Similar to the arms, the thighs are structures that are sensitive to aging and weight changes. Some patients experience rashes and discomfort from stubborn fat causing the inner thighs to rub each other when walking. Others are bothered by the saggy appearance on their thighs, which prevents them from wearing swimsuits or certain clothing. Either scenarios can be frustrating for the patient, since this part of the body is usually difficult to address with diet or exercises. If a patient can identify themselves with a scenario close to the one described above, they are probably a great candidate for a thigh rejuvenation.
Dr. Couto is a Cleveland Clinic trained plastic surgeon, and one of the few plastic surgeons in Latin America to have completed an American Society of Aesthetic Plastic Surgeon (ASAPS) endorsed subspecialty training in Aesthetic Surgery and Medicine. During his training, Dr. Couto had the privilege to have mentors, such as Jeffrey M. Kenkel, a top leader in the field of body contouring, including thigh lift.
The thigh rejuvenation is a spectrum of procedures indicated for patients that are unhappy with the appearance of their inner thighs either by lax skin and/or excess fat in this area. Thigh rejuvenation can consist of elimination of stubborn fat with liposuction or excision and tightening of loose skin either through a thigh lift or the use of skin tightening energy-based devices.
The consultation is divided into five parts:
1) Health and Medical History Evaluation
A comprehensive evaluation of the patient’s health and medical history is performed. During this part of the consultation, we focus on identifying any potential risk factors for the surgery. Fortunately, most of these can be easily modified with lifestyle changes. Dr. Couto will emphasize the importance of avoiding nicotine products (e.g cigarette, nicotine patch, vape, etc), having the blood sugar levels well controlled, and the importance of adequate body weight. We like to set the patient for success, not for failure; therefore, modifying any potential risks is essential.
2) Learning Patient’s Surgical Goals
Dr. Couto has a deep discussion with the patient to learn what are the areas of concern and goals. Listening to our patient’s interest is crucial, since it’s our priority to determine if we can meet their expectations.
3) Physical Exam
A focused physical exam of the thighs is performed. During this part of the consultation, we evaluate the degree of skin excess and the distribution and amount of fat along the thighs. These factors help determine whether the patient is a candidate for a liposuction and skin tightening with energy based device (eg J Plasma/Renuvion) or if skin excess excision through a thighlift is required.
4) Recommendations & Surgical Plan
Following the physical exam, Dr. Couto develops a personalized surgical plan aimed to meet the patient’s expectations, achieve optimal aesthetic results, and maximize patient safety. During this time, Dr. Couto discusses with the patient the indicated surgical techniques and explains in detail everything pertaining to the procedure and its recovery.
5) Pricing and Scheduling Information
Once the evaluation has been completed, our team will provide an individualized quote that is tailored to the procedures discussed during the consultation and discuss the steps involved to book the procedure with us.
Patients with saggy and droopy thighs due to the presence of excess skin and fat that does not improve with diet or exercise are candidates for a thigh rejuvenation. This procedure is not a weight loss method. Therefore, patients should be in a relatively normal body weight, and maintain an active and healthy life after the procedure to continue with the improved results.
Thigh rejuvenation can consist of liposuction and energy based skin tightening or a thigh lift. Most commonly, liposuction and thigh lift are performed together, as these two procedures work in a synergistic manner to better contour the thigh. When performed together, the liposuction (hyperlink) is performed first, followed by the thigh lift.
There are different types of thigh lifts, and each of the different techniques are characterized by the incision length. These t are selected by the location and amount of skin excess that requires resection.
Several weeks before the procedure, a preoperative appointment will be scheduled. During this appointment, we will discuss the surgical plan again, and clarify any questions involving the surgery. Furthermore, we thoroughly review the preoperative/postoperative instructions and the medication regimen with the patient and schedule your follow-up appointments.
We always emphasize to our patients that all vitamins and herbal supplements (eg. Fish oil, Omega-3, Garlic or Tumeric pills, Ginko Biloba) should be stopped at least 3 weeks before surgery, as this might increase risk of bleeding. Furthermore, we remind them that smoking, vaping or using any nicotine products can increase can affect their recovery.
