After losing 141 pounds, this female patient in her mid-30s had dramatically changed her body, reducing her weight from 287 to 146 pounds. What remained, however, was substantial loose skin throughout her thighs and lower body.
Her thighs remained wide because of excess skin and tissue extending from the groin toward the knees. She also had fullness through the saddlebags and upper inner thighs, along with distinctive folds of loose skin immediately above both knees.
The fold above the right knee was especially pronounced.
That small area became one of the most interesting parts of her transformation.
A separate knee lift was considered during her original surgical planning, but was ultimately never performed. Instead, Dr. Siamak Agha treated her lower body in two stages: first with a Vertical Thighplasty, or Thigh Reduction, and approximately four months later with a High-Definition Lower Body Lift™. These operations were designed primarily to reduce excess thigh tissue and reposition the surrounding lower-body tissues, not as a direct knee-lift procedure. Yet their combined effect produced a meaningful improvement in the sagging skin above her knees.
After major weight loss, not all thigh laxity behaves in the same way. Some loose tissue primarily drops downward from the upper thigh. In selected patients, that may be addressed through a thigh lift with an incision positioned high within the groin crease.
This patient's problem was more extensive. She also had circumferential laxity, meaning there was excess tissue around the width of the thigh itself. Her excess extended from the groin down the inner legs and toward the knees.
She had significant looseness throughout the thighs, saddlebags, upper-inner-thigh fullness, excess tissue around the front of the knees and folds immediately above both knees, with the right side being more pronounced.
A short groin incision could not adequately remove that degree of excess. That is why Dr. Agha recommended a different operation.
Although this procedure is often called a Vertical Thigh Lift, Dr. Agha prefers the terms Vertical Thighplasty or Thigh Reduction because they better describe what the operation actually accomplishes.
The incision runs vertically, but the main purpose of the operation is not simply to pull the thigh upward. It is to reduce the circumference of the thigh.
For this patient, Dr. Agha designed an incision beginning near the pubic area and continuing down the inner thigh toward the knee. Its length reflected how far her excess tissue extended. During surgery, approximately 11 centimeters of excess skin was removed from each inner thigh.
Dr. Agha also used targeted liposuction to contour the upper inner thighs, saddlebags and areas immediately above the knees. Because the right knee area was fuller and had the more pronounced fold, the treatment was adjusted to her natural asymmetry.
The result was a substantial reduction in thigh width from the upper thighs toward the knees. This first stage addressed something that an upper-thigh lift alone could not: the amount of excess tissue surrounding the entire thigh. The existing gallery description similarly documents why her circumferential laxity required tissue removal extending down the leg rather than correction limited to the groin.
One of the most important tradeoffs of a comprehensive Thigh Reduction is the scar required to achieve it. If excess skin is concentrated only at the top of the thigh, a shorter incision may be sufficient. This patient's loose tissue continued much farther down her legs.
Stopping the incision substantially higher would also have stopped the reduction higher.
Dr. Agha therefore continued the tissue removal down the inner thighs toward the knees, bringing the correction much closer to the folds that concerned her.
This was not a knee lift. No separate section of knee skin was directly excised.
Instead, the longer Thigh Reduction allowed excess tissue to be removed farther down the leg than would have been possible through a traditional groin-only thigh lift.
The mature scar photograph also shows the honest tradeoff involved: a longer inner-thigh scar in exchange for a degree of circumferential reduction that a shorter incision could not provide.
Text link beneath image: See Additional Views and Scar Photos in Her Vertical Thighplasty Gallery
