Anterior Thighs
On the anterior thighs, optimally smooth results are more important than maximal volume reduction. Excessive liposuction of the anterior thighs can easily produce ugly irregularities of the skin. Removing more than 60 % of the subcutaneous fat of the anterior thigh is associated with a relatively high incidence of patient dissatisfaction.
Dangers of Circumferential Thigh Liposuction
Liposuction of the entire thigh during one day is not recommended. Circumferential liposuction accomplished by one surgical procedure often results in a prolonged swelling of the feet and legs, with significantly more discomfort and delayed return to normal activities. It is possible that liposuction of the entire circumference of the thigh may predispose the patient to deep leg-vein thrombosis and blood clots in the lung. Circumferential liposuction of the thighs is safer if it is accomplished as a serial procedure.
Serial Surgeries
Serial surgeries are preferred, with the sessions spaced one month or more apart. For example, one might treat the outer thighs and hips during one session. Then the anterior thighs, inner thighs, and knees can be treated during the separate session. In this way, bothersome swelling of the lower extremities is infrequent. Typically, patients can be expected to return to work within one to two days after surgery.
Leg Swelling
The cause of leg swelling after liposuction of the entire thigh is injury to the lymphatic vessels found in fatty tissue. Lymphatic vessels drain fluid from injured tissue. When the entire thigh is treated, the entire thigh is swollen, and remains swollen for a considerable length of time. By subdividing circumferential liposuction into two separate procedures, there will be fewer total number of days of postoperative disability. The portion of the thigh that is not treated provides functioning lymphatics that compensate for the impaired lymphatic drainage in the treated area.