Thigh lift scars - inner thigh or around the knee? (photos)

Question

I'm going through thigh lift consults and have attached photos of a recent mark up. Deciding between keeping the thigh scar on the inside or if the around the knee is necessary for the inside knee skin/fat. Doing Thigh lift with Lipo. What do you think of this plan of attack? Would you suggest differently if I were your patient? Would it be smart to go for the inside only then revise to the knee scar if necessary after? (Lost 90lbs, 7+ inches off each thigh)

Kenneth Hughes, MD · Answer

The groin incision thigh lift can be a very powerful tool to improve skin laxity along the inner thighs. The beauty of its design is that the scar can be hidden in the groin crease so that some of these scars are almost undetectable. At the same time, done correctly, inner thigh laxity to the level of the mid-thigh can be improved dramatically. The groin incision inner thigh lift will not improve the skin near the knees. Some patients may require an incision that extends for a small distance down the inner thigh, which is very difficult to see when placed appropriately. Any additional improvement near the lower part of the thigh and knee will involve an extended medial thigh lift (extended inner thigh lift). You would need to be seen in person by a board certified PS to determine what combination is most appropriate for you.

J. Timothy Katzen, MD, FACS · Answer

Hello CONCERTO3 in Edmonton,

Thank you for your detailed question regarding thigh lift incision options following significant weight loss.

Based on the extensive weight loss you've described and the images provided, a comprehensive approach would be beneficial. For the inner thigh area, I recommend an incision extending from the groin down to slightly below the knee. This approach will allow for substantial skin and fat removal while ensuring the scars are as discreet as possible.

Incorporating liposuction as part of your procedure is a prudent choice to further refine the contour of your thighs. The marking in your photo appears quite extensive and might reflect the maximum area for liposuction rather than excision. For optimal results and safety, the thigh lift scar should ideally be positioned just anterior to your prior thigh lift scar. This placement ensures a good blood supply and minimizes the risk of tissue complications.

Given the complexity of your case, I would advise against planning for an initial less extensive surgery with the possibility of revision. It's generally best to aim for the most effective single procedure tailored to your needs. If the scars or results require adjustment, revisions can be addressed at a later stage.

Thank you for sharing your concerns, and I wish you success in your upcoming surgery.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

Phillip Chang, MD · Answer

Hi concerto3

For patients with minimal to moderate extra skin:
Patients will benefit from a limited incision thigh lift which is also known as either a horizontal incision or crescent incision thigh lift. For more information about this procedure, please visit our website.

Maryam Zamani (Saheb-Al-Zamani), MD · Answer

Hello and thank you for submitting your photographs. Congratulations on your weight loss! Although a surgical plan is limited without physical examination (to assess your skin and tissue elasticity), I recommend a mid thigh lift (with scar limited to the inside of your thigh and above your knee), combined with VASER (ultrasound) liposuction and energy-based skin tightening using radiofrequency (J-plasma/ Renuvion or Inmode/ Bodytite). The thighlift can remove the poorer quality stretched skin while the addition of energy devices mentioned above encourage the remaining skin to tighten therefore limiting the length of scar required. Additionally, the energy treatment can be repeated at 1 year under freezing if further skin tightening is required/ desired. I would recommend seeing a board-certified plastic surgeon in consultation who has knowledge and access to technologies to enhance surgical results and limit scar length.
Best Regards,
Dr. Zamani

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