Thigh lift after massive weight loss is typically beyond cosmetic improvement. A good number of patients also seek the procedure to find relief from non-healing skin irritation and tissue breakdown caused by the redundant skin rubbing each other every time they walk and move around.
Leading Los Angeles plastic surgeon Dr. Tarick Smiley says that thigh lift after massive weight loss is commonly combined with tummy tuck and buttock lift. By simply extending the hip-to-hip incision of tummy tuck around the entire waistline, surgeons can reshape the outer thigh, anterior abdomen, and buttocks all at the same time.
Despite the contouring effects of the aforementioned technique (which is referred to as 360 degree lower body lift), patients with healing problems and other “risk factors” may have to stage their surgery to minimize risk of complications.
This is the typical incision pattern used in outer thigh lift surgery.
As a stand-alone procedure, the incision pattern used in thigh lift will depend on the location and the extent of redundant skin. For instance, the outer thigh requires an incision starting from the hip down to the groin and so the resulting scar lies precisely at the “panty line.”
Meanwhile, the inner or medial thigh lift requires incisions starting from the groin down to the knee and so the resulting scar is on the inner aspect of the thigh.
This is the actual scar resulting from a medial or inner thigh lift surgery.
Compared to other body contouring procedures, recovery from thigh lift is generally “tougher” because of the increased swelling due to gravity and the full weight of the legs. Hence, the first two weeks are the most critical period, requiring the patient to be extra cautious when moving.
The patient must move carefully and slowly to avoid pulling on the incisions. It is important to note that wound dehiscence (reopening) requires longer time to heal.
After two weeks, most patients can slowly increase their activity without causing an elevated heart rate. Over-exertion must be avoided for an additional 4-5 weeks to prevent more swelling and healing problems.
Most patients are advised to take 3-4 weeks off so they can focus on their recovery. Furthermore, protein supplements along with superb diet (more fresh fruits and vegetables and whole grains, while avoiding too much fats and sodium) can help patients improve their healing.
Oftentimes, thigh lift after massive weight loss is followed by other body contouring surgeries such as tummy tuck, arm lift, or back lift.
Male body contouring surgery can range from liposuction, breast reduction, to tummy tuck and other types of body lift following massive weight loss. While the goal is to achieve a more masculine physique, which possesses fundamental traits as suggested by several studies, the results will still depend on the patient’s “starting” anatomy.
Renowned Beverly Hills plastic surgeon Dr. Tarick Smiley, who regularly posts educational videos on Snapchat tackling the issue of male body contouring surgery, has provided a list of the most popular procedures and the corresponding ways to achieve gender-appropriate results.
- Liposuction —i.e., body contouring surgery in which the unwanted fat beneath the skin is removed with a hollowed tube
Unlike women who generally seek liposuction to appear more slender, men are more interested in looking more toned. Hence, male patients require less fat reduction.
Male liposuction typically entails a small amount of fat removal just to “reveal” the underlying muscle (like the appearance of six pack abs).
About 27,760 male breast reductions were performed in 2016, according to a survey released by the American Board of Plastic Surgery.
Gynecomastia, a condition in which the male breasts appear overdeveloped, affects up to 60 percent of men although in the vast majority of cases it disappears after puberty (or when the hormonal levels stabilize) or after cessation from drugs causing the woman-like breasts.
But for men whose enlarged breasts that persist longer than two years and even after the elimination of “possible contributing factors” (e.g., obesity, hormonal imbalance, drug, and medical condition), surgery might be a good option provided they are healthy.
All male tummy tuck patients have lost a significant amount of weight, leading to the redundant skin that may not just affect the abdomen, but also the flanks and back. Therefore, they typically require longer incisions, which of course lead to longer scars.
Tummy tuck not just removes the apron-like skin; if needed, the surgery may also involve muscle repair in which the pair of muscle extending from the breastbone to the pubic region is tightened in the midline.
