Thigh treatments

First, let’s define thighs. The legs are below the knees, and the thighs are above the knees.

Common concerns involving the thighs include:
“Saddlebags.” This condition is typically treated successfully with liposuction if the only issue is excess fat.

Excess fat in the upper inner thighs. In most cases, this can be corrected with liposuction. The skin in the inner thigh tends to sag, so tightening the skin may provide a better, firmer result. Renuvion or ThermiTight can be used to tighten the skin and may be performed simultaneously with liposuction. Renuvion appears to be safer and tightens the skin more effectively and more quickly by using radiofrequency combined with helium.

Cellulite. Cellulite is treated with a device called Aveli, which cuts the fibrous bands that cause dimpling. This is currently the most effective treatment for true cellulite, which typically appears as isolated dimples on the buttocks, lateral thighs, and front of the thighs. Aveli can be combined with any of the other procedures mentioned in this article.

Multiple wrinkles and sagging skin of the thighs. This occurs in varying forms and degrees and is often the result of weight loss or aging. Some patients require liposuction, but in many cases the sagging is due to loose skin rather than excess fat.

To date, the most effective treatment to reduce thigh wrinkles and sagging is the use of a liposuction cannula called a basket cannula to separate fat from the surrounding fibrous bands, with or without liposuction as needed. The basket cannula redistributes the fat more evenly, creating a smoother thigh contour. In effect, this acts as an internal fat graft by redistributing existing thigh fat. This process, called equalization, results in smoother thighs.

Thigh dimples, irregularities, and lumpiness often involve loose skin, so basket cannula equalization is usually followed by Renuvion to tighten the skin. If additional tightening is needed, other devices such as Everesse may be effective. Everesse tightens and thickens the skin by increasing the production of elastin and collagen. For dimples requiring added volume, Renuva is a newer filler that can last five years or longer and is best used for cellulite following Aveli treatment.

Wrinkles above the knees. If these are fine wrinkles, Renuvion or ThermiTight is usually sufficient. If the wrinkles are more severe, treatment can be followed with a microneedling device that emits radiofrequency at the same time, such as VirtueRF, to further tighten the skin.

Fatty inner knees. These are typically treated successfully with liposuction.
Below the knee: Fatty ankles. These require careful liposuction to achieve smooth, well-contoured results from all angles.

Most of the procedures mentioned above can be performed using local tumescent anesthesia with light sedation, depending on the patient’s preference. Compression garments are generally required for several weeks, depending on the extent of the procedure.

Dr. Ronald Finger, MD, FACS is a board-certified plastic surgeon with offices in Savannah and Bluffton. fingerandassociates.com