Unsure if this is cellulite, lax skin, lymphedema or a combo. What procedure(s) best for lifted knees and smooth thighs? (Photo)

Fat deposits around knee can be treated with conservative liposuction using small cannula. Addition of skin tightening procedure may improve final result. However, do not expect much improvement regarding signs of cellulitis.

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Hello, and thank you for your question regarding your thighs and whether this is cellulite, lax skin, lymphedema, or a combination, and what procedure is best for lifted knees and smooth thighs. Thank you for your pictures and your history. If you had lymphedema, the swelling would come and go. If this is the case, you may have lymphedema. However, this does not sound to be a case of lymphedema. After studying your pictures, you have skin laxity and some cellulite. The lack of skin tone is probably due to your age, genetics, and it could also be caused by the stretch and decompression of the skin after exercise or weight gain and loss. Since you said that it is spreading, your skin condition is probably due to your genetics and age. Since yours is a skin problem, most plastic surgeons would suggest a skin treatment. Most plastic surgeons would suggest radio frequency or RF. Alternatively, a slightly more aggressive approach would be conservative liposuction with RF. However, you need to be extremely careful that you do not do too much liposuction as this will make your thigh skin looser. Since your condition is mostly a skin issue and not a fat issue, skin excision would be the best treatment. The most definitive procedure is to have a medial thigh lift with an incision from the mid-thigh to just below the knee. This will remove skin and tighten the overall appearance of the mid and lower thigh and the knee region. As you said, it looks better when you pull the skin up. The only way to “pull the skin up” is to remove it. This is done with a vertical incision on the inseam of your inner thigh. Good luck. I hope that I have answered your questions regarding the thigh reduction. If you have any more questions regarding the thigh lift, thigh reduction, vertical thigh lift, medial thigh lift, spiral thigh lift, crescent thigh lift, or thigh lipo, contact an experienced plastic surgeon. Please seek an experienced, board-certified plastic surgeon with significant experience performing thigh lifts. Do your research. Make sure your chosen plastic surgeon has performed at least 100 thigh lifts. Make sure they have the before-and-after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. Sincerely, Dr. Katzen, MD, MBA. (President of the American Society of Bariatric Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

You might do very well with limited liposuction and minimally invasive radiofrequency skin tightening like Renuvion with micro-needling, like Morpheus, to remove some excess fat and tighten your skin.

With age, we lose skin elasticity.
This is similar to skin laxity in sense those skin laxity comes from weight loss.
The loss of skin elasticity can amplify contour irregularities from previous cellulite.
If you pull to put some tension on your skin, then it will most likely look similar to what it did when you were younger.
There’s no easy treatment for either loss of skin elasticity or cellulite.
Best,
Mats Hagstrom MD