The operation is performed under general anesthesia with endotracheal intubation. Before the intervention the affected area is shaved. The day before the operation the surgeon carrying out the operation discusses with the patient in detail what he/she wants in terms of changes and how the surgeon can achieve this, and draws the incision lines and resection boundaries precisely. The patient must be warned about having unrealistic expectations and be given detailed information about postoperative measures in order to avoid scar formation as far as possible. Intraoperative single-shot infection prophylaxis with cefaclor 2 g, treatment in the hospital, Steri-Strip dressing, thrombosis (fractionated heparin 1 ampule i.m. preoperatively and 3 days postoperatively) and embolism prophylaxis, special girdle.
If the loss of elasticity and slackness of the skin is confined to the upper third of the thigh, the operation may be carried out in a half-moon shaped skin/fat resection in this area (a). The scar is then located in the groin and runs into the buttock crease. There is no scar on the inner side of the thigh. This is the operation that is wanted most frequently and is also presented in detail in the video.
'.j If the overstretched and therefore loose skin stretches over the whole o inner side of the thigh as far as the knee, then it is necessary to carry out
3 additional vertical removal of skin/fat, depending on the extent of the
■o skin on the inner side of the thigh (b). The scar is then located in the
J2 groin and on the inner side of the thigh, depending on how far the slack-
•jf ness of the skin extends, to just above the knee.
If there is also pronounced wrinkling of skin on the buttock, then a skin/fat resection must be carried out here as well. The scar then will be in the buttock crease and runs forwards into the inguinal region. The resection lines are drawn before the operation with the patient in a standing position. It must be kept in mind here that the incision line in the area of the inguinal fold should be relatively high (two fingerwidths in the cranial direction) since the scars always descend slightly over time and then could be visible in the upper leg area.
The incision in the groin, which is at the height of the pubic hair boundary laterally, generally runs above the inguinal fold to the thigh-perineal crease and finishes at the innermost part of the buttock crease, which is lengthened accordingly if there is also a buttock lift.
If only a buttock lift is carried out, then only the resection in the area of the buttocks is drawn according to the extent desired.
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