Surgery Isn't Always Necessary to Achieve Smooth, Toned Thighs

With the effects of childbearing, unplanned surgeries, weight fluctuation, or just natural aging, loss of tone and skin elasticity in the thighs is a natural physical response. Sadly, I often hear patients attest to avoiding certain social situations and recreational activities, simply because of the insecurities surrounding the appearance of their legs. No bathing suits, no shorts, and for some, only below-the-knee dresses or pants play a part in their wardrobe. In short, their quality of life is hindered by their physical appearance, even if they are in great health. For many women who have tried diet and exercise to no effect, it's easy to give up hope for any improvement. They may tell themselves, "This is the way it is; there are no options." But this conclusion is untrue. There are options. However, before you run to the operating room, let's take a closer look at effective cosmetic treatments for thighs.

THIGH LIFT BEFORE

THIGH LIFT AFTER 32-year-old cosmetic surgery patient from North Georgia requested a thigh lift and liposuction to her flanks (love handles). Photos taken are four months post-op.

One of the most rewarding aspects of my work is educating patients on the many options available to them apart from traditional invasive surgery. Odd as it may seem, these days I spend more time talking patients out of surgery, and into alternative treatment options that truly have the power to shape and sculpt the overall appearance of virtually every aspect of the face and body. On average, I perform more than 600 surgical procedures per year. Clearly, there are some situations where surgery is absolutely the best approach. But in many cases, energy-based therapies (using heat, lasers, light, or sound) can offer dramatic improvement to the target area, minimizing risk, cost, scars, and downtime for the patient. In the case of thighs, this fact is especially true.

What is Thighplasty or a Thigh Lift?

A thigh lift, or thighplasty, addresses inner or outer thighs that can sometimes hang excessively and with a great deal of loose skin. In cases such as bariatric surgery or accelerated aging, liposuction alone will only increase loose skin, making the thighs look worse. In these cases, a thigh lift is a better option. It combines liposuction (when needed), with removal of excess skin, and tightening of loose skin. Still, my belief is that both a thighplasty and a thigh lift should come with a flashing yellow "CAUTION" sign. My reasoning is that while patients will experience an improvement in overall thigh shape and tonality, they are inevitably left with scarring on the inner or outer thigh that, no matter what anyone tells you, is permanent. The scars in these areas also tend to be more noticeable because of their location and because the tension in the healing areas can widen and/or thicken the scars. Unlike tummy tuck or breast lift scars, thigh lift scars are not easily hidden with clothing and can never be hidden with underwear or bikinis. Despite this word of caution, there are many cases, such as massive weight loss patients, in which a thigh lift is the only option to provide the patient's ideal results.

What are the alternatives to thigh surgery?

If I stress anything in my practice, it is that each patient comes with an individual physical blueprint and his/her challenges must then be addressed uniquely. Too often patients undergo surgery that is unnecessary and, even worse, yields less than satisfactory results. Working with a board-certified cosmetic surgeon who is highly-invested and skilled in the area of both liposculpting and energy-based technologies is the key to ensuring you will have the optimal treatment plan specifically for you.

LIPO BEFORE

LIPO AFTER 55-year-old liposuction patient, 125 lbs, 5 ft, requested removal of excess fatty deposits and minimization of appearance of cellulite. Photos taken are six months post-op.

In addition to liposuction (a minimally invasive procedure) and liposculpting (an advanced method of performing liposuction), there are options that are minimally invasive, and even some noninvasive, thanks to advancing technology. See below:

EXILIS

Exilis provides a non-surgical option for reducing fat and tightening skin using radio frequency technology. It is only minimally effective but the results are long-lasting and have no downtime, are done awake in the office, and have no scarring. Exilis is considered by many to be the benchmark and gold standard of noninvasive skin tightening devices in a sea of other devices promising the same result. Exilis delivers energy deep into the tissues to liquefy fat and stimulate collagen using the power of radio frequency technology. Through multiple treatments, it has been shown to kill fat cells with varying results from patient to patient. In the thigh area, it has been shown to reduce the appearance of cellulite in some patients, though only temporarily. For optimal results, four to six treatments are recommended, spaced one to two weeks apart. Most patients begin to experience the benefits after the first few treatments. Patients who are 20-30 lbs overweight, are showing early signs of aging, or have hit a plateau with regular diet and exercise will benefit the most from Exilis treatments.

