How Can I Improve the Look of My Thighs?
I see many patients who are unhappy with the appearance of their thighs. This area seems to poorly tolerate weight fluctuations. That being said, I see many patients who are weight stable who feel this is a place where they always have fullness:
“ I am tired of my thighs rubbing together”
“ No matter how much I exercise, I cannot change my thighs”
“I don’t like the way my jeans fit”
These are just a few of the statement’s patients make to me when seeking options to improve the thighs. It is important to consider the thigh as a cylinder, assessing it circumferentially. Not many of us have localized deposits of fat. Rather, fat and/or fullness impacts the thigh 360 degrees around.
What makes up the “thigh”?
The thigh is made up of skin, fat and muscle. All three may have an impact on the appearance of the thigh.
Skin – As we age and go through weight fluctuations, the skin can change. It can lose its “elasticity” or “recoil” making it more droopy or saggy. This may be seen in the inner thigh, outer thigh and around the knee. It is essential to assess this during your consultation as the skin remains the “cover” of the thigh and if it does not look good then one’s result from anything, can be less than satisfactory.
Fat – Fat in the thigh is distributed differently in all of us. We can have fat in the inner, outer and the top of the thigh. One can also have fat on top of and on the inside of the knee. These are all areas that can be addressed with procedures. One area I avoid is the back of the thigh. It rarely is “too full” and over-treatment here can result in folding of the skin and unsatisfactory appearance.
Muscle – How muscular one’s thighs are directly impacts its shape. If a patient has a muscular thigh, it may limit how much “slimming” we can achieve with procedures. Some people work hard to build muscle in the thighs and others are simply given the “genes” to have that look. We cannot alter the muscle of the thigh.
What areas may benefit from treatment?
After we assess each area and determine whether or not there is “excess” then we can start to formulate options for treatment. If the quality of the overlying skin is good, then we can address “fat excess” with a number of different techniques:
We have two devices in the office that can eliminate a small amount in the office without going to surgery. One of them uses cold to freeze fat while the other one uses a laser to cause a percentage of the fat cells to die. It is important to understand the appeal of these procedures as well as what we can achieve with them. As a general rule, these procedures, while less aggressive and invasive than surgery, cannot achieve the type of changes in contour that surgery can. Other than being a little sore, there really is not much in the way of down time with them. In the right type of patient, we can anticipate around 15-20% improvement in the areas treated. Treatments vary from 1-4 hours depending on how many areas are treated and what type of device is being used. Just as we see in liposuction, it is imperative that patients have good skin quality and tone overlying the fat being treated so that it can reconform to the underlying change in fat.
Liposuction is the traditional way to remove fat, reliably and predictably. There are many different “tools and technologies” available to the surgeon to accomplish fat removal. Some make “miraculous” claims as to their superiority. It is important to understand that there are no “magic” devices out there. The success of the procedure is completely reliant on the expertise and artistic ability of your physician. I do use a technique called “SAFE” liposuction developed by Simeon Wall, Jr, MD., and having been doing so for about 8 years. It has allowed me to get more predictable, safe changes in contour than I was able to achieve with ultrasonic liposuction. Usually 1 or 2 small incisions ( less than a quarter of an inch) are used at each site to remove the fat. Fat can be removed predictably from the inner and outer thighs; the top of the thighs and the knees.
“Skin laxity or redundancy” implies loose skin. This is more difficult to treat predictably and often requires a more aggressive approach.
There are a number of skin tightening devices that are available. We have two in our practice that is used largely for facial treatments. We have tried many devices over the years in many different areas. Unfortunately, I do not think these devices give us predictable and significant changes in the thigh area. Most patients that have loose skin of the thigh and poorer quality skin that is less responsive to these types of procedures.
Thigh Lift Surgery remains the mainstay of treatment for loose skin of the thighs. There is a tradeoff of a scar for improve shape and contour. In some cases, the incision can be well hid and in others, it may be more visible. In general, the length of the incision is proportionate to the degree and extent of the loose skin.
Where are the incisions placed?
Inner thighs – The incisions for removal of inner thigh skin will either be hidden in the groin crease or be found along the inner aspect of the thigh. Depending on the extent of the loose skin it may extend from the groin down to and even below the knee. Patients who require the more aggressive incision are typically those who have lost a considerable amount of weight.
Outer thighs – Most of the time the incision to address the outer thighs is the same one we use for a buttock lift. It addresses loose skin of the outer thigh and buttock. It is a powerful procedure that is often combined with an abdominoplasty to provide circumferential waist contouring.
What to expect during recovery?
Recovery from these procedures varies tremendously depending on which procedure is chosen, what body area(s) are being treated and whether or not multiple areas are being treated at one time. The areas that are concerning to you can be reviewed at your consultation and then following an examination, your treatment options can be discussed. Expectations as well as risks and benefits can be reviewed allowing you to learn what options may suit your goals the best. Check out our Rapid Recovery Program.
Did you know? Dr. Kenkel has nearly 25 years of experience with body contouring procedures and remains on the cutting edge allowing you a predictable and safe outcome. Meet him here:
Finally, anytime you consider body contouring procedures it is important to understand that the treatments you select can have a positive change on your shape only if you embrace a healthy lifestyle watching what you eat and being physically active. It truly is a partnership between Dr. Kenkel and his patient.