Thank you for your question. Based on the photo, the inward angulation of your knees may be related to your bone structure, joint alignment, or lower limb anatomy rather than a cosmetic soft-tissue issue. A proper orthopedic evaluation would be necessary to determine whether any corrective treatment is indicated. Regarding the skin pigmentation around the knees, this is a common concern and may be caused by friction, genetics, previous inflammation, or skin thickening. Depending on the underlying cause, treatments such as medical-grade skincare, chemical peels, laser treatments, or other pigmentation therapies may help improve the appearance. I would recommend an in-person consultation with both an orthopedic specialist for the knee alignment and a dermatologist or aesthetic physician for the pigmentation concerns to determine the most appropriate treatment options. Dr. Andreas Ioannides Plastic & Reconstructive Surgeon