How to Reduce Thighplasty Complications Using the Boomerang Technique

Background

Patients who undergo bariatric surgery represent an increased demand for plastic surgeons^1,2. After massive weigh loss, skin ptosis observed on the thighs is a frequent complaint¹. In order to reduce the reported incidence of complications (18 to 33%)³ this study describes a thighplasty technique with a boomerang-like resection that decreases suture tension, reporting complications and satisfaction in a case series.

Methods

16 patients with massive weight loss after bariatric surgery underwent the Boomerang thighplasty, between March 2011 and August 2012.

Skin Markings: On standing position with lower limbs rotated laterally,  a median line on the medial thigh and a line paralel to the groin crease are drawn. Skin laxity is evaluated by pinch test and an anterior and diagonal line is marked. A line dividing the posterior angle (bisectrix) is marked. A semi-circle is drawn and its radius one third the distance of the bisectrix (Figure 1).

Operative Technique: In supine position, lower limbs abducted and knees bent the marked excess skin and subcutaneous is resected preserving deep fascia and great saphenous vein. The flap is not attached to the Colles fascia^4,5. Closure with suction drains placed. In case of localized lipodystrophy, a 1:500.000 dilute epinephrine solution was infiltrated prior to aspiration.

Satisfaction Questionaire: A survey was answered on the 6^th month post-op with 10 questions related to scar,  edema,  symmetry, sensibility, contour, lighter thigh perception, mobility, agility, ease in getting dressed and final cosmetic result.

Results

No dehiscence, hematoma or infection in a 1 year follow-up (Figure 2). One patient presented hematoma and was aspirated. Satisfaction reached 86% (average grade 25,8 from a total of 30 points).

Figure 1. Skin Markings

Figure 2. 1 month Post-op medial view

Conclusion

The Boomerang Thighplasty appeared to be reproductible with decreased complication data and elevated satisfaction for post-bariatric patients.