Your Questions

Q: Dr. Eppley, I am interested in liposuction or perhaps one of the non-invasive body contouring approaches. I am a petite 23-year old female who is 5’4” tall and weights 112 lbs. I am in pretty good shape, but have areas of fat on each of my inner posterior thighs that will not go away with any form of exercise and have been there all my life. I would be very happy with a visible reduction of this area and the bulges eliminated. I am also very apprehensive about any procedure requiring general anesthesia and would greatly prefer to reduce risk. But on the other hand, I don’t want to waste money on noninvasive treatments that don’t offer a significant improvement.

A: Liposuction would be the most efficient and effective method of fat removal for your inner thigh areas. But given their small size, this could be done under local anesthesia with or without oral or IV sedation if you were so motivated. While Coolsculpting or Exilis devices would produce some positive changes in the inner thigh bulges, it would not be as much nor as fast as with microcannula liposuction fat extraction. Since these inner thigh bulges have been present your entire life and this body area is not a known fat depot side, the reductive changes induced by liposuction should be permanent.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am 48 years old and am tired of my ugly looking inner thighs. Not only do they touch and rub all the time, which is irritating and embarrassing, but the skin is loose and not very tight.I want to know if liposuction on my inner thighs will tighten them or make them even more saggy. I want some fat removed but I don’t want to make them look worse.

A:  The inner thighs, although not a big area, represent a challenge for satisfying liposuction results. The quality of skin in the inner thighs is typically not good in that it has poor elasticity. This translates into a very limited ability to contract which is a critical factor needed to get good liposuction outcomes. As a result, liposuction of the inner thighs does not tighten the skin and in some cases may even make it look worse.While liposuction can help slim down the inner thighs, it is an area that is notorious for irregularities and unevenness. This is because the skin in this area does not shrink or tighten well after it is deflated by fat removal. It is also an area that is very difficult to get smooth results because it is a curved structure rather than a flat surface. While everyone's skin elasticity is different, your description of your inner thighs does not sound very favorable for good skin contraction after liposuction. This does not mean that you should not have it but that a conservative approach should be done with expected modest changes. You may want to consider liposuction combined with an inner thigh lift. That is a great way to hedge against the risks of loose and irregular skin by treating the skin problem at the same time.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am 29 years old and have always had heavy legs. For whatever reason, I got stretchmarks on my inner thighs during my teen years and they have never gone away. I want to get liposuction and was wondering if my stretchmarks would affect the result in any way. Will it not look as good afterwards if the skin is stretched out to begin with. If so, is there an alternative to liposuction that would be better? Thanks!

A: You have brought up a very good question, particularly when one is contemplating liposuction of the inner thighs. The inner thighs is a common area for patient dissatisfaction after liposuction. This is because the skin of the inner thighs does not have as much elasticity as other body areas so it is prone to not adapt well (shrink down) after fat reduction. This can lead to an inner thigh with irregularities and more loose skin after liposuction. This is why liposuction of the inner thighs must always be done more conservatively than in many other body areas and patient should expect modest improvements only. This would be particularly true when it it recognized before surgery that the skin is of questionable elasticity. Having stretch marks put you into the questionable skin quality category. One must think carefully about liposuction in this area under these circumstances and, without examining you, I can not tell you whether you would be wise to have liposuction or not. There are some emerging non-surgical technologies that are good alternative choices. Radiofrequency devices, like Exilis, can be very beneficial for skin tightening and some fat reduction. Whether you should have this alone or done after your liposuction surgery is a good question that can only be answered by an examination.

Dr. Barry Eppley

Indianapolis, Indiana

Q:  Dear Dr. Eppley, I had liposuction six months on my stomach, saddle bags, flanks and inner thighs. The doctor told me he removed 4 liters of fat. I am very happy with the results with the exception of my inner thighs. I now have some saggy skin and irregularities of the inner thighs. Is this common afterwards? Can some form of non-surgical skin tightening be done to make it better?

A: Liposuction can be tremendously effective for many body areas and the inner thighs are no exception. But inner thigh skin does not usually have much ability to contract so only conservative fat removal should be done in this area and patient expectations should be tempered as to how much size reduction can be done. If too much fat is suctioned out, the inner thigh skin can be made to sag with irregularities. There are numerous non-surgical skin tightening devices that can be tried and they have all have some effect. My current favorite device is Exilis which uses monopolar radiofrequency energy to create skin tightening through a series of treatments. If this is not successful, you may need a definite inner thigh lift which will solve this concern.  

Dr. Barry Eppley

Indianapolis, Indiana