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