Q: Dr. Eppley, I hope you can help me. I am almost 30 and I have had ‘fat’ legs since my early teens. My grandma and mother have the same. When I lose weight my legs still stay fat; I go to the gym regularly and this has gone some way to improve muscle tone but not to achieve any fat loss from my ankles or calves. I would love my legs to look slimmer and more shapely.
A: Lower leg liposuction can be effective at improving the fuller lower leg from the knees to the ankles and making them more shapely. But it is not done in a circumferential manner as many people think. Rather it is done by treating selective areas to improve their silhouette or profile through inner knee, upper medial calf, and inner and outer lower ankle liposuction. While such lower extremity liposuction can be very effective it can take several months to get to see its benefits. As the lower legs have increased venous pressure and slower lymphatic outflow due to gravity they hang onto swelling for some time after the surgery. It usually takes about three full months to see the final results of the lower leg reshaping.
Dr. Barry Eppley
Q: Dr. Eppley, Hello, I was reading the article on the knee liposuction procedure that you do. I had liposuction in the knee area and now I have an actual fold of skin over the right knee. Is there anything that can be done? It is not fat but actual skin that hangs over the knee. Thank you so much for your response. I need to get something done because it is so ugly!!!
A: Liposuction in the knees can be one of the most satisfying body areas to treat. However, this is primarily in the medial or inside area of the knee. The skin retracts very well on the inside of the knee so few contour deformities arise with the elimination of the inner knee bulge. Many patients also have a fullness across the top of the knee, known as the suprapatellar region. While liposuction can be done in this area with good fat removal, it can result in an unflattering roll of skin. This is because the skin across the knee must be very flexible to allow for knee extension and, most importantly, knee flexion. (bending) This skin ‘excess’ is hidden when the knee is fuller but becomes unmasked when it’s volume is deflated. Improvement of this suprapatellar fold of skin is very difficult. The absolute cure is skin fold excision but the resulting scar is unacceptable with significant widening and an aesthetic outcome that might be worse than the original problem. The only reasonable treatment option is additional small cannula liposuction into and above the skin fold to try and get it flatter. The success of that approach is one of some improvement but no absolute cure.