INTRODUCTION:

The inner thigh is one of those problematic areas of the body where fat tends to accumulate and at the same time, the skin is very loose. Because of this, liposuction is not very effective at dealing with excess fat and skin in this area. Even if the fat is removed, the skin will remain loose and will not contract or shrink as it does in other areas of the body. This is the reason why when there is excess fat deposits and skin on the inner (medial) thigh, most surgeons recommend an operation called a medial thigh lift.

IS A MEDIAL THIGH LIFT FOR YOU?

Patients troubled by excess fat and skin on the inner thigh, might have other concerns such as fat deposits and droopy outer thighs as well. In evaluating your particular situation, the surgeon will ask about your particular area of concern, as the inner (medial) and the outer (lateral) thighs are not addressed by the same surgery. Liposuction of the medial thigh is one of the operations with one of the lowest patient-satisfaction rates. This is because even if the fat is removed, the skin remains loose and the inner thigh remains droopy.

UNDERSTANDING THE SURGERY:

 

The wedge of excess tissue is removed by making another incision further down in the thigh in order to remove all the excess skin and fat from the inner thigh while still allowing the two skin margins to come together without too much tension.


If the circumference of the thigh needs to be addressed as well, there is a possibility that a longitudinal incision might need to be made running vertically on the leg along the inner thigh.

 

This incision need not be too long, but it would allow the surgeon to make the upper part of the thigh smaller by removing some of the circumference of the thigh. In patients who have experienced significant weight loss and have profound laxity of the thigh, the incision can reach down to the knee but in most patients, the vertical incision if needed can be no longer that the mid-thigh and achieve adequate results.

In closing the incision, the surgeon will anchor the tissues on the thigh in a layer of fibrous tissue which exists under the skin, in order to minimize the possibility that the vulva might be slightly distorted by the weight of the thigh tissue, one of the possible complications of this operation.

 

Your surgeon might opt to use drains for this operation. These drains are usually in the form of small tubes that are placed through the original incision or through a puncture in the skin and are designed to evacuate any blood or serous fluid which might otherwise accumulate in the incision or under the skin. Your surgeon or the nursing staff will give you instructions on the care of these drains and will teach you how to empty them when they become full. Keeping a record of the amount of fluid collected by the drains will help your surgeon decide when to remove them.

Besides the usual complications with any surgery such as reactions to anesthesia, bleeding, infection, scar formation etc., there are certain complications particular to this operation.

Wound dehiscence: The groin area (perineum) is not considered a very "clean" area in surgical terms. Incisions made in this area of the body have a fairly high incidence of infections or separation of the edges (dehiscence) as compared to other areas of the body. Should a wound dehiscence occur, the wound should eventually heal as long as it is kept as clean as possible and treated with frequent dressing changes. This will require patience on the part of the patient and the surgeon however, as this will sometimes take several days to weeks.

Scar migration: Although the suturing in this operation is done on such a way as to minimize the effect of weight of the inner thigh and gravity on the incision, there is always the possibility that the scar from this operation might migrate inferiorly or widen. This scar is usually placed on the crease between the groin and the leg and it is usually not very conspicuous, even in beach wear.

Distortion of labia majora: Besides scar migration, the effect of gravity and the weight of the inner thigh can also have the effect of distorting the labia. Surgeons try to minimize this effect by anchoring the weight of the inner thigh with sutures to the deeper tissues of the groin or thigh, but sometimes it is impossible to eliminate all tension on the skin, and some distortion of the tissues of the groin can occur.

Numbness: Any time that incisions are made on the skin, superficial nerves which provide sensation to the skin are severed. This can result in numbness of the skin in areas adjacent to where the incision is made. This condition is usually temporary as the sensation usually returns after several weeks to months. There is always the possibility that the return of sensation can be only partial or that numbness persists for a prolonged period of time or become permanent.

WHAT TO EXPECT AFTER THE SURGERY:

The medial thigh lift is usually done under general anesthesia and an overnight hospital stay is usually recommended. Although pain is not usually a hallmark of this operation, you might experience a significant amount of "tightness" or "stiffness" on the inner leg and groin. You might be asked to remain lying down for most of the first day and to keep your legs as close together as possible while walking. Your surgeon might opt to use a compression garment which will give you some support and will also keep the tissues compressed and potentially minimize the accumulation of fluid or blood under the tissues. You will be instructed on the care of the drains if they are used and on the care of the wounds. You will usually be allowed to shower after the first 24-48 hours after the surgery and will be instructed on keeping the wounds clean and dry. You might also be asked to apply antibiotic ointment to the incision lines on a regular basis.

On your postoperative visit, the incisions will be inspected, and drains and sutures might be removed if indicated. With time, the stiffness will disappear and soon you will be able to get back to normal walking and leg function. Continued care of the incision lines and optimal hygiene will optimize the scar and decrease the risk of complications.

THE NEW YOU

The medial thigh lift is an operation which offers a great option to deal with a difficult area of the body, where liposuction offers less than optimal result. After the incisions heal and the stiffness disappears, you can expect more toned, and trimmer thighs with scars which are barely noticeable even in swim wear. Although this operation only addresses the inner thigh, it can also reduce the circumference of the thigh resulting in a more youthful and toned look to the entire upper leg.