The Surgical Incisions and Results – Delaware and Pennsylvania

This educational writing on body lift surgery and body contouring surgery is part of a four part series. It is important to learn about the operations and all aspects about them. I specialize in exclusively cosmetic surgery and operations like body lift, lower body lift, and breast lift. Patients from Delaware, Pennsylvania, New Jersey, Maryland and surrounding states will find the these writings helpful. Similar concepts are reviewed for breast lift and can be seen in the writing “Breast Lift Surgery and Breast Reduction Surgery : Understanding the Incisions.”

Body contouring or body lift operations are composed of many different operations that can be combined or done separately. These operations include arm lift, breast lift, tummy tuck, buttock lift, and thigh lift. Lower body lift surgery usually is the combination of a tummy tuck and thigh lift surgery. Sometimes staging of operations is required as they all can’t be done at one time. Please see the “Procedure Info” section of my web page under Body Lift, for further discussion of this topic and staging surgery.

Thigh lift surgery typically has one of two incision patterns. The first pattern involves an incision high on the thigh in the groin crease. The incision length is typically 6 to 9 inches long. The second pattern involves a “stocking seam” incision from the groin to the knee area. This pattern has a longer incision. People all want the shorter incision. The cosmetic surgeon does also. This first incision pattern is the shorter one, but does not work as well as the second pattern, with the incision down the leg. This is because the second pattern allows for significantly more skin removal and usually dramatically better results.

The first pattern in the groin area is placed in a well hidden area, and this is the main advantage of this incision. New techniques involve suturing the deeper layers of the thigh skin or flap to the bony tissue of the pubis. This new technique, that I use, is reported to give superior results than standard thigh lifts. It is sometimes claimed that this thigh lift gives better scars, without spreading of the scar with time. The “Real-Reality” or truth is that thigh lift incisions can spread, regardless of which pattern or surgical technique is used. Most of the time the incision fades well. Most people are very happy with the operation and the results. But it is important to understand that a risk of the operation is the incision not fading as well as hoped or spreading of the incision.

Now that we understand what the thigh lift or lower body lift scar might look like, it is important to understand what type of results we can expect from surgery. In general, the thigh lift with the incision pattern in the groin, usually involves lower thigh liposuction. This operation typically gives moderate improvement to the upper inner thigh area. The improvement is best in the 4 to 6 inch area near the groin. Beneath the 6 inch area and further down the thigh, the results are from liposuction alone. The results are best in that small distance, very close to the groin. Further down the thigh, there is going to be persistent looseness of skin. This is because it is not removed by the smaller incision pattern that does not go down the leg.

Liposuction, which is done to the lower thigh, makes a person “a smaller version of you.” Please see the educational writing on liposuction titled “Delaware Body Contouring – Understanding Liposuction.” There is minimal tightening of skin with liposuction in this type of situation, with loose thigh skin to start. With incision pattern one, with just the groin incision, the thigh lift result or lower body lift result is improvement for a short distance in the upper inner thigh with substantially less improvement further down the thigh.

The second incision pattern is a stocking seam incision running down the inside of the thigh. This incision is along the inside of the thigh and tends to be longer. However, it allows for significant excess skin removal and hence significantly better results. A basic concept in plastic surgery involves the understanding of the relationship between skin removal and incisions. Small incision patterns allow for small skin removal. Larger incision patterns allow for larger skin removal. Larger skin removal gives better and more dramatic results.

This concept is very important when it comes to thigh lift results or lower body lift results. The same concept applies to tummy tuck surgery when comparing mini tummy tuck versus a “classic” tummy tuck operation. With the mini tummy tuck, less skin is removed. The results will not be as dramatic as with a classic tummy tuck with the longer incision. When it comes to the thigh incisions, longer incisions give better results. The stocking seam incision or the second incision pattern discussed for thigh lifts tends to be associated with much better thigh improvement and results. These patients tend to get much more substantial and dramatic improvement in the appearance of the thigh.

The best candidates for this procedure are patients who really want improvement, and typically need it. Significant weight loss for example is a good indication. These patients typically have major or significant looseness of the skin. Patients might say, ”I don’t care about the incision, just get rid of all this loose skin.” When they have this much loose skin, patients tend to love the result of the thigh lift, with the stocking seam incision. The operation gets them back into tighter pants and clothing.

In contrast, women who have minimal loose skin in the thighs, with some excess fat, might not want the longer incision. They might want less dramatic changes, and hence the long scar can sometimes outweigh the benefits achieved by the thigh lift. This patient might choose liposuction only or the shorter incision pattern. The doctor will review these options in detail with you.

If a patient is considering a thigh lift or body lift, she must understand the “Real-Reality” of the scars and the “Real-Reality” of the results. If a patient has significant loose skin, then there is a good chance they will be happy with the dramatic results that can be achieved with a thigh lift. However, if a patient has minimal looseness of the thigh skin, then they must be very careful when deciding to proceed with this surgery, other options must be considered.