Full thigh liposuction is a very beautiful procedure that can change a life, but it requires the surgeon to have great experience and flawless execution skills because both thighs must not only be slimmed and improved but also identical.
This is entirely possible, and for my part, I have successfully liposculpted hundreds of full thighs to date. Of course, the younger the patient, the easier the procedure and the more predictable the results. The tissues are firm, the skin is toned, and the results will confirm this, as a consequence. I have even performed this procedure on women aged 60 and older with very appreciable results. They only expressed one regret: having waited so long to have the thighs they had always desired. However, in older patients, a more conservative approach is needed for the inner part of the thigh to avoid creating sagging skin.
The outer side of the thigh, having already been explained above with the violin deformity, we will focus on the three other sides of the thigh: the inner, anterior, and posterior sides.
The Inner Thigh
The inner thigh is a site that the English would say. Several surgeons refuse to tackle it, having obtained very poor results and mistakenly believing that this region is impossible to liposculpt. They are wrong because this site sculpts very well and gives magnificent results. The trick: hold the cannula like a violin bow and play it gently. The inner thigh loves a serenade!
This site is further subdivided into three sections that must be approached differently, remembering that in the inner thigh, the fat is devoid of fibers and resembles jelly. Once observed, it aspirates so easily that it is easy to overdo it. The result will be disappointing, which an experienced surgeon will avoid. On the other hand, this lack of fibers makes it an excellent fat when you want to reinject it into an area where it is lacking. Therefore, we have here:
the upper third or the bulge;
the middle third or the groove;
the lower third or the knee.
The upper third or bulge of the thigh is a privileged site for liposuction, easy to perform with good results, sometimes even with sagging or aged skin. The secret is to work superficially and remove enough, as patients feel a visceral hatred for this fatty site, which becomes particularly unsightly with age. Moreover, the improvement is felt daily, as when the thighs rub against each other, these people experience a real ordeal. A procedure as benign as liposuction relieves them of this discomfort forever, without leaving the slightest scar, since a “cunning” surgeon can make the incision in the pubic hair and thus leave no trace of their passage. I must admit, however, that pubic hair is disappearing, and this little trick is becoming less and less possible.
The middle third or the groove often has a depression that must be wary of if you want to correct this flaw. Sometimes, if the groove is very visible, it is necessary to completely refrain from aspirating at this location or to touch it barely, just to make the link between the other two thirds.
The position of the patient on the operating table is also very important to achieve a result close to perfection. It is all these small details that will make patients happy, thanks to results that meet their expectations.
The lower third, that is, the knee, is a site that requires caution because, again, since we are on the inner thigh, the fat devoid of fibers will aspirate very easily. However, well liposculpted, the knee will be particularly beautiful and will give a very nice leg. Moreover, the skin heals very well at this level, and the incisions leave virtually no visible trace.
A patient very satisfied with her knee liposuction found, however, that when she crouched, her knees looked less natural. I explained to her that it is the crouching position that is less natural and that she had the choice of having magnificent knees 999 times out of 1000, or once out of 1000, when she crouched. This anecdote makes you smile: a liposculptor must know how to negotiate this kind of argument.
On another occasion, I had removed a very unsightly saddlebag, and the patient came back to see me six months later to tell me that when sitting on the toilet, her outer thigh took on a strange shape, but otherwise, she was still as happy and satisfied! I had to spend half an hour convincing her that she had the choice between super thighs all day or, when sitting on the toilet, a less pleasant profile to look at…
Should we just move the mirror?
The Anterior Thigh
The anterior thigh is a site that is not often involved. Indeed, it has certain pitfalls that the experienced liposculptor will know how to avoid. First, the patient looks at the front part of her thighs from above and sees herself differently from reality, since in the eyes of others, it is from the front that she shows her thighs. The patient, when looking in the mirror, no longer sees the flaws she saw from above or sees them differently. She then believes that it is the lighting that distorts reality or the perspective of her own height while she tries as best she can to explain to the surgeon what she does not like about the front part of her thighs. It could be waves, holes, bumps, skin irregularities, or simply an accumulation of too much fat at this level.
Here is the course of action:
When the anterior thigh is too fatty, it can be liposculpted, but on the condition of never removing more than 50% of the fat and using very fine cannulas no larger than a knitting needle (3 mm). Otherwise, skin irregularities may occur, and this is a site that does not forgive.
If the anterior thigh is not too fatty but really presents what the patient saw from above, it may be a bit cellulitic. To the point where sometimes patients refuse to wear shorts. At that point, it is possible to simply use a special cannula (Toledo or Blugerman) that loosens the skin without aspirating fat, with the hope of improving this cellulite, which is due to multiple adhesions as I have already explained.
However, the degree of improvement of this cellulite cannot be predicted with certainty, and it is important to explain this in advance to the patient, as this type of improvement is not as predictable as pure and simple liposuction. When leaving this very particular site that is the anterior thigh, let’s mention the upper part of the knee, which is often plump. Although not easy, an experienced surgeon will manage to level this area well, without leaving traces of their passage.
The Posterior Thigh
This time it is true, with very rare exceptions, the posterior part of the thigh is not well suited for liposuction. First, the fat is generally very thin there, and venturing there could lead to skin irregularities.
Moreover, from a medical-surgical point of view, if we treated all four sides of the thigh in the same session, that is, the entire circumferential thigh, we could have serious complications of phlebitis due to a “tourniquet effect,” that is, postoperative edema that would trap the thigh by obstructing circulation.
On the posterior thigh, we limit ourselves to operating on a thin portion, located just below the buttock, and quantitatively insignificant, called the “banana” under the buttock.
The “banana” under the buttock is particularly unsightly in some and deserves to be aspirated. Moreover, I always include it when I operate on a saddlebag. Again, allow me to use the English word, as the banana has a very useful anatomical role, as it supports the buttock, and if it were removed too radically, it would produce a sagging buttock, worsening the situation rather than improving it.
But rest assured, the experienced surgeon will proceed very superficially at the level of the “banana,” to refine this particular site. I am convinced that the superficial liposuction technique of Gasparotti, which I have already mentioned, applies everywhere on the body, but for the “banana” under the buttock, this technique is a “must” if you want results close to perfection. While slightly reducing the posterior thigh, the disappearance of this banana under the buttock improves the visual effect in a very beautiful way.
The Total Thigh Viewed from Different Angles
The total thigh can present all kinds of peculiarities that the liposculptor must face while remaining very creative.
