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Four-Step Medial Thighplasty: Refined and Reproducible

Armijo, Bryan S. M.D.; Campbell, Carey F. M.D.; Rohrich, Rod J. M.D.

Plastic and Reconstructive Surgery: November 2014 - Volume 134 - Issue 5 - p 717e–725e
doi: 10.1097/PRS.0000000000000116
Cosmetic: Original Articles

Background: The medial thigh remains a troublesome region for body contouring in both the aging patient and in the massive weight loss patient. Liposuction-assisted medial thighplasty is the next step in the series of medial thigh contouring refinements to improve complications and outcomes.

Methods: Forty-five patients are presented who underwent medial thigh contouring with liposuction-assisted medial thighplasty. After anatomical analysis of the medial thigh, noting skin and fat redundancy, patients were selected for either an upper/inner medial thighplasty or an extended medial thighplasty. Operative markings, liposuction, and the excisional technique are presented with intraoperative video footage.

Results: Twenty-nine patients (64 percent) presented with aging thigh lipodystrophy, whereas 16 patients (36 percent) were massive weight loss lipodystrophy patients. The patients’ ages ranged from 30 to 67 years, with 0.5 month to 9.5 years of follow-up. Liposuction evacuation volumes ranged from 175 to 1950 ml per thigh. Ten patients had minor wound breakdown, which healed with conservative wound care.

Conclusions: Liposuction-assisted medial thighplasty is a safe, efficient, and reproducible procedure that should follow a four-step algorithm: (1) L-shaped anterior markings, (2) superwet infiltration, (3) circumferential combined superficial ultrasound-assisted/suction-assisted liposuction, and (4) predesigned and patterned skin excision and layered closure. It simplifies the markings and resection, and the procedure preserves the lymphatics and nerves, minimizes blood loss, and maintains the saphenous vein system to prevent skin loss and wound breakdown. It produces reliable and predictable results, with optimal outcomes. This technique offers another refinement in the evolution of medial thigh contouring.

Supplemental Digital Content is available in the text.

Dallas, Texas

From the Dallas Plastic Surgery Institute; and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.

Received for publication December 13, 2012; accepted June 26, 2013.

Disclosure: Rod J. Rohrich, M.D., receives instrument royalties from Micrins Instruments and book royalties from Quality Medical Publishing. He received clinical research grant support from Neodyne Biosciences, Inc., for participation in a clinical trial. The other authors have no financial interests to disclose. No funding was received for this article.

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Rod J. Rohrich, M.D., Department of Plastic Surgery, The University of Texas Southwestern Medical Center, 1801 Inwood Road, Dallas, Texas 75390-9132,

©2014American Society of Plastic Surgeons