Current Concepts in Medial Thighplasty
Section snippets
Anatomy
In contradistinction to other areas undergoing surgical rejuvenation, such as the abdomen or the lateral thigh, the medial thigh has a relatively thin dermal component. Under the dermis are two distinct layers of adipose tissue. Between these two layers is a poorly defined superficial fascial layer.
The deep layer of the superficial perineal fascia as described by Lockwood is a distinct connective tissue layer lying below the subcutaneous fat of the perineum. The layer attaches to the
Patient selection
One of the earliest signs of aging of the lower extremities is the presentation of medial thigh laxity. The skin of the superior medial thigh is quite thin, which may allow for the development of early ptosis. Women begin to present with these symptoms between the ages of 35 and 45. They also commonly complain of fat deposition in the trochanteric and hip areas as well as in the medial thigh. It is important to address the lower torso circumferentially with suction lipectomy at the time of
Classification of medial thigh patients
There are two separate categories of medial thigh patients. They are divided into those patients who have undergone MWL and those that have not. The non-MWL patients are divided into four categories. Patients who present with type I medial thigh deformity and possess only lipodystrophy with no sign of skin laxity can be treated with liposuction alone (Fig. 3). Those patients who present with skin laxity confined to the upper one-third of the thigh require liposuction and a horizontally
Classic medial thigh lift
In the classic medial thigh lift, the patient is marked in the standing anterior position with the knees apart. In this position, retraction of the skin both medially and posteriorly demonstrates the amount of skin to be removed. In addition, the location of fat deposits are delineated and marked for liposuction. The femoral triangles are marked to avoid dissection into the lymphatics. The incision is marked from the level of the ischium along the inner surface of the buttock's fold medially
Discussion
Most of the recent techniques of medial thigh lift are now based on Lockwood's concept of supporting the thigh lift with sutures to create a superficial fascialike suspension [11]. The techniques all attempt to anchor the lift on some portion of Colles' fascia. This technique of closure appears to address many of the problems associated with the original techniques of the medial thigh lift. The recent modifications all attempt to increase the fascial support and decrease tension on the healing
References (11)
Surgical reduction of the abdomen, thighs and buttocks
Surg Clin North Am
(1971)The “Crural Meloplasty” for lifting of the thighs
Clin Plast Surg
(1975)Correction of ptosis of the thighs: the thigh lift
Plast Reconstr Surg
(1966)Fascial anchoring technique in medial thigh lifts
Plast Reconstr Surg
(1988)Lower body lift with superficial fascial system suspension
Plast Reconstr Surg
(1993)
Cited by (40)
Abdominoplasty with Combined Surgery
2020, Clinics in Plastic SurgeryCitation Excerpt :Similarly, abdominoplasty is performed before the anterior thigh lift, because secondary lift of the thigh occurs. A thigh lift may either be performed proximally circumferentially as in the anterior proximal extended thigh lift, or as a vertical extended thigh lift classically performed for massive weight loss patients.10,11 The anterior proximal extended thigh lift is this author’s preferred approach for patients undergoing belt lipectomy because the impact of the thigh lift is compounded by the back lift, and the incisions are well-hidden in bathing suits and underwear.
Vertical Medial Thigh Contouring
2019, Clinics in Plastic SurgeryCitation Excerpt :A vertical medial thigh lift uses a longitudinal incision with a horizontal vector of pull to tighten the thigh like a cylinder. This allows adequate correction of the thigh laxity down the length of the leg and is the preferred method for treating the after weight loss patient.1–3,10–13 The laxity in the thigh has both a vertical and horizontal component.
Inner Thigh Lift
2019, Aesthetic Surgery Techniques: A Case-Based ApproachInner Thigh Lift
2018, Aesthetic Surgery Techniques: A Case-Based ApproachMedial thighplasty: Current concepts and practices
2016, Annales de Chirurgie Plastique EsthetiqueCitation Excerpt :While these techniques exhibit less pronounced vertical correction than in the primary description, on the contrary they have a horizontal correction vector that is indispensable for numerous patients coming to the end of a period of massive weight loss [21]. The liposuction procedure that removes fat from the internal hemi-circumference of the thigh can be carried out either during the same procedure or during another intervention, usually 6 months subsequent to thigh lift [19,22]. When the authors thereby proceeding by two stages carry out full-thickness cutaneous resection, it is so as to diminish the risk of lymphoedema that they conserve the great saphenous vein [19].
The vertical medial thigh lift
2014, Clinics in Plastic SurgeryCitation Excerpt :Although the concept seemed to be a logical approach to address problems associated with medial thigh lifts, it added little to existing procedures. In recent years, primarily in response to the increase in numbers of individuals with postbariatric body contour concerns, plastic surgeons have again advocated the excision of soft excess in both a vertical and horizontal vector to address medial thigh deformities.4,16–20 In addition, the significance of addressing the vertical soft tissue excess of the lower abdomen, hips, thighs, and buttocks before performing an effective medial thigh lift has become more generally accepted.