Inner Thigh Lift

The Clinical Problem ( Fig. 38.1 )

The medial thigh is a problematic zone for body contouring both in the aging patient, who has skin laxity and lipodystrophy, and in the massive weight loss patient, with critical skin flaccidity in the medial thigh.

Patients with morbid obesity who have undergone massive weight loss (MWL) following a diet or bariatric surgery develop body dysmorphia due to skin laxity and dermal fat excesses. They suffer interference in their quality of life because of the difficulty of personal hygiene, ambulation, and physical activities, as well as skin infections, postural changes, low self-esteem, and changes to the body image.

To remove the dermal fat excesses and improve the thigh contour, plastic surgeons have performed thigh lift procedures, associated with or without liposuction. The medial thigh lift was first introduced by Lewis in 1957 for the treatment of extreme flaccidness of the medial thigh.

However, this traditional technique was related to the recurrence of ptosis, scar migration, and vulvar deformities. Therefore, in 1988, Lockwood proposed a technique of anchoring the dermal tissue from the distal medial thigh to the deep layer of the superficial perineal fascia (Colles fascia) to reduce scar migration, leading to a more stable and long-term outcome.

Surgical Preparation and Technique