Thight Lift Before Tummy Tuck and Labia Stretching in Groin Versus Vertical Incision?

Hi Is it reasonable to have a thigh lift as a first procedure before tummy tuck. Will the tummy excess skin not contribute for the groin incision scar to migrate more easily? My doc says its fine, but somehow I'm not sure. Second question - is the risk of labia stretching smaller with vertical T incision than with groin incision? Thanks in advance!

Doctor Answers 5

Thigh Lift and Tummy Tuck considerations

Different Plastic Surgeons with great experience and results often argue the answer to your question. The most important choice is finding the best surgeon (see link).                          My own preference is to do a tummy tuck and medial thigh lift at the same time. It is true that there may be some labial widening caused by the scar drifting downward, but this is easier to hide than a vertical scar often extending below most shorts. My choice as to whether a vertical scar is needed is on the basis of my exam and where the most excess skin is located. For example if a roll  of skin high up  on the inside of the thigh then a groin scar incision is  preferred, where as if there is circumferential excess from the knee to the groin then a vertical incision is best in my hands

Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Thight Lift Before Tummy Tuck and Labia Stretching in Groin Versus Vertical Incision?

I would suggest an abdominoplasty or tummy tuck to be done first. As the procedure implies, the tummy tuck almost exclusively takes care of the abdomen. The abdominoplasty or tummy tuck does very little to the inner leg. The extent of how far laterally or over the hip region the abdominoplasty incision extends, will determine how much impact the abdominoplasty has on the lateral thigh. Typically, the longer the abdominoplasty incision is, the more impact there is on the lateral thigh. The most dramatic lateral thigh lift or reductions is accomplished with a 360 lower body lift. This is basically an abdominoplasty with significant lateral extension which meets in the back.

After the abdominoplasty is done then I would consider a inner or medial thigh lift. The inner or medal thigh lift can be accomplished through a variety of incisions. Almost medial thigh lifts entail an incision from the groin to the inner leg. As the incision extends in the pubic region, it is very important that the fascia that is attached to the labia is not stretched or pulled laterally. If this fascia is disrupted and sutured incorrectly, patients are left with a flattened pubic region and laterally displaced or open labia.

I am not sure what you mean by vertical T incision. There are two ways to make a vertical T incision for the inner or medial thigh lift.
To make a vertical T incision, some plastic surgeons make an incision in the inner portion of the medial thigh following the seam on a pair of pants. As this incision nears the groin, a counter incision is made that follows the panty line on the inner groin. This results in a vertical T incision. The resulting T is in the upper inner thigh. This incision is a good choice for excess skin and fat in the upper inner thigh.
Another way to make a vertical T incision for a medial thigh lift is to extend the groin incision upward toward the tummy tuck or 360 lower body lift incision. The resulting T is in the upper panty line; typically, this is where the pubic hair meets the tummy tuck or 360 lower body lift incision.

However, all T incisions have a high chance of wound breakdown. At all costs, the T incision should be avoided. There are ways to fashion the medial thigh lift without risking a T incision in the upper inner groin or in the upper outer pubic region. A good plastic surgeon can fashion a low abdominoplasty scar and also achieve an excellent media thigh lift without needing a T incision. Good luck with your tummy tuck and medial thigh lift.

J. Timothy Katzen, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 207 reviews

Abdominoplasty And Thigh Lift Surgery

It's not unusual for massive weight loss patients to require abdominoplasty and thigh lift surgery. Which procedure is performed first depends upon a variety of factors. In many cases, the order is determined by the patient's preference.

The vast majority of surgeons would prefer that the abdominoplasty be performed first. This is especially true when extended abdominoplasties are performed because these procedures have the potential to elevate the lateral thighs and buttocks. Under these circumstances, the abdominoplasty can have a significant impact upon thigh contour. For this reason, we prefer that the medial thigh lift be performed as a secondary procedure.

There's no question that the transverse groin incision utilized during thigh lift surgery can cause distortion of the labia. This can be avoided with an isolated vertical thigh lift incision. Unfortunately, most patients have excess thigh skin in both the transverse and vertical dimensions. For this reason, an isolated vertical thigh lift would probably not provide an optimal aesthetic result.

In your particular case, it's difficult to make a specific recommendation without pictures or a physical examination. For this reason, it's important to consult a board certified plastic surgeon with experience in this area. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Thigh Lift scars

Thigh lift scars are usually visible. When placed in the groin they almost migrate down somewhat and therefore are visible in a typical one piece bathing suit that does not have some type of skirt. They are better hidden, however, then a scar which travels down the entire length of the inner thigh. The benefit of the vertical scar is that it can get out more tissue in the right places and often helps the lower portion of the upper thigh which is the area that bothers many people. Many times with a vertical incision we also use a groin incision to elevate the skin rather than just tighten it circumferentially. Any time the groin incision is used it can separate the labia somewhat but there are surgical maneuvers which help to minimize this. I would opt for a surgeon who has performed many of these operations as it gives you the best chance of a good result. Even in my patients, I tell them that a thigh lift operation is not as good as a tummy tuck or breast simply has a higher rate of patients not being completely satisfied.

William LoVerme, MD
Boston Plastic Surgeon
4.4 out of 5 stars 32 reviews

Tummy Tuck or Thigh Lift First

   There is a fascial separation between the leg and abdomen, which keeps domains separate.  In all but the most lax of individuals, this will maintain integrity.  All things being equal the groin incision probably has a higher risk of labial separation, but this is more dependent upon technique and judgement rather than pattern of excision. Find the plastic surgeon with ELITE credentials who performs hundreds of tummy tucks and body contouring procedures each year.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.