Wrinkling and lose skin around the knee. What can I do? I’m im my late 30’s and workout almost everyday.

Hello, and thank you for your question
First of all you should ask -"Do they really work?" I would urge you to find a responsible and knowledgable plastic surgeon and not focus on brand names as this is the least important part of your decision.  As far as longevity- the six week results of your intervention are as permanent as anything in your body can be.  You will continue to age depending on your genetics and environmental factors.
The problem with noninvasive skin tightening is that everyone wants it and everyone wants to believe it works.  The result is practitioners of all sorts capitalizing on this demand.  The truth about skin tightening interventions is that almost "all of them work", yet none of them actually give long term results.  What I mean by this is that there are many ways to convert energy into heat inside or below the skin causing contraction.  The problem is that to deliver clinically effective results the tissue needs to reach at a minimum 43 C which is uncomfortable and can be scary for the patient and the practitioner.  This often results in ineffective treatment and wasted time and money.  I have developed extensive experience with noninvasive technologies, not because I'm a fan but because my patients demand it.  After using several "best in class" technologies to deliver definitive results, my patients were relatively pleased but I was underwhelmed.  This is why I started using  a treatment that we call Maercks Multimodal Therapy(MMT) in my practice.  All this is is an intelligently designed multitechnology treatment customized for the individual patient.  I use multiple diffferent frequencies and administration systems for radiofrequency delivery, three different ultrasound frequencies, infrared pulsed light, two different laser systems in concert to deliver immediate significant results that are hard to argue with and continue improving for weeks.  I think the only way to get real results is to combine technologies under the direction of a plastic surgeon that understands the capabilities and limitations of noninvasive skin tightening.  No one technology really delivers anything significant.  Also realiize that even my MMT results that I am very proud of do not remotely compare to what I can achieve with surgery and the cost can approach or exceed that of surgery depending on location and individual patient findings.
I hope this helps! Wishing you fantastic results,
Dr. Rian A. Maercks, M.D. 

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 thanks for the question. This type of skin laxity can usually be addressed nonsurgically, using treatments like Thermage or Ultherapy. The devices harness the latest technology to penetrate deeply into the dermal structure, constricting tissue and tightening skin from the inside out. Make sure you work with a board-certified cosmetic dermatologist with extensive experience in nonsurgical body contouring to ensure the best results. Good luck!

Thank you for your question and pictures. We use a combination of ThermiTight (subdermal radiofrequency) and Sculptra (collagen stimulator) for improvement of knee wrinkles. I'm not impressed by threads, and though filler can be used often it requires a lot and is not very cost effective. Make sure you see an experienced physician for an in-person consultation and evaluation. Best wishes.

We use energy devices like Thermage and BodyTite and Renuvion (radiofrequency energy) and Ultherapy (ultrasound) to obtain skin tightening in the thighs and knees. Sculptra to the knees can also help build collagen and improve loose skin and wrinkles. If you have skin laxity in the knees, internal threads (like Silhouette InstaLift) can eliminate sagging skin and build collagen over time. Sometimes VASER HD liposuction and/or Kybella or TrusculptID can help small problem areas of fat. Microneedling RF like morpheus8, fractora, inmode intensif also help improve skin laxity and if there is sundamage fraxel or erbium laser can help.   I recommend getting a formal evaluation with a cosmetic dermatologist to determine which combination of treatments will work best for you. Best, Dr. Emer

Treating  a depressed area with a filler should help.  Tightening the skin on the knee with a aggressive micro-needling radiofrequency unit such as Profound should help. Multiple sessions may be needed. Avoid the sun as it will break down the collagen and elastic fibers. Find someone with experience.
Jeff Rapaport MD FAAD
Realself All-star