I want shapely feminine legs, my body is very pear shaped. What do you recommend? How effective is lower body lipo? (photo)

I do not wear skirts, dresses, or shorts because my legs have no shape. My thighs are so big and I have big ankles and a lot of fat behind my knee. I am working to lose whatever weight I need but I know that alone won't give me the shape I want. What would you recommend? I just want to be able to have shapely feminine legs. And what would be a ball park cost ? I will also be replacing old breast implants as well.

Doctor Answers 9

Getting shapely legs

Thank you for showing your pictures.

You appear to have true lipodystrophy of your lower extremities.

That's medical jargon for a disproportionate fat distribution.

It's possible you may also have a Lipedema.

Lipedema is a condition that affects women more than men and causes fat in the lower extremities to expand and swelling with age.

Lipedema is a poorly understood condition and there are no real treatment options other than liposuction.

I'm not saying you have this condition but if you're fat distribution has worsened with time then there's a possibility you may have some lipedema.

Your best course of action is well done liposuction of your entire lower extremities.

This should include circumferential liposuction of your thighs and legs.

A big note of warning.

Lower extremity liposuction is technically difficult.

Especially liposuction of the inner thighs, calves and ankles.

The area around the knees can also be difficult as the front of the thigh or the gluteal crease.

If too much fat is taking out then your skin will be compromised and will have contour irregularities in a sagging appearance.

If that is taking out incorrectly then you can be left with bumps, streaks and contour irregularities.

There are non-surgical treatment options as well.

The overall patient satisfaction of these is not nearly as good as liposuction.

Other options include cool sculpting and various radio frequency techniques.

For curved area is cool sculpting it seems to be particularly challenging.

I would suggest you have multiple in person consultations with board-certified plastic surgeon's who have particular expertise or extensive experience with liposuction including liposuction below the knees.

My practice is devoted exclusively to body contouring using various forms of liposuction and fat transferred.

I'm the only board-certified plastic surgeon in the western United States who is devoted his back is entirely to these two procedures.

There are many very talented plastic surgeons in the bay area.

I suggest making a list and interviewing at least four or five plastic surgeons.

For most cosmetics  procedures interviewing one or two plastic surgeons as long as their credentials and reputations are good it's probably sufficient.

When it comes to circumferential lower extremity's including calves and ankles true expertise is needed to avoid undesirable long-term poor outcomes.


Mats Hagstrom M.D.

San Francisco Plastic Surgeon
4.8 out of 5 stars 18 reviews

Improve leg shape

Thank you for asking about your leg shape

  • Your photos are very helpful - liposuction should give you a lot of improvement.
  • Liposuction of the ankles themselves can be difficult but your fat appears to end just above them.
  • As for weight loss - plan to lose about 10 pounds after liposuction so the fat doesn't return to new areas.
  • The back of your thighs has a little 'cellulite', ie skin indentations. Liposuction will not improve that.
  • Cost varies by surgeon and by area but you can find the average cost in your area on Real Self.
  • Be sure to discuss recovery after leg liposuction - swelling after calf liposuction is especially severe and can take a year to fully resolve. be sure your surgeon has you get a pair of knee high compression socks.

Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

I want shapely feminine legs, my body is very pear shaped. What do you recommend? How effective is lower body lipo?

Hello T and thank you for your photos and question.  From your photos you apear to be a very good candidate for liposuction to sculpt your thighs and possibly your calves.  Depending upon the amount of fat present, the change and improvement can be dramatic.

Meet with an ABPS Bd Certified plastic surgeon to review your options and photos of other patients to show you what can be achieved.  Best regards,

Jon A Perlman MD FACS 

Certified, American Board of Plastic Surgery 

Extreme Makeover Surgeon ABC TV

Best of Los Angeles Award 2015, 2016 

Beverly Hills, Ca

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Thighs, knees, calves and ankles do very well with liposuction and is easy to undergo.

I would liposuction your thighs and knees in one procedure and come back 1-2 days later and do your calves and ankles. It is all under tumescent local with a little iv sedation and is easy to undergo with almost no pain at all. I will stand you up several times to fine tune the results. Cost is roughly $14,000 -18,000 for quality work and is soooooo worth it.

David Hansen, MD
Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 42 reviews

I want shapely feminine legs, my body is very pear shaped. What do you recommend? How effective is lower body lipo?

Lower body, inner and outer thigh and calf and ankle liposuction is very effective in slimming and contouring these specific areas.

Fred Suess, MD (retired)
San Francisco Plastic Surgeon
4.5 out of 5 stars 8 reviews

Lipedema Treatment

It looks as if you have lipedema the best treatment for this is liposuction but if you have loose skin you will need a thigh lift.  the calves can also be treated. I suggest seeing an expert in this type of contouring as it needs an expert.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews


Thank you for the photos and question and YES you are an excellent candidate for liposuction to your legs.  So go on some complimentary consultations with experts, become informed, compare fees and photos and techniques and find your surgeon

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 61 reviews

I want shapely feminine legs, my body is very pear shaped. What do you recommend? How effective is lower body lipo?

Thank you for your question and photos. Based on your photos, you do have excess fat both on the thighs and legs. You would benefit from VASER liposuction in these areas. The thighs will need to be reduced circumferentially and the legs need the muscles defined and the ankles shaped. The breast surgery can be done at the same time. You also have some cellulite which the liposuction will not improve. This can be addressed with Thermitight at the same time or later. Costs depends on geographic area, single or multiple procedures and surgeon's reputation and skill. See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

George Marosan, MD
Bellevue Plastic Surgeon
4.8 out of 5 stars 38 reviews

I want shapely feminine legs, my body is very pear shaped. What do you recommend? How effective is lower body lipo?

From your photos, I believe you would be a good candidate for liposuction.  You do appear to have some issues of cellulite and may benefit from the addition of ultrasound treatment along with the liposuction.  VASER ultrasound assisted liposuction along with VASERsmooth cellulite treatment may give you the best overall results.  Costs can vary, but many practices offer free consultations in which the cost of your procedure could be determined in advance.  Seek out a plastic surgeon who has extensive experience and who is board certified.  Best wishes, Dr. Lepore. 

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.8 out of 5 stars 56 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.