“From T to L to I: risk factors in medial thigh lifts after massive weight loss. Is less sometimes more”?

Thigh lift surgery is considered a complication-prone operation, with publications reporting complication rates between 35% and 74%. Though thorough, 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 cohort of massive weight loss (MWL) patients. A retrospective cohort study from 2008 to 2023 of 750 thigh lifts on 375 patients was performed. The data collected was collated into the three thigh lift techniques and analyzed according to preoperative risk factors and postoperative complications. The overall complication rate was the lowest for I (40.3%), followed by T (66.6%) and then L (73.9%). An analysis of major complications reveals values of 9.5%, 33%, and 39.1%, respectively. This study also shows that smoking, a BMI of 30 and above, higher temperatures, and prolonged operative duration increase the risks of complications. The I-incision technique for thigh lift surgery after massive weight loss (MWL) has fewer complications, reduces scarring and operating times, and has a low revision rate.