title: Four-step medial thighplasty: refined and reproducible.
abstract: 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.
authors.affiliation: Dallas, Texas From the Dallas Plastic Surgery Institute; and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Bryan S
authors.initials: BS
authors.lastname: Armijo
authors.forename: Carey F
authors.initials: CF
authors.lastname: Campbell
authors.forename: Rod J
authors.initials: RJ
authors.lastname: Rohrich
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology*; D015331:Cohort Studies; D062109:Dermatologic Surgical Procedures / Q000379:methods; D004954:Esthetics; D005260:Female; D006801:Humans; D015187:Lipectomy / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D013518:Surgery, Plastic / Q000379:methods*; D013781:Texas; D013848:Thigh / Q000601:surgery*; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*; D014945:Wound Healing / Q000502:physiology