After major weight loss, the inner thighs are often left with loose skin that rubs with every step. Chafing, rashes and skin breakdown between the thighs are among the most common reasons people ask about surgery, and they rarely improve with exercise, because the problem is skin rather than muscle or fat.
In short: A thigh lift (medial thighplasty) removes loose skin and residual fat from the inner thighs. After major weight loss the skin is usually loose both from top to bottom and around the thigh, so most patients need a vertical thigh lift, with a scar running down the inner thigh towards the knee, often combined with a scar in the groin crease. A groin-only lift is suited to smaller amounts of loose skin. It is usually a two-night stay, and a Medicare rebate under item 30169 may apply where the criteria are met.
- Why the thighs change
- Is it right for you?
- Types of thigh lift
- Order of operations
- Recovery
- Scars
- Cost and Medicare
- Questions
Why the inner thighs change after weight loss
The skin of the inner thigh is thin and has little support from the tissues beneath it. When weight is lost after years of stretching, that skin cannot contract enough to match the smaller thigh. It hangs in folds that rub together when you walk, trap moisture and break down, and it can make exercise, clothing and even sitting uncomfortable.
After major weight loss, whether through bariatric surgery, weight-loss medication or lifestyle change, the loose skin usually extends from the groin to the knee and is loose around the thigh as well as vertically. That pattern determines which operation is needed.
Is a thigh lift right for you?
- your weight has been stable for at least six months, ideally twelve
- the inner thighs rub, chafe or develop rashes despite skin care
- loose skin limits walking, exercise or clothing
- the problem is mainly loose skin, not fat that would respond to other treatment
- you accept a scar on the inner thigh in exchange for removing the skin
- you are free of all nicotine, or able to stop completely at least eight weeks before surgery and stay off it for eight weeks after
If you have not had major weight loss and your concern is limited to the upper inner thigh, the general thigh lift page covers the shorter options.
Work out which thigh lift you need
Dr Kumar assesses the direction and extent of loose skin, the fat that remains, and whether other operations should come first. A GP referral is required.
The pinch test
Pinch the skin on the inner thigh and let go. If it springs back, there is reasonable elasticity and liposuction is in play. If it stays creased or hangs, it is a skin problem and no amount of fat removal will correct it — in fact removing the fat underneath makes it hang more. Why liposuction alone will not fix loose skin.
The functional problems to document
- Recurrent rash or skin breakdown where the thighs touch, particularly in summer
- Chafing that limits walking or exercise
- Difficulty with clothing
- Skin infections needing treatment
Have these seen and recorded by your GP. Item 30169 — removal of redundant non-abdominal skin for functional problems following significant weight loss — turns on exactly this kind of documented finding rather than on appearance. The full criteria.
Types of thigh lift
| Technique | Scar | Suits |
|---|---|---|
| Groin (crescent) thigh lift | In the groin crease only | A small amount of vertical looseness in the upper inner thigh |
| Vertical thigh lift | Down the inner thigh towards the knee | Skin loose around the thigh along its length, typical after major weight loss |
| Combined vertical and groin lift | Groin crease plus inner thigh, forming an L or T | Skin loose both around the thigh and from top to bottom |
| Any of the above with liposuction | As above | Where residual fat remains |
A groin-only lift removes relatively little skin and its benefit can fade as the skin settles, which is why most patients after major weight loss need the vertical component.
The limitation worth understanding. Pulling upward on thigh skin from an incision in the groin works over a limited distance. Push it further and two things happen: the scar is dragged downwards out of the crease where it becomes visible, and the vulva or scrotum can be distorted by the tension. Securing the deeper tissue to the fixed structures in the groin is what reduces that risk, and it is one reason this operation is more technically demanding than its modest scar suggests.
What the operation involves
Markings are made with you standing, so the amount of skin to be removed can be judged under the effect of gravity. Under general anaesthetic, liposuction may first be used where residual fat remains. The loose skin is then removed along the inner thigh and, where needed, in the groin crease. Where a groin incision is used, the deep tissues are anchored to firm tissue near the pubic bone so that the scar is less likely to drift down the thigh or pull on the genital area over time. The skin is closed in layers. Drains are used and are removed by Dr Kumar’s nurses once the drainage has settled.
Order of operations
A thigh lift is usually not the first operation after weight loss. A lower body lift or abdominoplasty lifts the front and outer thighs and changes how the inner thigh skin sits, so doing the thigh lift afterwards means less skin needs to be removed and the result is more predictable. Thigh lifts are commonly planned three to six months after abdominal or body lift surgery.
Arms and thighs are usually done at separate operations, because having both restricted at the same time makes early recovery much harder. After weight loss, keeping each operation within a safe length reduces the risk of complications.
Recovery, week by week
| When | What to expect |
|---|---|
| In hospital | Usually two nights at Westmead Private Hospital. You will be walking from the first day, with compression stockings and measures to reduce the risk of clots. A compression garment is fitted. |
| Weeks 1 to 2 | Time off work. Tightness and swelling in the thighs, sometimes extending to the knees and lower legs. Short walks several times a day. Avoid sitting with your legs spread wide or squatting, and keep the groin clean and dry, because this is where healing is slowest. Drains are removed by Dr Kumar’s nurses once the drainage has settled. First review with Dr Kumar and his nurses at about one week. |
| Weeks 2 to 6 | Most patients return to work from about two weeks, then gradually resume most everyday activities over the next four weeks. How quickly depends on how physical the activity is and the area operated on. No heavy lifting or straining, and drive only once you can do so comfortably and safely. The Prineo and Micropore dressings come off at six weeks, and the compression garment is worn for six weeks. |
| Weeks 6 to 12 | After your six-week review, exercise and more physical work are built up progressively. Most patients are cleared for full activity at the 12-week review. |
| 3 to 12 months | Swelling settles and the scars mature. Reviews at 6 months and 12 months. |
Dressings, garments and scar care are managed by Dr Kumar’s nurses, who also work on the wards at Westmead Private Hospital. The nurses who prepare you for surgery are the same ones who look after you at every post-operative review.
