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Posts Tagged ‘inner thigh lifts’

Complication Rates of Inner Thigh Lifts

Thursday, January 8th, 2015

 

There are may women who are not happy with the appearance of their inner thighs. But when significant weight loss has occurred after dieting or bariatric surgery, the inner thigh can develop considerable loose skin which is maximally unaesthetic in its appearance. This is the most common patient in which an inner thigh lift (medial thighplasty) is done.

The inner thigh lift can treat varying amounts of loose tissue and there are a variety of patterns of skin and fat excisions that can be done. These patterns include horizontal, short vertical and long vertical inner thigh lifts. The pattern of excision chosen is based on the location and extent of the loose tissues and how much of the length of the inner thigh is involved. Despite inner thighs being now more than ever before, it is the one body contouring procedure which is probably written about and critiques the least.

Thigh Lift Scars Dr Barry Eppley IndianapolisIn the January 2015 issue of the journal Plastic and Reconstructive Surgery, an article was published entitled ‘Medial Thigh Lift in the Massive Weight Loss Population: Outcomes and Complications’. In this paper, 106 patients (90 women, 16 men) over a nine year period who had various types of inner thigh lifts performed were assessed. Horizontal thigh lifts had a 43% complication rate, short scar inner thigh lifts had a 67% complication rate, full length vertical inner thigh lifts had a 74% complication rate. Complications included wound dehiscence (50%), seroma (25%), infection (16%)  and hematoma. (6%) Chronic leg edema occurred in 25% of the patients which in a few patients took up to one year to resolve. Liposuction outside the scope of the excision was associated with increased complication rates.

For those plastic surgeons that have performed more than just a few inner thigh lifts, this study really rings true. Inner thigh lifts are associated with a high rate of complications and some degree of suture line dehiscence is the norm and not the exception. It is only a question of how big the separation will be and how long it will take to heal. To no surprise, the more extensive the inner thigh lift is (the longer the scar) the higher the rate of potential complications. It is a bit surprising that liposuction also increases the rate of wound dehiscences. But probably not surprising when thought about biologically since it traumatizes the skin flaps and disrupts lymphatic outflow.

Why do thigh lifts have such a rate of wound problems compared to other body contouring procedures? It simply is the location of the incisions are in an area of the body that is exposed to a lot of stress and shearing on the wound closure. It is also over an area of a density of lymph nodes (inguinal lymph node basin) which make sit prone to seroma formation.

Fortunately most of the wound complications associated with inner thigh lifts are not major and do go on to heal on their own without significant scarring complications. But what this study suggests is that over aggressive inner thigh lifts are doomed for problems and a more conservative inner thigh lift, while falling somewhat short of patient expectations in some cases, will more likely have a smoother and shorter recovery period.

Dr. Barry Eppley

Indianapolis, Indiana

Postoperative Instructions: Inner Thigh Lifts

Tuesday, March 5th, 2013

 

Inner thigh lifts are done to recontour the bulging or full area between the inside of the upper legs. In some cases, it is done to correct sagging inner thigh skin after a large amount of weight loss. Through a crecent removal of skin of varying widths with the upper end in the groin crease, the sagging thigh is lifted and tightened. Liposuction of the fat in the thigh skin below the excision is often done to debulk the inner thigh area as well. The location of the incisional closure/scar is hidden as much as possible in the groin crease.

The postoperative instructions for inner thigh lifts are as follows:

1.  Thigh lifts usually have a minimal amount of postoperative discomfort but they will feel very tight. There will be some swelling of the thighs and groins after this kind of surgery. This will go away within a few weeks.

2.  There are no dressings or garments to cover the incisions but they will be heavily taped. The tapes are to be left in place to serve both as a dressing and reinforcement of the incisions.

3.  After 48 hours, take a shower and do not worry about getting the tapes wet.  Do not take a bath or submerge the incisions under water for three weeks after surgery.

4.   The tapes on your incisions will be removed by Dr. Eppley at your first follow-up visit. Most of the sutures will be dissolvable and underneath the skin. There may be several support sutures on the outside which will be removed two weeks after surgery.

5.   Numbness of the skin around the groin and inner thigh is normal after this kind of surgery. Normal feeling will return but it may take up to three months after surgery for that to occur.

6.   Avoid exercise of any kind for four weeks after surgery so breakdown (opening) of the incisions can be prevented. Too much activity too soon is the main reason why problems with healing of the incisions occurs.

7. Squatting places the greatest stress on the inner thigh incisions and should be avoided as much as possible until the incisions are well healed.

8. You may drive when you feel comfortable and can react normally and are off pain medication.

9. The inner thigh scars will initially be red and ropey feeling. This will take months to settle down.

10.   If any redness, tenderness, or drainage develops after the first week of surgery, call Dr. Eppley and have your pharmacy number ready.

Consent for Plastic Surgery: Inner Thigh Lifts

Monday, March 4th, 2013

 

Every plastic surgery procedure has numerous issues that every patient who is undergoing a procedure should know. These explanations are always on a consent form that you should read in detail before surgery. This consent form, while many perceive as strictly a legal protection for the doctor, is actually more intended to improve the understanding of the inner thigh lift procedure. The following is what Dr. Eppley discusses with his patients for this procedure. This list includes many, but not all,of the different outcomes from surgery. It should generate both a better understanding of the procedure and should answer any remaining questions that one would have.

ALTERNATIVES

The alternatives to thigh lift surgery are liposuction which can remove some inner thigh fat but has little effect on skin tightening or lifting.

GOALS

The goal of thigh lift surgery is to slim and lift the inner thighs and reduce any prominent inner thigh bulging. Creating an space or gap between the inner thighs is not a realistic goal for most patients.

LIMITATIONS

The limitations of an inner thigh lift is in how much reduction and tightening can be achieved. There is a limit as to how much skin can be removed without risking wound healing problems and noticeable scar widening afterwards.

EXPECTED OUTCOME

Expected outcomes include the following: temporary swelling and bruising of the inner thighs, a temporary feeling of tightness and numbness of the inner thighs that is felt most with leg extension and squatting and up to 3 months after surgery until the inner thighs feel completely normal again.

RISKS

Significant complications from inner thigh lifts have not occurred. More common risks include infection,  wound separation, scar widening, a persistent tight feeling and discomfort on leg extension, and inner thigh irregularities and asymmetries and limited improvement in the profile of the inner thighs. Any of these risks may require revisional surgery for improvement.

ADDITIONAL SURGERY

Should additional surgery be required for inner thigh revision or any complications, this will generate additional costs.


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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