Massive weight loss patients tend to lose large amounts of fat in the thighs, but localized fat deposits and folds of sagging, wrinkled skin along the upper half of the inner thighs and in the groin area tend to remain. This skin excess is uncomfortable as well as unattractive. Although a circumferential body lift makes a remarkable improvement in the contour of the front, back, and outer thighs, it is less effective in reducing the skin excess of the inner thighs. In this case, an inner thigh lift is a good corrective option.
If there is an excessive amount of skin laxity not only at the top of the inner thigh but also extending along the entire length of the inner thigh, toward the knees, a thighplasty may be needed to remove the skin excess. Thigh re-contouring takes 2 to 3 hours and may be done at the same time as a circumferential body lift or as a separate procedure.
Inner Thigh Lift
For an inner (medial) thigh lift, each thigh receives an incision in the natural groin crease where the inner thigh meets the trunk or torso (between the thigh and the labia or scrotum) and extends to the gluteal crease. In other words, the incisions run a few inches alongside the genitals from front to back. This incision location means the scars are well hidden by underwear and swim suits. Through these incisions, an ellipse of skin and underlying fat deposits are removed from each upper inner thigh. The skin lower on the thighs is then lifted to a higher position and the incision closed with stitches.
A thighplasty incorporates the inner thigh lift but another incision is made in each thigh that extends down toward the knee. This permits removal of larger quantities of loose, sagging skin. In addition to removing excess fat and lifting the skin upward, a thighplasty allows the surgeon to pull the skin on the front of the thigh toward the back and the skin on the back of the thigh toward the front. The skin along the length of the medial thigh can therefore be tightened more effectively. The obvious disadvantage of a thighplasty is the scar that extends from the groin toward the knee. Although the scars will fade over time, they will never be invisible and may be noticeable if you wear shorts.
In people with large amounts of fat in the inner thighs (in addition to sagging skin), two surgeries are required to achieve the best results. First, liposuction of the inner thighs is done to "de-bulk" the excess fat. This can be done at the same time as a circumferential body lift or other re-contouring procedure. About 6 months later, an inner thigh lift and/or thighplasty is performed to remove the excess skin.