Due to the natural diffusion of redundant skin and tissue laxity that commonly follows drastic weight loss, most tummy tuck patients also need arm lift, buttock lift, and lower body lift for a more proportionate result.
While body contouring can help patients achieve a more masculine physique—which is generally defined as an inverted triangle torso as it tapers from the shoulders to the waist—it is important to note that their underlying anatomies will still have a large effect on the final results.
Therefore, the right candidates for male body contouring surgery must be able to explain their “realistic” goals in details to their surgeons.
Most people battling obesity for many years think that weight loss [bariatric] surgery is the only solution to their problem. However, they may not realize that lifestyle changes, full commitment and grit, guidance from experts, and community support will also play a critical role in their lifelong journey towards being healthy.
Plastic surgery, such as circumferential body lift surgery and tummy tuck, is also a critical part of their weight loss journey. After massive weight loss, redundant skin and tissue laxity affect the thighs, upper arms, abdomen, hips, back, buttocks, and breasts.
Surveys have suggested that body contouring after massive weight loss is one of the fastest growing fields in plastic surgery due to the growing number of patients seeking bariatric surgeries. Furthermore, researchers have found that it can substantially improve the patients’ quality of life and body image.
And with improved body image, patients will have a stronger motivation to stick to healthier lifestyle and ultimately preserve the results of body contouring surgeries.
“The excess skin not just prevents MWL patients from fitting better in their clothes. It can also result in skin irritation, pain, foul odor, and discomfort,” said leading Beverly Hills plastic surgeon Dr. Tarick Smiley.
One of the most powerful plastic surgery techniques for MWL patients is circumferential body lift, which basically combines tummy tuck, outer thigh lift, and buttock lift. Hence, the resulting scar can stretch across the lower abdomen, hips, and upper buttocks.
Incisions are made to remove crescent-shaped segments of skin and some excess fat from the buttocks, outer thigh, and abdominal areas. If needed, the pair of abdominal muscle, which extends below the breastbone and to the area just above the pubic region, is tightened with internal sutures at the same time.
The remaining skin is then tightened and redraped to the new contour. Afterwards, dressings are applied and drains are put in place to prevent seroma or fluid buildup. To further control swelling and promote healing, firm elastic bandages or compression garments are used to support the area.
Since circumferential body lift surgery is basically a multiple surgeries operation, it entails a “tough” recovery. Meanwhile, most patients are back on their feet 2-3 weeks after surgery, although they should still avoid strenuous activities and heavy lifting for another 3-4 weeks to prevent healing problems.
The axillary lift is a type of body lift commonly performed in massive weight loss patients. This procedure deals with the redundant skin and fat along the armpit, which not only causes unsightly bulges but also poor odor, skin rashes, and non-healing irritation.
Leading Los Angeles plastic surgeon Dr. Tarick Smiley has recently demonstrated the axillary lift on his Snapcat account. He performed the surgery in a female patient who had lost a lot of weight and so she was left with redundant skin.
The celebrity surgeon created a wedge-shaped incision covering the armpit and the lateral chest, thus allowing him to remove a large amount of skin and fat. The wound was then closed in a way that the resulting scar would lie parallel to the transverse armpit fold.
Dr. Smiley says it is of critical importance to remove just the right amount of redundant skin to allow for proper wound closure and to prevent limited activities of the arm.
“We should strike the perfect balance between creating a tighter, smoother armpit area and avoiding too much tension, which happens after an over-aggressive skin resection,” says Dr. Smiley.
Hence, he highlights the importance of the surgeon’s experience and “eye for details” when performing any type of body contouring surgery after weight loss.
The resulting scar from the axillary lift could migrate or appear conspicuous if there is too much tension on skin. For this reason, Dr. Smiley always closes the wound in several rows so the tension on the superficial layer is mitigated, which also allows for good healing.
To further promote favorable scars, he recommends silicone sheets and gels as they hydrate the skin. Wound that heals in a moist environment is known to fade better.
