Your Questions

Q: Dr. Eppley, I am interested in inner inner thigh liposuction. I want to create a space between my inner thighs, a so called thigh gap. How much total fat do you think you could harvest? If I take a big pinch of skin and fat at my inner thighs I can make a visible thigh gap. Would that be a realistic result from inner thigh liposuction. My weight is around 132 to 137lbs at 5’4” if that helps with any part of the assessment.

A: The thigh appearance you are showing, known as a thigh gap, can not be created by liposuction. That is asking liposuction to do more than it is capable of. Many thigh gaps that you see in ads and model pictures have been created by ‘Photoshop liposuction’ or the women are exceptionally thin and have it by genetics. If you don’t naturally have a thigh gap, surgery is not likely to create one.

The inner thigh area is a challenging area for good liposuction results because the skin is unforgiving (poor elasticity) and has little ability to retract and reshape. If one is very aggressive and too much fat is removed there will be contour deformities and indentations as a result…thinner but misshapen. Conversely, if one is more conservative and does not take too much fat, then the resultant change is very modest. This is why the inner thighs are the #1 body area for dissatisfaction from liposuction…the results are often not enough or another aesthetic problem has been created. You have to ‘pick your poison’ so to speak…a modest change with likely smooth skin or a more aggressive volume reduction and a higher risk of contour irregularities and skin dimpling.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am 32 years old, 5’ 4” and weigh 148 lbs. I have been struggling my entire life with a very disproportioned body. I have a pear-shaped body with saddle bags and thighs that don’t seem to match what I look like above my waistline. This gives  me a problem when it comes to finding clothes particularly pants. I want to get liposuction to improve this problem but I have two concerns. First, how effective will it really be? Can it really make a significant difference in the shape of my lower body? Second, I have cellulite and stretch marks and am afraid that it will make them look worse. Despite these fears, I am so frustrated with these bulges of flab that I can do nothing about, no amount of exercise does anything. Plus this flab irritates me when I walk as it jiggles.

A:  While your concerns about liposuction is understandable, they should not stop you from eventually getting a positive change from the procedure. This congenital distribution of fat will respond to no amount of diet and exercise as it is not due to a caloric excess. It is the natural proportion of your body. Thus to make a change in its shape, it must be surgically modified. While liposuction will not make your thighs petite or even come to match your upper body, it will make a visible improvement that is most evident in silhouette and in how your pants will fit. While liposuction will not improve the appearance of cellulite and stretch marks, and can even occasionally make cellulite look a little worse, the improvement in your thigh contours make that risk a good aesthetic trade-off in most cases.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I’m having surgery in a few weeks consisting of a full tummy tuck and liposuction of the, flanks and outer thighs. How much fat did you estimate in inches that can be removed from each of these areas? Particularly with my outer thighs, I was hoping that whatever amount of fat was removed would be visibly noticeable to the eye.

A: While I don’t have the advantage of knowing what your body/thighs look like, there would be little purpose in having the procedure if the change was not noticeable. I never like to use inches as a circumferential measurement outcome for any liposuction-treated area or a tummy tuck because the visible change can be substantial but the circumferential measurement change can be less impressive. This, of course, highly depends on the body type and the size of the original problem. But you have to remember that only one section of the thigh (outer) is being treated not the circumferential thigh so that measurement will never be impressive as the outer profile or silhouette view. For a tummy tuck, only the front half of the body is being treated so the amount of ‘inches’ reduction will depend on the existing size of the frontal abdominal fullness and/or overhang.

While in many patients, inches do come off from a tummy tuck, that can be avery disappointing assessment criteria when looking at outer thigh liposuction…that is rarely an inchess off procedure.

Dr. Barry Eppley

Indianapolis,Indiana

Q: Dr. Eppley, I have some additional questions about thigh liposuction. I need a fair amount of fat removed frm my thighs and during our consult you estimated that it would be about 1.5 L per thigh.  I know you are the expert but I’m wondering if I should get more removed (have you seen these thighs lately? Ha!). I believe your concern was that I have somewhat of  “cellulitic” thighs – nothing too severe but my legs aren’t perfect either (I’m 5’5, 165 lbs). How big of a factor is this when taking the amount of lipo into consideration?  Would it be risky to remove a little more per thigh?  Part of me would like more removed.  However, the other part of me worries about skin elasticity and “lumpiness” or other skin irregularities produced from the procedure.

A: The key concept for your thigh reduction to consider is that the more aggressive you are with liposuction in someone who has pre-existing thigh cellulite, the more likely you are to worsen the appearance of the cellulite and create unevenness. Contrary to a common public misconception, liposuction is not a treat for thigh cellulite but a potential exacerbation of that problem. It is a delicate balance between improvement in thigh size and not worsening the overlying skin’s contour. The ‘price’ to be paid for aggressive liposuction (maximal fat removal) is increased skin irregularities. Removing anywhere near 1 liter of fat from the saddlebag area is a lot and is certainly aggressive. But almost assuredly, increased skin irregularities will be the trade-off.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I was wondering what are the prices of your procedures I have been looking into mommy makeover for several years, (breast life/augmentation,tummy tuck, and some liposuction of the inner thighs and back flanks. I’m not looking to be a supermodel/size 6, I would be quite happy size 12 – 16. I just want a flatter tummy, non droopy boobs and thighs that don’t rub together. I have attached several pictures, could you please tell me what the cost would be, and if there is anyway to have our insurance company pay. I’m very depressed with the way I look, I just want my outside to reflect the way I feel on inside. I want to be that sexy person for my husband, and confident for myself. I hate trying to find clothes that hide my tire ring for a tummy, and replace pants because they got worn in the thigh area. I would also like to wear shirts without having my breast hang down to my tummy area. I need help, can you help me………..

A: Thank you for sending your pictures. I can not comment on your breasts since the pictures have a bra on but I will assume, for the sake of this discussion, that you need a full breast lift. Otherwise, you would benefit tremendously by having a full abdominoplasty to get rid of the overhanging pannus combined with liposuction of the flanks. This is the one procedure that will provide the greatest overall change. You do not have enough of an abdominal pannus to qualify for insurance coverage based on my experience. From a thigh standpoint, I don’t know that liposuction can ever take you to the point where your thighs don’t rub, that is not a realistic goal. Some improvement can be achieved in their fullness but to say they would not rub together would not be an accurate statement about the achievable result.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am 5’6” and weigh 125lbs. I am fairly thin for my height but my thighs are just to big for my body. My lower half doesn’t fit my upper half and no amount of exercise or weight will change that. I now know that fir sure as I have tried for years. I am a size 6/8 in jeans and that just drives me crazy . I know that liposuction removes fat and helps contour areas of the body. But does that mean it can give the appearance of thinner legs and make me able to fit into smaller jeans?

A:  Your question  is both a good and a common one. I  have seen many people who are disproportionate in various body areas. They are not overweight but one area of their body doesn’t fit the rest. This is very common in the thighs or saddlebag areas. Liposuction can effectively reduce prominent saddle bags and, when combined with inner thigh and knee liposuction, can give the leg a much improved silhouette. For some patients this will make their leg thinner and they may be able to fit into smaller jeans. For other patients, despite the improved look, they make not end up with truly thinner legs and may only feel more loose in their current jean size. I think it is always best to think of liposuction as contouring or spot reduction. Making any body area truly thinner may be expecting more than the procedure can do in many cases.  

Dr. Barry Eppley

Indianapolis, Indiana