How can plastic surgery make my legs thinner?

Thick. Stubby. Meaty. Yams. There are literally hundreds of words that patients use to describe their dissatisfaction with their legs.

So what can be done about it? In general, surgery to slim a patient's legs is most effective in the upper parts of the leg (i.e., the thigh), but becomes less effective the farther down the leg you go. In the right person, liposuction of the inner thigh, outer thigh, buttock area (or "banana roll"), and even the area around the knees may improve the appearance of thick legs. Liposuction's ability to make the legs look slimmer depends on the length of the leg, the quality and retractility of the skin (the higher the elasticity the better), and the amount of fat that can be liposuctioned without deformity.

Not all people are good candidate for leg liposuction, however. Patients who have a significant amount of extra skin (for instance, after massive weight loss) may have additional skin that needs to be excised (i.e., thigh lift). In these cases, in addition to liposuction, the extra skin is excised from the inner thigh as a crescent in the groin crease, as a longitudinal or vertical strip of tissue, or as a "T" shaped excision of skin and fat.

While thigh sculpting is commonly practiced, liposuction of the calves and ankles is less common. Many thick calves are the result of large gastrocnemius muscles, which in turn, is genetically determined. Fat can be liposuctioned; muscle cannot. Surgical options for treatment of excess muscle include removal of strips or subtotal muscle belly excision, which trades some muscle bulk for a significant scar. In addition, there are risks of prolonged pain, swelling, and even a blood clot. Conversely, for patients with excessive fat deposits in the calves and/or ankles, liposuction (often with ultrasound or laser assistance) is an option.

In cases of liposuction and/or surgical excision, patients typically go home the same day. We generally use a compression garment to reduce swelling for a total of three weeks after surgery. Patients are expected to start walking on the same day as surgery. Some patients return to work after 24-48 hours after liposuction; after a thigh lift, patients should expect to take off between 5 -10 days. We generally have patients resume exercise activities at three weeks post-op. With liposuction, the only scars are the liposuction cannula ports; with thigh lifts, patients can expect an incision in the inner groin crease, or along the thigh inseam if a larger piece of skin is removed. With regard to cost, ASPS statistics list the national average for a thigh lift at about $4,800; for liposuction, the average cost is about $3,200.

And, of course, not all patients are unhappy with their legs because they are too large. Some patients are interested in a more muscular profile, in which case perhaps some extra time in the gym is in order. Others may be interested in a fuller figure, in which case fat grafting to the hips and/or buttocks are an option. For those patients with "chicken legs," calf augmentation with an implant or fat grafting are two techniques growing in popularity.

If you are interested in surgery to improve your legs, start with some further research. ASPS has detailed information on the full range of surgical and noninvasive procedures available today, along with hundreds of before and after photographs. We also recommend that you find a board-certified plastic surgeon in your area. Schedule a face-to-face consultation to find out which technique is best suited for your individual needs and long-term goals.