Inner thigh laxity

The thighs are an important and visible part of the anatomy, and modern fashion places a high emphasis on the thigh contour. The thigh consists of taut, elastic skin with a thin layer of subcutaneous fat covering the underlying muscle and bone. When standing with the feet together, the inner thighs should have a slight gap running from pelvis down to the knees.

The aesthetic female thigh is one that gently tapers in width from the top of the thigh down to the knees, whereas the aesthetic male thigh is generally cylindrical or fusiform with visible muscle contours. After successful thigh rejuvenation, individuals have improved body image and self-confidence, permitting them to choose from a wider range of modern fashion.

Thighplasty - Treatment for Inner Thigh Laxity Post Weight Loss

How Does It Manifest?

The unaesthetic thigh appearance includes excess lax skin, excess fat with obliteration of the thigh gap or a combination of both. Excess fat manifests as loss of the aesthetic tapered contour in the female thigh, or the loss of visible muscle definition in the male. Loose skin tends to gather on the medial (inner) thigh that drapes vertically downwards. In cases of significant weight loss, these skin folds may render it difficult or impossible for men to urinate in a standing position because urine may get trapped within these skin folds.

How does it arise?

The inner thigh skin has naturally few fibrous attachments to the underlying muscle. With significant weight loss, there is thinning of the skin and the subcutaneous fat layer. This results in excess unsupported skin that droops vertically downwards and creates the visible deformities. There are also persistent areas of fat deposits in the inner and outer thighs that do not disappear with weight loss; this is due to alterations in the metabolism of adipocytes (fat storage cells).

 

How is thigh laxity in weight loss individuals different?

Thigh laxity following weight loss is often much more extensive and severe than in regular post-pregnancy or aging individuals. Special skin excision techniques are needed to ensure maximal excess skin excision while minimizing the scar burden to achieve attractive postoperative outcomes. The skin in weight loss individuals is thinner and may require longer healing time than average individuals.

Specialized wound care techniques may be required in these cases to optimize wound healing and minimize scarring. Intimate knowledge of these anatomical and physiological differences and tailoring the treatment accordingly delivers optimal and bespoke outcomes.

Thighplasty

Thighplasty removes inner thigh skin excess, reduces remnant fat deposits through well-concealed scars in the inner thigh. It is an outpatient procedure may be performed under intravenous sedation or general anesthesia.

The following are good candidates for thighplasty:

  • Stable weight for at least 3 months
  • Normal or near-normal BMI with localized fat deposits

Individuals who have a high BMI may wish to consider other forms of weight loss interventions (e.g. diet and exercise interventions, or bariatric surgery) to achieve ideal weight prior to thighplasty for best results.

Thighplasty restores the thigh contour by excising excess droopy skin while minimizing scar visibility. High-definition liposuction techniques may be applied at specific areas to accentuate the muscle contour (e.g. the quadriceps groove), and fat obtained from liposuction may be grafted into the muscles to augment muscle bulk. These techniques enhance the athletic, toned appearance.

Individuals are advised to stop herbal supplements and traditional medicine, and start special medications 7 days prior to surgery to minimize bruising and swelling.

The location and amount of excess skin and fat are determined preoperatively, and the proposed scar marked out. Liposuction, if required, is performed through small incisions made at the inner thigh. It is performed using specialized cannulas that break up, and then aspirate the fat. The excess skin and fat is excised, taking care to preserve important nerve and vascular structures in the inner thigh. The amount of skin to be excised is a fine art: sufficient to create a pleasing contour, yet within appropriate limits to avoid excessive wound tension and complications. In individuals requesting for high definition of the thigh, additional 5-mm incisions are performed to facilitate liposuction and fat grafting, to accentuate the junctions between the thigh muscles.

Minor postoperative bruising and swelling is expected, which will mostly resolve after the 10th postoperative day. Many individuals are able to return to work after the 3rd postoperative day.

Stitch removal is not required as the stitches used are self-dissolving. Showering is possible from the second postoperative day onwards. Bruising may be minimized by avoidance of strenuous activity for the first 14 days. Specific post-operative compression garments may be required in the first 14 days to minimize postoperative bruising and swelling, guide the shrinkage of skin and prevent formation of irregular skin folds.

The Picasso Advantage

Post-weight loss thigh contouring is a niche and emerging field within plastic surgery. At Picasso Plastic Surgery, we are pleased to have embraced this subspecialty very early on in Singapore. Dr Yeo is privileged to have visited and learnt from some of the foremost overseas experts in this field in the past. He is similarly privileged to have worked with outstanding bariatric general surgeons and has accumulated experience in this area. Dr Yeo is regularly invited to speak on post-weight loss contouring at plastic surgery conferences in the Asia Pacific region.

Our clinic has an en suite operating facility that has MOH certification as an Ambulatory Surgical Center (ASC). An en suite operating facility within the clinic assures your maximal privacy and convenience and keeps facility and equipment costs contained. Our operating room carries a full range of equipment tailored for brachioplasty and aimed at delivering an optimal result.