ULTHERAPY

An ultrasound procedure, Ultherapy is the only FDA-cleared non-invasive procedure to lift skin on the neck, lower face, and brow areas. Ultherapy was recently shown to provide significant tightening of the skin on thighs and knee areas, with improvements that continue for up to six months. Further research is ongoing determining the benefit of the Ulthera device on the body, but it appears to work best in thinner skin areas.

VANQUISH ME

For those who have less fat to remove, or are willing to trade dramatic results for an easier, less expensive option to lipo, a new procedure called Vanquish goes one step beyond noninvasive: It never touches your body. An applicator that hovers over the skin delivers radio frequency (RF) energy that heats fat cells to 45 degrees Celsius, killing them. The procedure is painless and can treat a larger area than most other RF devices. If you want to target the entire abdomen instead of just love handles, this procedure can do it. It has also shown dramatic results in reducing fat in the extremities, such as outer thigh bulges. The newest "ME" version of the device has taken the results to the next level with very high patient satisfaction ratings.

A word about Cellulite

"Cellulite" refers to deposits of subcutaneous fat close to the surface of the skin. These fat deposits are held within the fibrous connective tissues that connect muscles to the skin. The fat bulging outward against this fibrous tissue creates the hallmark dimpled, or "cottage cheese," look. Because we all have fat, even the very slim can have cellulite. As we age and our skin loses elasticity, the look of cellulite becomes more pronounced. Don't let promotional gimmicks like over-the-counter supplements and creams fool you. There is simply no method of completely eliminating cellulite at this time. We can only minimize its appearance and results may vary. Laser treatments such as CelluSmooth and Cellulaze, when administered by a board-certified cosmetic surgeon, can offer immediate and long-lasting visible improvements. Patients can expect to be bruised for a few weeks and the final results may take several months to be revealed, during which time the skin will continue to smooth out. Because the procedures are quick and minimally invasive, most patients will be able to resume normal activity the next day. There are also new treatments on the horizon that will be available soon that are showing the greatest promise to date. More to come as we at Southern Surgical Arts stay on the leading edge of the research.

Lasers and Ultrasound Heat-based Tightening

This is perhaps the greatest development in the quest to tighten areas of loose skin in the body. Particularly exciting for the thigh region for reasons outlined above - one can avoid scars that are difficult to hide. As an adjunct to liposculpting, heat-based laser wavelengths or ultrasound friction generated heat is used to heat the deep fascial compartments and deep skin layer areas. The treatments do require surgery but require only several minimally invasive incisions (about the size of a grain of rice). The results are not immediate, as it takes several months for your body to develop the skin thickening and tightening effects; however, taken overall with a solid liposculpting technique, a skilled cosmetic surgeon can provide moderate level results that are indeed long-lasting. While the results are still not as powerful as a surgical thigh lift, there are NO SCARS. Patients also experience faster healing and incur less risk than that of traditional thigh surgery. Of all the treatment options listed here, we have found that this option is the one with which most patients are best suited, yet least familiar.

Summary

Do your homework! Especially when it comes to your thighs. Don't be misguided into thinking your options are limited to major surgery, or nothing at all. As with any cosmetic procedure, interview several surgeons before choosing one. Anyone who jumps straight to surgery without laying out all of your options may not be your best bet. Educate yourself on treatment options offered through each surgical practice and ask questions regarding training and skill-level of administering technicians. Most importantly, be in control of your health, your body, and your decision. The number of options available for improving the appearance of your thighs has never been better!

For a free consultation, contact Southern Surgical Arts at 423-266-3331 or visit www.southernsurgicalarts.com.

Dr. Deal

Noteworthy:

"Both a thighplasty and a thigh lift should come with a flashing yellow "CAUTION" sign."

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Dr. Chad Deal, M.D.
Southern Surgical Arts