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

Question

Hello! I'm a very petite (5ft), thin (98lb,yet flabby) 47 yo. I have had bothersome cellulite above my knee (and some back of legs) since I was young. Over the last few years, my knees have become less tight, and the celllulite above my knees has spread, and begun to look lumpy up my whole thigh (and some in butt/back). What could this be and what procedures would help? When I pull my skin up, it looks much smoother. Thanks!!

Zoran Potparic, MD · Answer

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.

Raffy Karamanoukian, MD, FACS · Answer

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

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding cellulite, skin laxity, lymphedema, and possible treatment options for smoother thighs and lifted knees. Thank you for sharing your history and picture.

From your description and images, it is unlikely that you have lipedema or lymphedema. Lipedema typically presents as painful, disproportionate fat accumulation in the thighs and lower body that does not respond to diet and exercise. If your fat is painful to the touch or worsens with pressure, lipedema could be a possibility. Lymphedema, on the other hand, is persistent swelling that does not fluctuate throughout the day. If your swelling comes and goes, lymphedema is less likely.

More commonly, what you are experiencing is a combination of cellulite and skin laxity in the thighs and knees. This is often due to natural aging, genetics, sun damage, or a loss of muscle tone in the quadriceps. As collagen production decreases with age, the skin thins and loses elasticity, causing dimpling and sagging, especially around the knees and upper thighs.

In terms of treatment, there are several options depending on your desired results.

VASER Liposuction with Skin Tightening – Given that you are petite and thin but describe yourself as "flabby," liposuction alone would not be the best option, as it could worsen skin laxity. However, VASER liposuction combined with radiofrequency treatments like Renuvion or BodyTite could be beneficial. These technologies use heat to stimulate collagen production and contract loose skin, helping improve the smoothness of the thighs and knees.

Thigh Lift or Knee Lift – Since you mentioned that pulling the skin up creates a smoother appearance, a surgical lift may be necessary for optimal results. A crescent thigh lift or mini knee lift could be performed to remove excess sagging skin while minimizing visible scars.

Cellulite-Specific Treatments – If cellulite is your primary concern, options such as Cellfina or QWO injections may be considered. These treatments break the fibrous bands that create dimpling, leading to a smoother appearance. However, these do not address loose skin and may need to be combined with other procedures for the best outcome.

Given your thin frame and skin laxity concerns, I would recommend consulting with an experienced, board-certified plastic surgeon specializing in body contouring. They can assess whether you are a candidate for minimally invasive skin tightening or if a lift would provide a longer-lasting and more dramatic improvement.

I hope this helps answer your question regarding how to improve the appearance of your thighs and knees. Good luck!

Sincerely,
Dr. Katzen

Connie Hiers, MD, FACS · Answer

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.

Mats Hagstrom, MD (license on probation) · Answer

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

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

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

Answers (5)

Answer: Legs

Answer: Legs

Answer: Impact of age on cellulite

Answer: Impact of age on cellulite

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Recommended reading

Everything you need to know about Thigh Lift

Our mission is to create a world where every investment in modern beauty is Worth It.