Inner Thigh Lift

Q: Dr. Eppley, my objective is to reduce fat and tighten the skin in the inner thigh area, front, and back of thigh. I have decided to do this procedure but am searching to find the right surgeon and recommended procedure – inner thigh lift vs. Smart lipo. Please let me know if I can provide more information as I have attached some pictures. Thank you very much for the information and timely responses.

A: Thank you for sending your thigh pictures. What you are seeking is common, a reduced in size firmer inner thigh region. But the solution to it is anything but common or easy. The reality is that the inner thigh region is very difficult to get satisfactory results from an aesthetic standpoint, It will always leave one wanting better.

You have correctly identified the only two treatment options that exist for the inner thigh…fat reduction or an inner thigh lift. (removal of skin and fat) Neither is perfect, each one has their own advantage and disadvantages. Liposuction is a ‘scarless method’ that removes fat and relies on creating its results by skin contraction. The inner thigh skin is one of the poorest tissues to contract in the body so such results are usually only a modest reduction. (less than you want). Do not get hung up or enthralled with such liposuction technologies as Smartlipo which promote better skin retraction. I have the device and have failed to see any difference between it and other forms of liposuction. Also one must avoid being too aggressive with liposuction in the inner thigh as such efforts can result in very visible skin irregularities. The inner thigh is the number one area of dissatisfaction of the entire body with liposuction because of this very issue. This it pays to be more conservative but that also means less of a result.

Inner thigh lifts (which are combined with liposuction) produce a better result but does so at the price of a scar in the groin crease. That scar has a tendency in non-bariatric patients to end up drifting below the groin line due to tension and risks wider scarring.

You are a classic case of what you want you simply can’t get it the way you want it. (aka the best result with the least amount of scarring) You would be best off to initially do liposuction and let the results prove to you that any further efforts such as a lift would be worth it. Liposuction will provide some improvement and, as long as no substantial skin irregularities develop, it will be somewhat better but with no negative consequences. The risk of adverse and irreversible scarring makes the inner thigh best left for the bariatric patient.

Dr. Barry Eppley
Indianapolis, Indiana