81 Medial Thighplasty

Rod J. Rohrich, Erez Dayan, and Joshua M. Cohen

Abstract

Liposuction-assisted medial thighplasty is a safe, efficient, and reproducible procedure that should follow a four-step algorithm: (1) L-shaped anterior markings, (2) superwet infiltration, (3) circumferential combined superficial ultrasound-assisted/suction-assisted liposuction, and (4) predesigned and patterned skin excision and layered closure. It simplifies the markings and resection, and the procedure preserves the lymphatics and nerves, minimizes blood loss, and maintains the saphenous vein system to prevent skin loss and wound breakdown. It produces reliable and predictable results, with optimal outcomes. This technique offers another refinement in the evolution of medial thigh contouring.

Medial thigh lift – thighplasty – body contouring

81 Medial Thighplasty

Key Points

Traditional medial thigh lift has been associated with postoperative problems such as inferior wound migration, scar widening, lateral traction deformities of the vulva, and early recurrence of ptosis. Possible surgical damage to the lymphatic vessels increases the risk of seroma and recovery can be painful due to the sensitivity of the area.
A modified approach to the medial thigh lift presented in this chapter avoids many of the complications associated with traditional thigh lift while allowing for predictable aesthetic outcomes.

81.1 Preoperative Steps

The patient is marked to create an inverted L-shaped incision, which leads to a predesigned and patterned skin excision. The patient is marked first in the standing position with the legs slightly apart. The final desired location of the incision is along the medial thigh from the lower aspect of the knee to the crease.
Using a skin pinch method, the medial thigh skin is assessed for redundancy and mobility by transposing in both the anterior and posterior directions to meet the previously drawn line. This demonstrates the amount of skin to be removed. This maneuver leads to an ellipse pattern skin excision that tapers at the medial knee. The width of the ellipse is based on the skin pinch and typically ranges between 10 and 15 cm (Fig. 81.1).
The anterior, proximal incision is drawn such that a gentle curve is achieved in an inverted L-shaped anterior marking. The superior and inferior end of the incision ends up conical.