While I'm not in the tall and skinny category... I finally found something that works for me. I carry a 1911 at five oclock, mag well to the outside, using a left hand IWB holster. I broke my arm some years ago and it still gives me some problems. All I can say is that it works for me. I'm not going to tell you how many holsters I went through over the years to find that combination. Now if I can just find one with a right hand thumb break... I'm probably going to break down and have K&D make me one.