I'm not sure which procedures I would need to improve my thighs and knees after weight loss (Photo)

Question

I lost weight and my thighs are now too giggly and I have stubborn fat around my knees. Besides tightening things up I'm interested to learn about transferring fat to my buttocks since that went droopy after weight loss, or any other procedure that would fit my needs.

Gerald Minniti, MD, FACS · Answer

Careful and judicious liposuction of the inner knee, inner thigh, and outer thigh would contour them effectively. Your skin appears supple and elastic, so it would tolerate the suctioning well. As for the buttocks, what would improve it the most would be liposuction of the hips and waist; the addition of fat grafting to the buttock proper would be an additional maneuver that would also help, but is not necessary to achieve excellent buttock shape

J. Timothy Katzen, MD, FACS · Answer

Hello and thank you for your question regarding what to do with your thighs and knees after significant weight loss. First, congratulations on your weight loss journey—that is a tremendous achievement. Thank you also for providing your pictures, which are very helpful in evaluating your concerns. Based on your photos and history, you appear to be an excellent candidate for VASER liposuction of the thighs and knees. Specifically, I would recommend liposuction to the anterior (front), lateral (outer), and medial (inner) thigh regions, as well as around the knees to target the stubborn fat in those areas.

In addition, many patients who have experienced major weight loss notice drooping or volume loss in their buttocks. This can be improved by transferring fat harvested during your liposuction procedure. During the surgery, fat from the thighs, abdomen, and love handles (superior iliac crest) can be carefully collected, cleaned, and processed. That purified fat can then be injected into your buttocks to enhance projection and shape, a procedure commonly referred to as a Brazilian Butt Lift (BBL).

If your skin quality is poor or if you have significant sagging skin on your thighs, you may ultimately require a thigh lift in addition to liposuction. This can be evaluated more thoroughly during a physical exam.

I hope this helps clarify your options and answer your question regarding what to do for your thighs, knees, and buttocks after weight loss. Please be sure to consult with a board-certified plastic surgeon who has significant experience in VASER liposuction and fat transfer to the buttocks. Your best results will come from a personalized surgical plan tailored to your unique anatomy and goals.

Sincerely,
Dr. Katzen, MD, MBA, FACS, FICS

Camille Cash, MD · Answer

Liposuction with J Plasma may help with removing excess fat from the thighs and tighten the skin somewhat.  Depending on the degree of skin laxity you may be a candidate for BodyTite.  I've included a video on this procedure that I hope you find helpful.  The best next step is to visit with a board certified plastic surgeon near you to learn more about options.

Mats Hagstrom, MD (license on probation) · Answer

In reality, we don’t have great procedures for middle-aged women who have flabby thighs.
Unless you have significant skin laxity, a thigh lift is probably not a good procedure.
Inner thigh, liposuction is notorious for under delivering quality results, especially in patients who already have skin laxity issues.
Liposuction of the inner knee area does respond well.
Based on the pictures you’ve included I recommend you consider liposuction of your torso with or without gluteal fat transfer a.k.a. BBL.
You are an excellent candidate for Liposuction of your midsection. Well done, Liposuction can eliminate your hip tips and adding fat transfer can help hyper feminize your body further.
Delivering consistent quality liposuction results is more difficult than most people realize.
The number of plastic surgeons who approach mastery of this procedure is in reality quite small.
Liposuction is a permanent and irreversible procedure that can potentially leave people disfigured.
Provider selection is by far the most important variable when it comes to this procedure.
The second Most important variable is patient candidacy which has been previously addressed. 
To find the right plastic surgeon start by getting a set of complete body pictures taken the same way plastic surgeons take before and after pictures.
The pictures you included are reasonably good, but try to mimic how plastic surgeons take the pictures.
Cropped the pictures at your neck and just below the knees.
Try taking the pictures with straight angles, standing in an upright neutral position.
Bring pictures of yourself to use as a reference during any plastic surgery consultation.
Do not rely on memory or looking in the mirror when comparing results or reviewing before and after pictures.
To find the right provider, I suggest patient’s schedule multiple in person consultations.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar body characteristics to your own.
This is why you need to bring pictures of yourself to use as reference.
Highly experienced surgeons should have access to 100s or preferably thousands of before and after pictures to choose from.
There’s no correct number of consultations needed to find the right provider.
The more consultations you schedule the more likely you are to find the better provider for your needs.
Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures.
Make sure you review the results(before and after pictures) of every area the doctor recommends treating.
Schedule in person consultations exclusively.
Avoid virtual consultations whenever possible.
The biggest mistake I see patients make is having only one consultation and then scheduling surgery.
The second biggest mistake I see patients make is assuming that a board certified plastic surgeon with years of experience and overall good reviews has mastered most plastic surgical procedures.
Always get confirmation of what should seem like an endless supply of quality before and after pictures of previous patients who look just like you do.
Being Shawn a handful of pre-selected images representing only the best results of a provider career maybe insufficient to get a clear understanding of what average results may look like in the hands of each provider, what your results are likely to look like or how many of these procedures that surgeon has actually done.
For fat transfer results always confirm that after pictures were taken at least 3 to 6 months after the date of surgery.
When in doubt, slow down and schedule more consultations.
In regards to your lower extremities, I think you’re better off not having surgery.
Best,
Mats Hagstrom MD

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