Thigh Reduction

Post bariatric or weight loss surgery (Thigh Reduction)
 

Thigh reduction

Following massive weight loss many patients are left with residual folds of skin, significant amounts of stretch marks, residual fat which does not go back so it is common for this group of patients to request excision of these excessive folds. 

The procedures that are usually involved with respect to the thighs, a thigh reduction, with or without lift. 
 
Indications: Usually after massive weight loss
 
These people would have either had a gastric banding operation or gone through a programme of diet & exercise resulting in massive weight loss & this has left them with excessive folds of skin & fat which they do not find sightly & would like to have dealt with.  

It is important that the person achieves his or her ideal new weight or at least close enough & they are medically fit. 

A thigh reduction is an operation that is used to remove the excess fold of skin & fat in the inner aspects of the thigh which normally rubs against each other as people walk or run. This can lead to recurrent discolouration of skin and fungal infections in this area. 
The operation is usually combined with some form of a lift of the thigh because the excess fold of skin & fat in this area usually droops & becomes unsightly to the patient. A lift also helps tighten & improve the appearance of this area.  

Who requests a thigh reduction?:  This is usually requested by people after significant weight loss where excessive folds of skin & residual fat rub on each other & can make underwear uncomfortable.
Anaesthetic: This is usually performed under general anaesthetic.
Duration of stay in hospital: Usually 2 days.
Time off work: Usually 4-6 weeks.
Duration of operation: 2 hours. This may vary depending on the size of the patient.
Technique: There are different incision patterns that are used. The resulting scar usually runs in the groin crease as well as a short vertical aspect with the patient therefore ending up with a T-shape scar. Absorbable sutures are usually used. Commonly drains are used. 
Post-Op Care: The patient is usually placed on painkillers as well as antibiotics, a supportive or pressure garment which is usually ordered before the operation, is fitted in theatre & usually worn for a period of four to six weeks to help make the arm more comfortable and reduce the amount of overall swelling. 
Risks/Complications: The usual complications are in accord with having the anaesthesia which includes chest infection & blood clots in the leg which can dislodge & travel to the lung, potentially fatal & the risk of this is reduced by fitting the patient with tight stockings as well as giving an injection of a blood thinning drug. Bleeding can occur & blood accumulation may require a trip back to theatre for evacuation. Infection is usually prevented by administration of antibiotics.Wound breakdown usually superficial & minor & just requires dressing for a few weeks. The scars are usually red initially & become pale as they mature. In some patients they can become lumpy & may require treatment with steroids & scar revision. Dog ears are prominent folds which occur at the ends of scars, especially the lower end of the scar & may require a correction under local anaesthetic a few months down the line.