Thigh Lift Surgery
OverviewThe thighs are an area that tend to accumulate excess fat and saggy skin. This is especially the case with women, as the hips and thighs are areas of major fat deposits in the “female fat distribution” type. (1) Unsightly skin sagging is often seen in people who lose a significant amount of weight, especially if it is accomplished in a short time. Hence, thigh lift surgery – removal of excess fat and skin – has become a popular procedure. Thigh lift surgery, or thighplasty, has evolved immensely over the past 30 years. Procedures range from simple liposuction to full sculpting and body contouring. Extensive research has been conducted on the effects of thigh lift surgery, and one consistent finding is increased quality of life in people with massive weight loss. (2) Not only do people find their thighs more aesthetically pleasing after a thigh lift, they even find that their legs function better due the removal of excess tissue. (2)
The type of surgery chosen is based on each individual’s goals and desires. Each type of procedure has its own target area, outcome expectations, and recovery time. The major types of thigh lift include:
- Mini Thigh Lift
- Medial/inner Thigh Lift
- Vertical Thigh Lift
- Outer/lateral Thigh Lift
- Posterior Thigh lift
- Spiral Thigh Lift
Mini Thigh Lift
- Purpose: to reduce sagging in the upper part of the inner thigh. Instead of tightening the entire thigh, this method only targets the upper third of the inner thigh. Individuals who have a mild amount of excess skin and want their thighs to appear more toned are perfect candidates for the mini thigh lift.
- Procedure: A small incision in the groin region is used to perform liposuction and subsequent removal of excess skin. It takes about 2 hours from start to finish. The end result is a smoother appearance of the inner thigh with no bumps or dents.
- Recovery: Since this is the least invasive of the procedures, recovery time is quick. The patient can begin light exercise after 2 weeks.
Medial/Inner Thigh Lift
- Purpose: to remove excess skin and fat in the upper inner thigh region when diet and exercise alone do not suffice. This is the most common procedure for people who have lost large amounts of weight in a short time. However, aging can also cause sagging in the inner thigh.
- Procedure: The surgeon makes an incision along the crease where the thigh meets the pubic region to minimize visible scarring. Then, the surgeon removes excess skin and fat, using liposuction if necessary. The skin is pulled and lifted tighter to give a firm appearance.
- Recovery: Immediately after surgery, there will be bruising, swelling, and soreness. The patient should remain relatively sedentary in the first two weeks to help the healing process. Over a period of one month, he or she can engage in light activities, but should not return to full activity until eight weeks post-operative. In the first month following surgery, the patient must wear a compression garment to promote proper contouring of the thighs.
Vertical Thigh Lift
- Purpose: For people who have excess skin and fat around their entire thigh (not just upper inner), the vertical thigh lift is most appropriate. This procedure focuses on the middle and lower sections of the thigh as well. Since it is more invasive, the vertical thigh lift is only recommended for people who need extensive amounts of tissue removed.
- Procedure: Vertical lifts require a larger incision, where a graft of skin is cut and removed from the upper inner thigh to the medial (inner) knee area. It gets the nickname “crescent lift” from its ellipse-shaped incision. Excess skin and fat are removed, and then the skin is pulled tighter. The scar following surgery will appear like a “T” in the inner thighs but will not be visible with the legs closed.
- Recovery: This procedure is more extensive, and thus requires more recovery time. Bruising and swelling may be more noticeable, and there may be more post-operative pain. The surgeon should discuss all post-operative expectations prior to the procedure. Depending on the extent of surgery, the patient may need to wear compression garments for up to eight weeks and remain on light activity status until 12 weeks post-op.
Outer/Lateral Thigh Lift
- Purpose: to remove excess tissue that accumulates around the outer thigh region, which may include the waist and buttock regions. Many people suffer from fat and cellulite accumulation in the outer thigh and buttocks, making this method ideal for such situations.
