Synonyms
Thigh plastic surgery, liposuction, dermolipectomy med. : Dermolipectomy A thigh lift (dermolipectomy of the thigh) is the surgical removal of excess fatty tissue and skin from the thigh for cosmetic beautification. The reasons (indications) for a thigh lift are of a purely aesthetic or cosmetic nature, mainly due to excess fatty tissue or excess skin.
A thigh lift can also be performed in the case of so-called “saddlebags fat” or cellulite, a dentlike deformation of the subcutaneous fat tissue (subcutaneous adipose tissue), in which case liposuction is usually sufficient. However, an additional skin lift may be necessary, especially after significant weight loss or fluctuations in the past. A thigh lift is usually a complex operation lasting several hours and should only be performed on healthy patients.
One should always bear in mind that an operation also involves certain rsiks. It is also possible to reduce the fat on the inner side of the thigh or on the entire thigh without an operation. In Germany about 20000 pure liposuctions are performed annually, thigh lifts are performed in about 7000 patients per year. The percentage of women who undergo surgery is significantly higher than that of men.
History
The first liposuctions were performed by Kesselring in 1976. Before that, it was only possible to create a slimmer and firmer thigh by removing excess skin and the associated fatty tissue. Since then, numerous different surgical techniques have been tested and improved.
The thigh lifts frequently performed today are usually a combination of liposuction and skin tightening, so-called dermolipectomies. The most common cause of a thigh lift is excess fatty tissue and excess skin on the thigh due to overweight. Due to strong weight gain on the one hand or constantly fluctuating weight on the other hand, the skin and connective tissue of the thigh lose elasticity (stretch) and become very slack over time.
Thus it can happen that especially after a major weight loss the thigh is not slim and firm, but looks very unsatisfactory from a cosmetic point of view. For those affected, this excess skin or the very flabby and wrinkled skin is often even worse and more stressful than the high weight and large thigh circumference before weight loss. In overweight patients, there is usually a strong increase in fatty tissue in the entire thigh.
This can be even, but also in unusual and not the typical places of the natural fat tissue distribution, so that fat may also have to be suctioned off in these places. Most patients suffer from pronounced fat pads on the buttocks, the middle and sides of the thigh and in the knee area. If the affected patients can prove a strong psychological impairment and thus a restriction of the quality of life, the health insurance company may cover part of the operation costs.
However, this is only very rarely the case and should be agreed in advance with the respective insurance company. Before a thigh lift, as before any operation, the risks and previous illnesses must be clarified, and the so-called anamnesis (patient history) is taken by the attending physician. In order to assess the risk of the operation, questions are asked about underlying diseases such as high blood pressure or diabetes mellitus, but also about the general physical condition, the use of medication and the consumption of alcohol or nicotine.
Also of importance for the planning of operations are pregnancies, weight loss or gain, previous operations and the current weight and height. To plan the operation, the patient is examined in different body positions (standing, sitting, lying) and undressed. The existing deformation of the thigh is measured and photographed and the possible incision is drawn in.
Before the operation, there is a detailed discussion about the possibilities and the expected result, as well as possible complications and risks.If complications arise as a result of the operation, which make further medical treatment or even further operations necessary, these costs must also be borne by the patients. Since, for example, a stay in an intensive care unit can quickly run into the multi-digit euro range, it may be worthwhile taking out follow-up cost insurance for cosmetic operations, which is available for little money and is recommended and arranged by many plastic surgery departments. Since a thigh lift is an elective procedure, patients do not receive a certificate of incapacity for work.
For this procedure, patients should therefore plan at least two weeks’ vacation. Before the operation, the course of the incision is marked on the thigh. In most surgical techniques, an incision is made at the beginning of the operation at the side of the genital area at the base of the thigh, if possible in a natural fold.
In the case of very obese patients or patients with pronounced riding breeches deformity or cellulite, liposuction may be additionally performed in these severely deformed (deformed) areas before the actual operation. Excess fatty tissue is removed, as is excess skin. Often, especially in cases of severe obesity, the navel must be cut out and, after the tissue has been removed, it must be re-inserted and sutured.
The individual layers of the abdominal wall are also sutured again individually. After the abdominal wall lift, the skin is moved under little tension in the direction of the original skin incision and usually sutured with intracutaneous sutures (sutures located in the skin) in order to achieve an optimal cosmetic result. Suction drains are used so that the fluid and blood that forms can drain off and the wound can heal better.
Patients receive a very tight wrap bandage while still under anesthesia, which is replaced after one or two days by a bandage with Velcro fastener. This must be worn continuously over the next few weeks and may only be removed briefly for washing so that the tissue can grow again without cavities forming (risk of seroma formation or risk of infection). The most frequent complications are wound healing disorders, especially in smokers, post-bleeding and infections.
Poor wound healing or inconsistent wearing of the compressing panty girdle or wrapping after surgery can also lead to fluid accumulation in the wound cavity (seroma), especially in large surgical wounds. In this case, it may be necessary to operate again to allow the wound to heal. Frequent late complications are disturbances of sensation (sensitivity) in the surgical area and cosmetic problems such as retraction of the scar or asymmetries.
Deaths due to thigh lifts have been described in about 1 – 4 % of patients. The most common causes are thromboembolism, injuries to blood vessels, fat embolism and fatal complications caused by anesthesia or medication. However, circulatory failure can also be a possible cause of death, especially in patients with previous diseases of the cardiovascular system. Patients with known relevant heart diseases should therefore carefully consider whether they would voluntarily expose themselves to the risks of a thigh lift.
