What is the bulging fat behind my knees and would liposuction be the solution? (Photos)

Question

I have had this protrusion for over 20 years since I was in my early twenties. I have always been athletic but the fatty bulges have always been there behind my knees. Is is soft and squishy but when I extend my leg it gets harder and more taut and bulgy. It is uncomfortable and unsightly. I went to a lipedema specialist but he didn’t think that was the cause. I would really like to know what this fat is and what kind of doctor I should see for treatment/removal of these fatty deposits behind my knees.

Jason Emer, MD · Answer

You need a formal evaluation by an expert in body shaping and contouring to determine what is best.  Traditional liposution awake and smartliposuction are old methods and do very poorly for tightening skin or significant skin tightening or contouring.  Small problem areas can be improved slightly by these methods.  The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heat the skin with radiofrequency devices such as J PLASMA/RENUVION, InMode BodyTite, ThermiRF to heat the under surface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HIDEF VASER contouring and can only be done by a well . trained body contouring specialist. At the same time fat should be harvested, PRP and stem cells added and injected into muscles or indentations/cellulite to get body shaping and contouring.  This is known as a brazilian butt lift when you inject the fat to the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face.  Cellulite should also be treated with cellfina, sculptra, subcision and/or fillers such as bellafill, renuva synthetic fat, or sculptra.  If skin is very loose before surgery then it will need to be removed such as lower abdominal skin (tummy tuck/abdominoplasty), breast skin (breast lift), arm skin (brachioplasty).  Overall you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting.  Dr. Emer.

Thomas Wright, MD · Answer

The area behind your knee is called the Politeal Fossa.  The space contains the popliteal artery and veins and many other structure including subcutaneous fat.  A common cause of fullness behind the knee is an Baker's Cyst which is when a synovial cyst forms behind the knee from the knee joint. Rarely dilation of veins can cause fullness.  It could be subcutaneous fat however subcutaneous fat is rarely " unconfortable " unless it is affected by a condition such as lipedema.  I recommend you get an Venous  Ultrasound and to asses if there is any deeper structural causes of the fullness. If there are no concerns with deeper structures you may wan to get a second opinion about a lipedema diagnosis or consider  liposuction to remove the excess fat. Wishing you the best of health.

Kenneth Hughes, MD · Answer

Liposuction may be a viable option but venous competence needs to be assessed as well.  Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Robert M. Tornambe, MD · Answer

motif.   The areas in your photos appear to be normal musculature, however physical examination is needed to confirm this. Usually the areas above the knees on the front view are areas of concern for most women. In this case Liposuction is an excellent option. Consult with a board-certified plastic surgeon in your area for a full of valuation to see if liposuction is indicated for you. Good luck.

David Azouz, MD, FACS, FRCS(C) · Answer

To determine what is present around the knee a plastic surgeon will be able to determine if this fat, scar tissue, musculature through a physical exam.  This will then guide the plastic surgeon if liposuction is an option.  In general liposuction can be a good option to contour the knee, thigh, buttocks and banana roll.

Darryl J. Blinski, MD · Answer

Though liposuction is an option that area of the anatomy 9posterior knees) has many vascular, nerves that could be effected or damaged. I might try KyBella off label injection sessions to melt the fat. Fees are per side $900 each and about 3 sessions may be needed. So fees could be near $6,000.

Jason Pozner, MD · Answer

In the photos it looks like localized fat bulges but best to have an in person consultation. treatment would be with liposuction and can be performed under local anesthesia for this limited area. If the skin is loose I would add Bodytite RF to help tighten the skin

Jon Ver Halen, MD, FACS (license suspended) · Answer

Dear Motif,Hello and thank you for your excellent question. If that is truly fat behind your knees (which it looks like it is), liposuction is a good option. You may want to look into a body contouring procedure that combines both liposuction with laser, radiofrequency (RF), or acoustic therapy to produce the best balance of fat reduction and skin tightening and smoothing for your body type and anatomy. For the last 12 years, we have been developing a proprietary technique that we call IDEAL Liposuction. First off, all devices and instruments used are FDA-approved, unlike some of the liposuction and fat transfer devices being used today. These procedures are usually performed in the office, with only local anesthesia. We typically use Smart / Laser Liposuction or VASER (ultrasound) to reduce dense, fibrous fat, and stimulate collagen formation; Radiofrequency-based skin tightening to maximize skin contraction; and Ultrasound, RF, or subcision (Z Wave, Venus, Cellfina) to treat cellulite. Patients go home the same day as surgery, do not need any narcotics postop for pain control, and can return to light exercise and work two days after their procedure. In my practice, we select the appropriate treatment for each patient based on their skin quality, amount of fat and surgical goals. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!
  
Best,
  
Jon Ver Halen, MD FACS
  
Harvard educated plastic surgeon
  
Texas “Top Doc” 2017, 2018
  
RealSelf100
  
America’s Top Plastic Surgeons, Consumer’s Research Council, 2010 – 2018
  
BeautyAdvisor Top Contributor

What is the bulging fat behind my knees and would liposuction be the solution? (Photos)

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