What Is Thigh Lift?
A thigh lift is an operation in which the excess skin in the area of the thighs is removed. Usually the patient comes in after undergoing gastric bypass surgery or the patient has undergone significant weight loss leaving this area rather hollowed out and unsightly. We evaluate these patients first and see if they are good candidates to undergo this procedure. If so we then offer them the procedure. In many cases, we have the patients undergo a 6 to 8 weight training and fitness course to maximize their underlying physique and maximize their fat loss. This ensures we start with good underlying tissue. We then do our best to give the patient the best operation aesthetically. We take care to place the incisions in the medial aspect of the thighs so that patients cannot see them when they look in the mirror. This helps to hide the incisions best. Ideally, the patients will have had their weights plateau prior to the operation and this operation only serves to take care of the unsightly areas to give them a tighter, younger look.
How Painful Is the Procedure?
Like any surgical procedure, there is pain involved. Most patients comment that they have a moderate amount of pain. To help with the pain, we regularly give patients oral pain medicine upon their discharge from the hospital. In an attempt to also help with the more immediate post-operative pain, we place indwelling pain pump catheters. These are placed during surgery and enable a self-contained system to dispense local numbing medicine (Marcaine) into the area of the incision and help with anesthetizing the incision and wound area for the first 48 to 72 hours. The pain pump is heat activated so as long as it is taped to the body it will work. It is a continuous pump and does not need to be activated or regulated by you, the patient.
How Long Do I Have to Take Off From Work?
Great question. Most often I suggest to patients that they consider taking about 2 to 3 weeks off from work. Each patient is different but in my experience, I have seen most patients be active and up to most of their usual tasks by 3 weeks after surgery. Again each person and each body is different. One thing I need to mention is that I would require as most plastic surgeons do that you wear a contouring outfit to give you additional support during your recovery period. I would recommend you wear this compression garment for approximately 6 weeks following surgery.
What Are the Possible Complications of a Thigh Lift?
There are many possible complications of a thigh lift. Most often these complications include infection, bleeding, seroma formation, dehiscence, contour irregularity, asymmetric result, and numbness. One by one we will discuss these. Infection is an issue here because most of these operations leave the patient with large incisions. We do our best to hide the incisions but we cannot make them smaller. Therefore, we do our best to give the patient the best coverage and anti-bacterial support with preoperative, intra-operative and postoperative antibiotics. This helps to reduce the chances of getting an infection. The patient also helps with this by being diligent in the care of the incision. Bleeding is a possibility. However, this tends to be easily managed in the operating room. We are diligent in stopping all bleeding points that we can see. As for bleeding, however, the patient plays the most important role. Bleeding can best be prevented by the patient. Patients need to be off of any type of blood thinners such as coumadin, aspirin, Plavix, and must also be off of vitamins and additives for at least three weeks. It may sound strange but many of the bleeding complications seen are due to the use of vitamins. So again the patient by being diligent and thoughtful can be the best asset.
Seroma is a fluid collection and its formation is understandable when there are so many long incisions on the body. A seroma tends to accumulate in an area with an open space. In patients undergoing medial thigh lifts, this can be a definite problem. To help with this we tend to keep drains in place for several weeks. These drains help to evacuate any excess fluid and keep the underlying tissues as dry as possible allowing for maximal healing. The thigh area is also helped with the use of a compression garment that can help tighten tissue spaces and hinder the formation of a fluid collection. So again patient compliance can help reduce the chance of this complication.
Dehiscence is the breakdown of a wound following surgery. This can occur when two areas are tightly forced together. To prevent this we do exact measurements of the patient’s body contour and mark our incisions carefully. This gives the patient a certain amount of leeway and ensures that stress and movement do not cause a breakdown in the incisions.
Asymmetries and contour irregularities are often seen in these operations. Since there is a significant amount of tissue resected, most often small irregularities are noted. This is not to say that they are accepted. However, they are common. As the patients swelling dissipates, these areas are better assessed and they are individually tailored and repaired to give the patient the overall result that they want.
Last but not least, numbness. Numbness is common in and around the incision areas. This again is not unexpected. When incisions are made and tissues are moved, nerves can in some cases be cut and in other cases stretched. Because of this numbness is an expected complication. Most often the nerve sensation returns in time. Unfortunately, when exactly the function returns is unknown. Most often nerve sensation returns within 6 months to a year.
Can I Combine This Procedure With Any Other Procedure?
Yes. This operation can and is routinely combined with other procedures like an abdominoplasty. Please note that any procedure that may be too long or too arduous and place the patient at risk for significant bleeding or significant anesthetic exposure would have to be deferred and done in two stages. Please understand I say this without knowing exactly what you, the patient, may have in mind. I can only speak from my experience.
Am I a Good Candidate?
Plastic surgery is not for everyone. It involves certain risks like any operative procedure. As long as you are aware of this fact, you can be considered for the procedure. However, in every case, the patient is best served by a thorough evaluation of their history, their body, and their overall expectations. You as the patient have to be realistic and cognizant of what is possible and what is reasonable. Trust me I am from Beverly Hills and I have had the privilege of working with many of the famous groups of plastic surgeons in LA. I can simply tell you there is no magic. We offer an opportunity to help you with surgical procedures in correcting what you may think is abnormal about your body. Also please understand that for many patients no surgery is needed; just a friendly word of encouragement and confidence from the local plastic surgeon.