Occasionally, the axillary lift is combined with other body contouring surgeries such as brachioplasty (arm lift), arm liposuction, and even breast surgery, says Dr. Smiley.
Butt lift surgery (should not to be confused with Brazilian butt lift, which in essence is buttock augmentation via fat transfer) is typically performed in massive weight loss patients who often complain about the redundant skin.
Most buttock lift risks can be avoided or at least reduced with proper patient selection. The goal is to reserve this elective surgery only to people who have achieved their optimal health and weight.
Lab screening and lengthy consultation between the surgeon and his patient will help determine if the latter is healthy enough to handle surgery, according to the California Surgical Institute website.
Patient cooperation is another key factor to minimize butt lift risks. For instance, infection, increased bleeding, and poor healing are closely linked to smoking, aspirin and other drugs and supplements with blood thinning properties, and obesity—risk factors that can be eliminated by the patients’ themselves.
A good rule of thumb is to discontinue smoking and aspirin products at least three weeks before and after surgery.
Wound healing problem is one of the main issues during recovery. It is important to note that the incisions—whether made within the junction of the butt cheek and posterior thigh, or near the waistline if the surgery is combined with a lower body lift—are under a great deal of stress due to movement while walking, sitting, etc.
To reduce risk of wound healing problems, great surgeons know the importance of proper suturing techniques in which there is no or very little tension on the skin. For this reason, layers of sutures in which the deep tissue receives most of the tension are critical to promote good healing and scarring.
Nonetheless, patients should also do their part in reducing healing problems by avoiding over-exertion for a minimum of three weeks postop. For this reason, individuals whose work requires heavy lifting or any type of rigorous activity are advised to take a longer time off than people with desk job.
Unacceptable scarring (i.e., keloids or thick scars) is another risk, although this can be avoided with meticulous wound closure, wound care, and proactive scar treatments like silicone tapes and gel and sunscreen. Nonetheless, genetics remains one of the strongest predictors of how well a person will scar.
A circumferential body lift, also known as lower body lift, removes the redundant skin and fat around the frontal abdomen, hips, and back, resulting in a belt-shaped scar that is generally concealed by the patient’s underwear, says leading Beverly Hills plastic surgeon Dr. Tarick Smiley.
Circumferential body lift is almost always performed after massive weight loss and basically combines three major surgeries, namely, tummy tuck, outer thigh lift, and buttock lift. For this reason, it is only reserved for healthy patients with no healing problems.
While most patients having some type of body lift already know the basic preparations—e.g., 8-10 hour fasting prior to the operation, eating healthy, reaching the ideal weight, avoiding tobacco products and drugs with blood thinning properties (aspirin and ibuprofen)—they may not be aware of some seemingly trivial details explained below.
Due to the invasive nature of circumferential body lift, the amount of bleeding might be an issue. For this reason, some patients may need blood transfusion during surgery; however, in the ideal scenario they can donate blood at least four weeks ahead of time and have it stored in case they need it.
- Some natural remedies can affect healing
Some natural remedies and herbal supplements not just affect healing or increase bleeding, but may also may interact with anesthesia and painkillers. Furthermore, their effects are still widely unknown and so a good rule of thumb is to avoid them altogether at least 2-3 weeks before surgery and about a week afterward.
- Caregivers are life-savers
In the first few weeks postop, the patient should only focus on her recovery. Everything else—e.g., childcare, house chores, and office work—are put on the sidelines.
A good rule of thumb is to line up two or more caregivers, who can help the patient get around during recovery.
Loose soft clothes (button down shirt and loose-fitting pants) that are easy to put on and take off are important during recovery especially when the patient is made to wear compression garments and surgical drains.
- Ask for the surgeon’s shopping list
Most surgeons will provide a shopping list that typically includes painkillers, compression garments, scar creams, and even healthy snacks and drinks to help their patients plan their recovery well ahead of their surgery.