**3. Marking**

All patients are marked in standing position. Two points are marked to delineate the limits of incision line incorporating the extent of medial thigh excision. Anterior limit and extent of the line is marked usually on the mid-inguinal point while posterior extent line is limited by the medial limit of the gluteal crease. Anteriorly, the extent of incision can be extended up and laterally to the anterior superior iliac spine if needed. From the anterior point, a line is drawn down and medially and 1–2 cm caudal and parallel to the inguinal ligament, groin and perineal fold. The line is extended posteriorly into the medial part of gluteal crease. It is extremely important in the medial groin and perineal area to draw the line 2 cm caudal to crease to prevent labial distortion. Proposed inferior incision line is drawn as a crescent, width of the crescent at its middle does not generally exceed 10–12 cm. Once the lower limit of the line is drawn, proposed excision lines are pinched together to ensure tension free closure and are checked with thighs in adduction, external rotation and gentle abduction for a tension free closure.
