I would like to compliment Schmidt et al. for the article “Concomitant Liposuction Reduces Complications of Vertical Medial Thigh Lift in Massive Weight Loss Patients,”1 which discusses the decreased complication rate associated with liposuction during a medial thigh lift. Despite the good results presented in this article, potential wound complications requiring additional care have not been addressed when there is association between the vertical incision in the medial thigh and an incision in the horizontal groin crease when dealing with the excess proximal thigh skin in more severe cases. This problem can be associated also with metabolic changes from bariatric surgery and therapeutic corticosteroid therapy, among other causes.
Thus, to overcome those cases of potential wound complications, we have devised a technical modification of the conventional T-incision technique that was initially addressed by us under the name helicoidal thigh lift. The technique was associated safely with liposuction, as proposed by the authors.
Our first case was a 30-year-old female patient (body mass index, 26 kg/m2) who underwent pulse therapy with corticosteroids for acute pulmonary vasculitis and gained 60 pounds over 3 months. She lost 40 pounds after 6 months, but striae remained over her body (Fig. 1).
We devised the helicoidal incision approach to avoid wound complications and treat most of the thigh striae. The elliptical skin island resection started in the groin crease, ran obliquely and downward to the inner thigh, and followed the posterior aspect of the popliteal fossa. Vertical and horizontal skin components were able to be resected using the same single oblique incision on the medial aspect of the thigh. The postoperative course was uneventful, and the patient was very pleased with the final result (Fig. 2).
Once there are no scar intersections, as in the T standard incision, there are fewer cicatricial stress points subjected to potential complication. As far as we know, this modification has not been reported previously, and we would like to share it with our colleagues. Further controlled studies are needed to compare this approach with the standard techniques available to correct the problem.
Presented at the 2016 Symposium of Academic Students in the city of Porto Alegre, best of the session award.
There are no financial disclosures to be made by the author.
Ronaldo Webster, M.D., Ph.D.
Department of Plastic Surgery
Universidade Federal de Ciências da
Saúde de Porto Alegre
Porto Alegre, Brazil
1. Schmidt M, Pollhammer MS, Januszyk M, Duscher D, Huemer GMConcomitant liposuction reduces complications of vertical medial thigh lift in massive weight loss patients.Plast Reconstr Surg20161371748–1757
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