Scars and sensation
The vertical scar runs along the inner thigh, where it is mostly hidden when you stand with your legs together but visible in shorts and swimwear. The groin scar sits in the crease. Thigh scars can widen, and they are red and firm for several months before fading and flattening, usually over 12 to 18 months, though scar maturation varies between people. Some numbness of the inner thigh skin is common and usually improves.
Risks and complications
All surgery carries risk. Wound-healing problems are more common after a thigh lift than after many other body contouring operations, because the area is under tension with walking and is hard to keep dry. Risks include:
- wound separation, particularly in the groin and where the scars meet
- seroma, a collection of fluid that may need draining
- infection
- prolonged swelling of the lower legs
- bleeding or haematoma
- downward drift of the groin scar or distortion of the genital area
- thickened or widened scars
- blood clots in the legs or lungs
- the need for further surgery
Dr Kumar will go through your own risk profile at consultation. You can read more about the risks of surgery.
Cost and Medicare
Dr Kumar’s initial consultation fee is $400, with a Medicare rebate of approximately $88. A referral from your GP is required to see Dr Kumar. Surgical fees are quoted individually after consultation, once the operation and any staging are settled. The practice does not publish package prices for body surgery.
A thigh lift after weight loss may attract a Medicare rebate under item 30169. The item covers removal of redundant non-abdominal skin for functional problems following significant weight loss equivalent to at least five BMI points, where your weight has been stable for at least six months before surgery, for one or two non-abdominal areas. Medicare benefits are not available for surgery performed for cosmetic reasons.
When a Medicare item applies, your private health fund may also cover hospital costs, depending on your level of cover. The hospital runs a fund check before issuing its quote, so your itemised quote shows what your fund covers. The guide to Medicare rebates and plastic surgery explains how the system works, and costs and payment sets out what the quote includes and how the in-house payment plan works.
Results
Surgical photographs are restricted to viewers aged 18 and over. The outcomes shown in any photograph are relevant only to the patient pictured, and individual results will vary. You can view the thigh lift gallery and the body contouring after weight loss gallery.
Where Dr Kumar operates
Consultations are held at Westmead, Penrith and Orange. If you live a long way from Sydney, you can send photos to Dr Kumar’s team before your first appointment.
Thigh lifts after weight loss are performed at Westmead Private Hospital, an accredited Ramsay Health Care hospital. This operation is one of a group covered on the body contouring after weight loss page.
Common questions
Where will the scar be?
For a vertical thigh lift, along the inner thigh from the groin towards the knee, often with a scar in the groin crease as well. It is mostly hidden when you stand with your legs together, but visible in shorts and swimwear.
What is the difference between a groin lift and a vertical thigh lift?
A groin (crescent) lift removes a strip of skin in the groin crease and suits a small amount of looseness at the top of the thigh. A vertical thigh lift removes skin along the length of the inner thigh and is usually needed after major weight loss, when the skin is loose around the thigh.
Should I have a body lift or tummy tuck first?
Usually, yes. Abdominal and body lift surgery changes how the thigh skin sits, so a thigh lift done afterwards needs to remove less skin and gives a more predictable result. Thigh lifts are commonly planned three to six months later.
Is a thigh lift covered by Medicare?
It can be, under item 30169, when the loose skin causes functional problems after weight loss of at least five BMI points and your weight has been stable for at least six months. It does not apply to cosmetic surgery. Eligibility is assessed at consultation, and a GP referral is required.
Will it stop the chafing?
Removing the loose skin that rubs is the main aim, and for many patients chafing is much reduced. Individual results will vary, and some patients still have fullness at the top of the thigh.
How long before I can walk normally and go back to work?
You walk from the first day. Most people take about two weeks off work, then gradually return to most activities over the following four weeks, with cycling, lunges and other exercise built up after the six-week review. Most patients are cleared for full activity at 12 weeks.
Can my arms be done at the same time?
It is usually better to do them separately, because having arms and legs restricted at once makes early recovery much harder.
Do men have thigh lifts?
Yes. Men are well represented among Dr Kumar’s post-weight-loss patients, and inner thigh chafing affects men as often as women.
Can both legs be done at once?
Usually, yes. Both inner thighs are addressed in the same operation.
Will a thigh lift slim my thighs?
It lifts rather than narrows. Narrowing the thigh needs either liposuction or a vertical excision, and which of those applies is decided on examination.
Can the scar stretch downwards out of the groin crease?
It can, and that is the main specific risk of the groin-crease approach. Securing the deeper tissue to the fixed structures in the groin is what reduces it.
Will exercise tighten the skin on my thighs?
It builds the muscle underneath, which can improve the shape of a fuller thigh. It does not shrink stretched skin.
Talk it through with Dr Kumar
If loose skin on your inner thighs is causing chafing, rashes or limiting what you can do, a consultation will establish which thigh lift you need and when it should fit into your plan. Dr Kumar consults in Westmead, Penrith and Orange, and a GP referral is required. You can also download the post-weight-loss surgery guide first.
This page is intended as general information and is not a substitute for individual medical advice. All surgery carries risk, and individual results will vary. Surgical photographs on this website are intended for viewers aged 18 and over. Read more about the risks of surgery here.
Dr Rohit Kumar (MED0001630444) Registered medical practitioner, specialist plastic surgeon (specialist registration in surgery – plastic surgery).
