Background: Large amounts of weight loss, whether from bariatric surgery or through non-surgical diet and exercise, has an overall body deflation effect. This is manifest as loose skin which can be seen from the neck down to below the knees. All of this loose skin has created a whole spectrum of new body contouring procedures which are really extensions or expanded forms of traditional body lifting techniques.
The thighs are a well known area for the development of loose skin which is largely seen in the inner thigh area. The traditional horizontal groin crease thigh lift is not remotely adequate for most weight loss patients. Extended inner thigh lifts are what is usually needed and are done by either a T-shaped or inverted L-shaped skin excision pattern. While effective, the horizontal skin closure often poses problems of postoperative wound dehiscence, wide scarring and scar drift downward from the groin crease line.
A vertical inner thigh lift concept avoids the use of a groin crease excision/closure line. It is done by creating a larger vertically-oriented elliptical excision of skin from the inner thighs. Its use is reserved for those patients who on a preoperative pinch test produces little to no bunching at the upper end of the planned incision at the groin crease.
Case Study: This 28 year-old female had lost over 60 lbs and had previously been through breast augmentation and a tummy tuck to improve the loose skin in these area. She had loose skin on the inner thighs but it was largely along the inner thighs along a vertical line from the groin creaser to above the knees..
Under general anesthesia and in the frog-legged supine position, a large vertical ellipse of skin was marked out on the inner thighs. The widest margin of skin excision was central as determined by a preoperative pinch test and measured 14 cms. The skin was excised preserving the saphenous vein and closed in a single fine vertical line. No drains were used.
The vertical inner thigh lift will not work for every weight loss patient and depends on how much loose skin one has on their inner thighs. But when possible its uses avoids the potentially problematic horizontal groin crease incision and an intersecting horizontal and vertical skin closure.
Highlights:
1) Loose skin after large amounts of weight loss affects the body from neck to knees
2) Inner thigh lifts usually require a 3D removal of skin in both vertical and horizontal dimensions to be effective.
3) Vertical inner thigh lifts involve a 2D removal of skin and avoids horizontal groin crease scars.
Dr. Barry Eppley
Indianapolis, Indiana