Inner Thigh Reduction: Reshaping Using a Two-Way Vector Technique

The Clinical Problem ( Fig. 39.1 )

The lower extremities, and especially the thighs, are one of the most typical surgery consultations in Argentina. Most patients with massive weight loss desire a better-looking shape of the thighs because they look deflated and have poor skin tone.

Deformities in the thigh region vary according to age, degree of skin laxity, and distribution of adipose tissue. Patient dissatisfaction with surgery can be associated with poor wound healing, seroma, inguinal scar migration, and poor contouring requiring revisional surgery.

The surgeon's major challenge is how to restore the skin and redistribute the fat in the upper inner thigh to good effect. Inner thigh laxity can be classified according to the vectors of tissue ptosis in the inner thigh.

Surgical Preparation and Technique

Surgical assessment of the thigh involves understanding the ideal anatomic shape, ideal skin envelope, and ideal fat distribution. The inner thighs ideally have the shape of an inverted cone, wider proximally and narrowing gradually toward the knees. This inverted cone appearance is affected by thigh skin laxity and adipose tissue under the influence of gravity ( Fig. 39.2 ). The thigh can be anatomically divided into three zones ( Fig. 39.3 )—inguinal zone, medial inner thigh, and upper knee section.