Thigh Plasty For Massive Weight Loss Patients

By Jerome Edelstein, MD

Many people who have experienced massive weight loss (MWL) are troubled by thighs that cannot be reshaped through any amount of exercise or healthy eating.

Contouring the thighs is much harder than other areas of the body (such as the upper extremities and midsection), but is not impossible. In order to perform thighplasty, we must take several features of a patient’s body into consideration.

Skin and fat on the thighs covers underlying muscle and skeletal structure. In massive weight loss patients, this tissue hangs in a vertical direction. Even though most of the excess skin and fat from this region develops horizontally, it can also look as if it points downward.

When your surgeon begins to recontour the thighs, he pays special attention to delicate features of the area, most notably the superficial lymphatic structures (a transport system for fluid and immune cells). If the lymphatic structures are injured during a medial thigh lift, it can lead to serious complications.

The form of treatment we offer to MWL patients can be adapted since every person may suffer from a different degree of thigh deformity. While many men may not have developed an undesirable thigh contour, female patients are more likely to collect fat in this area. Even when a large amount of weight has been lost throughout the rest of the body, some women may still be troubled by stubborn thigh fat and saggy skin that seems impossible to be rid of.

The differing levels of thigh size and shape that patients experience means that we must be able to customize every recontouring procedure to suit the specific patient.BEFORE THE PROCEDUREWe begin evaluating each patient by assessing the extent and location of excess skin and fat. He also tests for any signs of medical issues such as deep vein thrombosis (clots in the legs) or lymphoedema (swelling). If these conditions do exist then thighplasty can’t be safely performed. If we have to remove horizontal skin as part of a woman’s thighplasty procedure, we are careful to check the extent of traction between the labia majora (skin lips) of the genital area. Properly judging traction in this area of the body is an essential thighplasty precaution that can help to avoid cosmetic complications such as spreading of the labia majora with the exposure of the labia minora (the inner lips).
MARKING AND TECHNIQUESSome MWL patients suffer from loose excess skin that can hang down to (or reach below) the knee. In these cases we must incorporate fat removal and redraping as part of the thighplasty procedure. This allows for a rejuvenated and healthier appearance after treatment is complete.