Pursestring thigh lift: direct approach for a problematic deformity.

Extreme thigh lipodystrophy localized in a "saddlebag" distribution can be difficult to treat with conventional body-lift approaches. We present a case of extreme thigh lipodystrophy treated with suction lipectomy and direct excision of skin and fat. The circular defects were closed with pursestring sutures and yielded a greatly improved contour and minimal iatrogenic deformity or scarring. In properly selected patients, the pursestring thigh-lift can provide a superior esthetic result.