From T to L to I: Risk Factors in Medial Thigh Lifts after Massive Weight Loss-Is Less Sometimes More?

Abstract

Thigh-lift surgery is considered a complication-prone operation, with publications reporting complication rates between 35% and 74%. These studies have not specifically evaluated the effects of each technique on the complication rates. This study presents complication rates for the 3 most common surgical techniques (T, L, and I thigh lifts) and evaluates possible causes in the largest reported cohort of patients with massive weight loss. A retrospective cohort study of 750 thigh lifts in 375 patients from 2008 through 2023 was performed. The data collected were collated into the 3 thigh-lift techniques and analyzed according to preoperative risk factors and postoperative complications. The overall complication rate was the lowest for I thigh lifts (40.3%), followed by T thigh lifts (66.6%) and then L thigh lifts (73.9%). An analysis of major complications revealed rates of 9.5%, 33%, and 39.1%, respectively. Smoking, a body mass index of 30 or above, higher temperatures, and prolonged operative duration were found to increase the risk of complications. The I incision technique for thigh-lift surgery after massive weight loss has fewer complications, reduces scarring and operating times, and has a low revision rate.