Abstract
Background: Demand for anesthesia-sparing body contouring techniques is rising. This study assessed the feasibility, safety, and outcomes of medial thigh lift performed exclusively under tumescent local anesthesia (TLA) in an outpatient setting. Methods: A retrospective review was conducted that included 43 female patients (mean age of 41.6 years; BMI of 27.6 kg/m(2)) treated from November 2019 to June 2023. All procedures used pure TLA without sedation; a horizontal excision alone or combined with liposuction was chosen according to preoperative evaluation. The end-points were operative time, intra-operative pain (four-point scale), complications, and 12-month patient satisfaction. Results: Surgery was completed under TLA in every case, with no conversion to general anesthesia. The median operative time was 30 min for excision-only procedures and 50 min when combined with liposuction. Intra-operative comfort was rated "excellent" (86.0%) or "good" (14.0%); no opioids were required postoperatively. The overall complication rate was 23.2% (10/43), limited to minor wound dehiscence (9.3%), dog-ear deformity (7.0%), and scar displacement/hypertrophy (7.0%). No seroma, hematoma, infection, thromboembolic events, sensory deficits, or hospital readmissions occurred. All patients were discharged after 4 h and resumed ambulation within 24 h. At 12 months, 97.7% reported being "very satisfied" or "satisfied." Conclusions: Medial thigh lift under pure TLA provides reliable anesthesia and hemostasis, minimizes perioperative morbidity, and enables same-day discharge, with high patient satisfaction. The low incidence of only minor complications supports TLA as a safe, effective, and resource-efficient alternative to general anesthesia for selected patients with mild-to-moderate thigh laxity. Further comparative and long-term studies are warranted.