There are numerous scientific studies demonstrating that the use of nicotine (eg. cigarettes, vaping, chewing, etc) affects a person’s capacity for healing, and thus increases risk of complications. If the patient is undergoing a thigh lift, Dr. Couto will ask the patient to stop smoking at least 8 weeks before the operation to reduce the risk of complications. Similarly, patients with a history of diabetes mellitus and that are candidates for a thigh lift must have a glycosylated hemoglobin (HgbA1c) of 7 or less to be able proceed with surgery. If the HbA1c is above this level, Dr. Couto will refer the patient to their primary care physician or endocrinologist to optimize medication regime or diet and help lower the HbA1c levels. Lastly, nutrition is crucial for an effective healing and recovery. Therefore, we recommend to our patients to optimize their nutrition intake after any surgical procedure. This could be easily achieved with supplements that are offered in our practice.
We will provide a detailed postoperative protocol to ensure that the patient has a comfortable and quick recovery. Surgical drains are only required for patients undergoing an extended necklift, for all other techniques, drains are not necessary. Surgical drains help prevent fluid collection in the neck and expedite the recovery. They are typically removed 5-7 days after surgery. The patient will be placed in a specialized compression garment that helps minimize swelling and maintains the thigh well contoured. Swelling and bruising are to be expected, and they can be noticeable for several weeks. In order to minimize the swelling and inflammation, we may have our patient undergo lymphatic drainage massages. It is common to feel soreness and sensitivity around the surgical site; however, this is easily controlled with an individualized postoperative pain medication protocol provided by Dr. Couto. The patient will be able to fully use their legs and perform their routine daily living activities, except for lifting or pulling objects above 10 pounds. We normally recommend our patients to take 7-10 days of work (less if working from home). The same day after surgery, Dr. Couto always instructs the patient to have a couple of walking laps around the house or neighborhood. Patients can resume their aerobic exercises (e.g. running, spinning, biking) 6-8 weeks after surgery, abdominal exercises 8 weeks after surgery, lower body workout 12 weeks after surgery. It may take 3-6 months for the swelling to completely subside and see your results.
The most common concern of a patient regarding a thigh rejuvenation is the length of the incision and if the scar would be noticeable. The length of the scar and location of the scar is determined by the location and amount of skin and fat excess that needs to be removed. For example, the incisions for a patient requiring only liposuction will be significantly smaller and less obvious that an individual requiring resection of skin excess through a thigh lift. In a formal thigh lift, the scar is unavoidable; the tradeoff of eliminating skin excess and optimizing the contour of the thigh is a scar. That being said, the scars are placed in strategic areas of the thighs to make them less noticeable. The great majority of our patients are not bothered by it, since they feel that the benefit of a nicely shaped thigh is way more than having a scar.
If the patient is having only liposuction of the thighs, you will not have drains placed. However, patients undergoing a thigh lift will most likely have drains postoperatively. Surgical drains help maintain the desired contour by preventing fluid from accumulating in the thighs. Surgical drains are commonly removed 5-7 days.
Uncontrolled diabetes can affect the ability of the body to heal wounds properly. Therefore, it is crucial for diabetic patients to have their blood sugar levels under control for this procedure. Patients with an HbA1c of 7 or less are candidates for this procedure.
Smoking cigarettes or the use of nicotine products (eg. vaping, chewing tobacco, tobacco gum) represents a higher risk of complication for patients undergoing thigh lift than for those having only liposuction of the thighs. Unlike isolated liposuction, a thigh lift consists of a greater degree of intervention and longer incision. Therefore, in a thigh lift the body requires greater healing capacity. This ability of the body to heal can be reduced when smoking cigarettes or using nicotine products.
There are numerous scientific studies showing that smoking cigarettes and/or using nicotine products increase your risk of postoperative complications. Nicotine affects the vascularity, and thus prevents the body from healing wounds properly following surgery. We recommend patients to stop smoking or use nicotine products at least 6 -8 weeks before surgery.
Yes! In fact, Dr. Couto always asks the patient to walk around your home the same day of surgery. Walking is a crucial aspect of recovery, since it reduces complications and expedites recuperation.
