Liposuction is, by far, the most common body plastic surgery procedure. If not by numbers, then certainly by surface area. One of the most frequently treated areas is that of the thighs. Whether it is unhappiness with saddlebags (outer thighs) or fullness and loose skin on the inner thighs, contouring of the legs between the hips and the knees is prime liposuction territory.
When considering thigh liposuction, there are several important concepts for patients to grasp. Reshaping the thighs with liposuction techniques is more than just ‘fat reduction’ or fat volume removal. Because the thighs are not just a flat surface but a circumferental round structure, treating them must take that into consideration.
The first thigh liposuction concept to understand is that reducing the circumferential measurement or fullness of the thighs is not usually practical. Because all liposuction methods use a straight cannula instrument on a round structure, it becomes easy to see how one major problem can occur…irregularities and unevenness of the contour of the thigh. A straight cannula combined with the fact that the surgery is performed with the patient lying horizontal on the operating room table, where fat areas shift and distort, is a recipe for this problem. Thigh lumpiness and areas of dips and valleys will make the most tolerant patient unhappy. As a result, making the thigh overall smaller is rarely a satisfying approach.
Secondly, volume reduction of thighs is best done on the lateral thigh or saddlebag area. On the outer aspect of the thigh, real visible reduction by significant fat removal can be done while maintaining a fairly smooth contour. (because it is the one area of the thigh that is relatively flat. Reduction of saddle bags can make for a real change in the contour of one’s legs and the way that a woman appears in pants or skirts.
Third, inner thigh liposuction is about shaping and not so much about significant volume reduction. Many women are bothered by the fullness in their inner thighs. But liposuction can not reduce them enough to ‘create a space between them’ or keep them from touching each other. Trying to do so invites indentations, irregularities, and loose hanging skin. Such a result occurs when liposuction is done too aggressively and tries to do too much. This is why inner thigh liposuction is one of the highest dissatisfied liposuction-treated areas. Think reshaping of the inner thigh done through the knees and into the calfs, adding subtle thinning and more shape into and around the knee area.
Lastly, be aware that the common problem of cellulite on the thighs will not be improved by liposuction. Liposuction is not an effective treatment for cellulite, no matter what you have read or have heard someone say. In fact, if liposuction is not done carefully under skin with visible cellulite, fat removal may make it appear worse afterwards. Aggressive liposuction done under cellulite is a mistake. Conversely, liposuction should be done conservatively and treatment should be directed at the lower levels of fat staying away from the underside of the skin. A little thigh reduction with no change in the appearance of cellulite is better than a bigger reduction with worse cellulite…that is not a good trade-off.
Dr. Barry Eppley
Indianapolis, Indiana