THIGH LIFT SURGERY

If there is skin excess and a loosening of the skin on the inner thigh, liposuction alone will not correct the silhouette of the inner side of the thigh. It will be necessary to associate it with a skin tightening. This procedure is called lifting of the inner thigh or thigh lift surgery.

The aim of the procedure is to remove the skin excess, reduce the localized fat overload on the inner thigh and tighten the remaining skin, taking care to attach it to the deep aponeurotic fascia.

During the two preoperative consultations at Laclinic-Montreux, or at the Beauty Suite in Lausanne, (near Geneva by train), Dr. Jean-Charles BAYOL will evaluate the importance of the loosening and the amount of excess skin. He will inform you of the necessity of a cutaneous redraping in order to obtain the best cosmetic result.

As with any procedure on the silhouette it is strongly recommended to stop smoking at least one month before and one month after the procedure, because it can delay the healing process.

No medication containing aspirin should be taken a week prior to surgery as aspirin promotes bleeding and increases the risk of hematomas.

Generally, a treatment to prepare the skin for surgery will be prescribed the day before and the morning of the procedure.

In most cases, surgery is performed under general anesthesia in the operating room. A thigh lift surgery can be performed under epidural anesthesia, sometimes under conscious or sedated anesthesia (local anesthesia deepened by tranquillizers administered intravenously). The choice between these different possibilities will be discussed with the anesthesiologist during the preoperative consultation regarding anesthesia.

Most often, such surgical procedure last one day at Laclinic in Montreux , the check-out being done the following day of the surgery in the morning after a postoperative monitoring period. A thigh lift can sometimes be done in ambulatory surgery.

Each cosmetic surgeon carries out his own technique, he will adapt it to each case in order to obtain the best result. The main steps are as follows (Figure 1):

Figure 1: Thigh lift surgery technique

The scar is located in the front, following the groin fold to the area between the perineum and the upper part of the inner thigh and extends backwards to the buttock fold where it ends.

In case of important skin excess (after a loss of weight following a surgery to treat obesity, for example) this scar will be completed by a vertical scar located on the inner thigh.

Doctor Jean-Charles BAYOL always performs a liposuction before a thigh lifting in order to reduce the fat excess and to obtain a better skin redraping.

The skin excess is removed (the amount will have been determined before the procedure), the remaining skin is lifted and fixed in depth to the aponeurotic ligaments located at the top of the inner. This deep fixation allows to maintain the correction and prevents the scar from falling back.

A light dressing is made; a panty is put in place at the end of the procedure.

If the thigh lift surgery is performed alone, the procedure lasts one to two hours. It can be longer in case of associated procedures (liposuction of other regions).

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The patient is usually discharged the day after the procedure.

As with any surgical procedure, edema and bruises will appear. They will fade then disappear in 15 to 20 days.

To reduce the importance of these follow-ups, you will be systematically taken care of by the department of physiotherapy, for a postoperative care. The check-out will happen on the same day, in the case of an outpatient hospitalization, or the next day, if you stay in hospital overnight. Gentle massages of the operated areas and LED care will ensure the lymphatic drainage and will promote the healing process. Several weeks after the procedure, an LPG treatment can be undertaken on the areas where the fat tissue has been collected.

The postoperative follow-ups are not very painful but it is more a stretching sensation. Analgesics will be systematically prescribed after surgery.

Because of the vulvar and anal proximity, local cleaning care should be systematically carried out after each urination and each bowel movement to avoid contamination of the scars.

The healing process can be a little unpleasant due to the tension on the sutures: during this period, it is necessary to avoid any movement of brutal stretching.

A professional leave of 8 to 15 days should be planned after surgery.

Sport activities can be resumed after 6 weeks.

It will take 6 to 12 months to assess the final result.

The liposuction associated with the cutaneous redraping will give a more harmonious silhouette to the inner thighs.

The scars will be pink in the first months, it will take one to two years to see the final cicatricial result (white and discreet scar). These scars should be protected from the sun for at least one year.

The inner thigh lift is a delicate procedure for which even the greatest rigor does not in any way protect from a certain number of imperfections or complications.

Most often, a correctly performed thigh lift surgery represents a real improvement with a satisfactory result fulfilling the patient’s expectations.

Localized imperfections can occur and do not constitute real complications:

• The scar can be visible or distended. If there were significant tensions in the cutaneous redraping, the scar can be lowered resulting in a vulvar traction. The scar may also not completely fade or even be hypertrophic. It should not be forgotten that, if it is the surgeon who performs the sutures, the cicatricial process is the fact of the patient’s body.

• The results of liposuction may be characterized by inadequate correction, a slight residual asymmetry or small surface irregularities.

It is possible to retouch these imperfections under local anesthesia. It will be necessary to wait at least 6 months after the procedure to consider it such a procedure.

Even if it is a cosmetic surgery, thigh lift surgery remains a true surgical procedure that carries certain risks and complications, as rare as they may be.

The procedure must be carried out in a real surgical structure, complications related to anesthesia are exceptional. They will be discussed with the anesthesiologist during the preoperative consultation regarding anesthesia.

Regarding surgery, the choice of a qualified plastic surgeon makes it possible to limit the risk of complication without being able to completely eliminate them.

Possible complications include:

• Thromboembolic events (phlebitis and pulmonary embolism): These complications are very rare but serious. The treatment is above all preventive: wearing compressive clothing, early lifting and mobilization of both legs and anticoagulant treatment may be prescribed.

• Hematoma: rare in this procedure, it may sometimes require a new procedure to enable its evacuation in order not to compromise the final cosmetic result.

• Infection: The risk of an infection is increased by the proximity of the natural orifices. Treatment involves surgical drainage and prescription of antibiotics. A local cleaning after each urination and each bowel movement is paramount to avoid any cicatricial contamination.

• Lymphatic flow: From the second week. It may sometimes require iterative punctures

• Delay in the cicatricial process: As seen above, delayed healing may occur and may prolong the postoperative follow-ups.

• Delayed healing following a localized cutaneous necrosis: This delay will prolong the operative follow-up. This necrosis can be prevented by stopping tobacco consumption one month before surgery. A moderate resection of the excess skin is also possible to avoid tension and scar loosening.

• Diminution of the sensitivity of the upper part of the inner thigh: Sensitivity will reappear most often after 3 to 6 months.

A lift of the inner thigh is a real surgical procedure. When the surgical indication is well planned, it gives a real satisfaction to the patient both cosmetic and functional (clothing, disappearance of friction and maceration).