Thigh and Buttock Lift

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The technique for a thigh lift is similar to that for brachioplasty. Deep, subcutaneous dissection of the fascia and step-by-step resection of the skin, previously marked precisely, are performed.

An operation on the medial side of the thigh is one of the most unsatisfactory operations an aesthetic/plastic surgeon can perform. The patient's expectations of the procedure are usually too great and he/she is then disappointed by the result. The patient should therefore be given an extremely detailed explanation prior to the thigh and buttock lift. The indication should be considered carefully and if the patient expects too much, they should preferably be turned away.

The extent of the resection should be defined carefully the day before the operation. If the skin on the inner side of the thigh is loose, the buttock region is usually also loose, so these operations can be combined well.

The incision line in the buttock area should not extend beyond the lateral buttock fold, as otherwise there may be residual aesthetically displeasing scars, which often disturb patients more than hanging skin.

With extremely slack skin in the area of the medial thigh, vertical tightening extending to the medial side of the knee can be performed in addition to horizontal tightening in the groin and buttock region. This allows extremely intense tightening of the entire medial thigh, but the residual scar should be drawn to the patient's attention and explained.

The video shows the most frequently requested operation for horizontal thigh and buttock lifting. In contrast to brachioplasty, it is important that the thick cutaneous/fatty flap be secured at two points to achieve a longer-lasting result and better scar formation, owing to gravity in the thigh area. The points for fixation are the periosteum of the pubic bone and the inguinal ligament. The extent of the resection is defined with key sutures, and the area is resected in stages so that not too much and not too little skin is removed. The operation is performed under general anesthesia on an inpatient basis. Thrombosis and infection prophylaxis is started. A special girdle must be worn for 3 weeks after the operation, followed by care of the scar with a silicone plaster.

Because of the many requests, hair transplantation, Prof. Mang's spacelift, and a few brief descriptions of adjuvant therapies are included in Volume 2.

Adjuvant therapies are being continually developed and newly published, mainly within the field of dermatology. For this reason, only the essential features of the adjuvant therapies are described very briefly in this manual, with no claim to completeness.

The essential texts on biological implants (collagen), lipotransfer, botu-linum toxin, dermabrasion, ultrapulse CO2 laser, erbium-YAG laser, coblation, and chemical peeling can be found in Volume 1. As only ultrapulse CO2 laser treatment was shown in Volume 1, we have filmed short videos for Volume 2 on biological implants (collagen, hyaluronic acid), botulinum toxin, dermabrasion, erbium-YAG laser, and chemical peeling. For space reasons, these films have been kept very short and should show that adjuvant therapies should also be included in the repertoire of an experienced aesthetic surgeon.

Two of these treatments have been described in detail in the video and the text.

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