Thighs lift in the post-bariatric patient – A systematic review

Abstract

BackgroundThigh lift, first described by Lewis in 1957, consists of thigh recontouring by various strategies. When considering the Post-Bariatric Thighs Lift (PBTL) the technical details become fundamental due to both patients’ comorbidities and increased risk of complications. Moreover, post-bariatric weight loss affects the thighs resulting in significant tissue redundancy, inner excess, lower thigh deformity, later excess and buttocks ptosis. With this paper, PBTL procedures are reviewed and a comprehensive classification system is proposed aiming to improve their medical and surgical management. MethodsA PRISMA systematic review was carried out by searching the PubMed (MEDLINE) library from May 2004 to May 2024 using the keywords ‘‘thighplasty OR thigh lift OR postbariatric thighplasty OR (thigh lift AND weight loss) OR (thigh lift AND liposuction)”. Eligibility criteria included original studies discussing PBTL with a minimum of 3 clinical cases. ResultsThe final synthesis included 17 articles and 496 patients from articles published in the last 20 years. Several papers revealed significant PBTL surgical strategies and technical measures. ConclusionsPBTL is challenging due to both technical factors and complex comorbidities of post-bariatric patients. A comprehensive assessment of PBTL may help choosing the appropriate treatment, based on patient’s individual needs. Liposuction assisted inner thigh lifts with combined horizontal-vertical scars and skin-only excision is effective and versatile for most patients. However, selected cases may benefit of alternative and more invasive strategies. Artificial Intelligence (AI) is a topic of growing interest and it will probably become increasingly relevant in PBTL. Future research is expected.