By: Jeffrey Wisnicki, M.D., F.A.C.S.

There’s no substitute for exercise. But there’s also no substitute for surgery.

Exercise will firm and define your muscles and reduce body fat. But loose skin may remain and that may be most effectively addressed with a tightening procedure.

This patient had particular concern over loose rolls of skin along the inside of her thighs which followed significant weight loss. An inner thigh lift (also referred to as a medial thigh lift) was performed removing the unwanted skin and fatty tissue excess. This helped smooth out theinside contours of the thighs specifically. The scars are hidden high within the groin crease. The lift may be combined with selective liposuction if needed. The procedure is performed under general anesthesia. It can be done on an outpatient basis allowing the patient to return home the same day. Drains are not typically used. Postoperative pain is not generally severe and is usually well controlled with oral medication as needed.

Care needs to be taken during the recovery period, particularly over the first couple of weeks. Activities need to be curtailed to avoid stresses on the suture lines and one must be conscious of leg positioning for the same reason. Lying down, standing and walking are not problems but sitting requires caution while healing after surgery. Avoiding direct pressure and sitting on carefully positioned cushions helps protect the surgical sites. Timing of the return to work depends on the nature of the work performed but typically is on the order of two weeks.

In a few cases following massive weight loss, removal of marked excess skin may require a vertical scar along the inside of the thigh. This decision will follow a discussion between patient and surgeon on advantage (tighter thigh skin in this scenario) versus disadvantage (longer, potentially more visible scar). Most other cases will allow for a relatively inconspicuous scar that falls above selected panty or swimsuit lines.

Potential complications with this procedure (as with all surgical procedures) may include infection, hematoma (bleeding), and abnormal scarring. Candidates for surgery should ideally be otherwise healthy and medically cleared. Precautions are always taken to minimize risk and treatment to address any problems is carried out when necessary.

As with all body contouring procedures, these operations are not designed as a substitute for weight reduction (although certainly this is achieved to some degree by virtue of the removal of skin and fat). In fact, these approaches are most beneficial following appropriate weight loss. In patients where sagging skin is less of an issue, but inner thighs bulge out due to localized fat deposits, liposuction alone may provide a satisfactory solution. With adequate skin elasticity, re-contouring of the thighs will occur with fat removal only. The inner thigh lift is reserved for those situations where there is poor skin elasticity resulting in unsightly sagging. The outcome of the right procedure for a given problem can be dramatic!