.
Sincerely,
Dr. Katzen

The vulval spreading is often due to too much skin being removed during medial thighplasty.  This is unlikely to improve with time.