- Procedure: The surgeon makes an incision around the waist, after which liposuction is used to remove excess fat from the outer thighs and buttocks. The skin is then pulled tighter and anchored at the hip bone. Scarring is extensive in this method but is usually covered by underwear and bathing suits.
- Recovery: More scarring requires more recovery time. The area of the bruising will be higher on the legs and hips due to the location of the incisions. The patient will have to find ways to rest without putting too much pressure on the incisions, which may involve lying prone (on the stomach).
Posterior Thigh Lift
- Purpose: This procedure targets fat, saggy, and excess skin in the posterior thigh and buttocks.
- Procedure: Incision sites will differ from person to person based on their anatomy, magnitude of liposuction, and desired outcomes. Most will end up with scarring that is minimally visible while wearing underwear or bathing suits.
- Recovery: The location of bruising for this procedure will be near the “sit bones,” which will make it uncomfortable to sit normally for the first few weeks.
Spiral Thigh Lift
- Purpose: The newest of the thigh lift techniques, this procedure targets the entire thigh— the front, back, upper, lower, inner, and outer. While removing excess skin and fat, it also leaves the contour of the thigh and buttock smoother and firmer.
- Procedure: As this procedure is the most extensive, it requires the largest incisions and leads to the most extensive scarring. Incisions are made along the inner groin down to the knee, and another is made from the groin to the hip bone. The “spiral” part comes from where the incisions meet along the posterior waist at the top of the buttock. The legs and buttocks are left smaller, firmer, toned-looking, and shapelier.
- Recovery: This requires the most recovery time given the amount of suturing necessary. The patient must return for regular follow-up visits to the surgeon to ensure the wounds are draining properly, incisions are healing well, and no infections are present.
People with undesirable excess skin or fat along the inner or outer thighs are good candidates for thigh lift surgery. The best candidates have a stable weight, and no serious medical conditions. Most adverse events following thigh lift surgery occur in smokers, so it is recommended that candidates cease smoking prior to considering surgery. (4) As with any body contouring surgery, the patient’s desires are important, but having a positive outlook and healthy mental status are equally imperative. Surgery does not correct an unhealthy lifestyle, so regular exercise and a proper diet must be practiced by the patient. If considering surgery, discuss options with your plastic surgeon to set realistic goals in order to avoid disappointment from unreal expectations.
As with any surgical intervention thighplasty comes with associated risks. It has been reported that 39-69% of patients develop some kind of complication after surgery, although the vast majority of complications are minor. One large study reported that 6.6% of patients will develop at least one major complication. (4) Of course, pain, swelling, redness, and bruising can be expected after this surgery. As well, scar formation along the incision sites can be expected, and is unpredictable. Other commonly reported complications include: (4)
- Wound re-opening (dehiscence)
- Hematoma (bleeding under the wound)
- Venous thromboembolism (potentially dangerous blood clots)
- Leg swelling
- Prolonged leg swelling
- Body-wide fluid overload
- Seroma (fluid collection under the wound)
- Scar migration
- Vulvar distortion
- Painful intercourse
- Fat or skin tissue deterioration (necrosis)
- Numbness and other changes in sensation
- Asymmetry, recurrence of loose skin, unsatisfactory outcome
Other risks are associated with the general anesthetic that is required with this surgery. These may include:
- Allergic reaction
- Heart attack, stroke
- Lung dysfunction
- Increases in blood pressure or body temperature
Surgery is typically the most aggressive approach to any cosmetic issue. However, in the case of dramatic, fast weight loss, thigh lift is the most effective in both short and long term for the thigh area and may be the only viable solution for those who wish to correct sagging excess skin. A number of treatment modalities – including laser and radiofrequency treatments – have been used to help tighten lax skin in the thigh region, but generally results are limited when dealing with excess skin.
According to the American Society of Plastic Surgeons (ASPS), the surgeon’s fee for a thigh lift in the U.S. in 2019 was $5,171. This does not include additional costs, such as anesthesia and hospital fees. Since there are a variety of thigh lift procedures available, the more complicated choices generally cost more. (6)