There are a host of head-to-toe treatments that can lift, shape, and enhance different parts of the body, and the legs are no different. However, the most commonly discussed leg procedures tend to focus on the thighs, calves, and feet, while missing one major area: the knees.
Due to their unique position on the body, the skin on and around the knees is prone to wrinkling, sagging, and drooping, and, as board certified dermatologist Ava Shamban, MD, founder of Ava MD, Skin Five Clinics, and The Box by Dr Ava, reveals, “gravity, position, and need for excess skin to accommodate the bend of the knee joint can make this area one of the hardest to improve with diet and exercise.”
If the appearance of your knees bothers you, you are not alone. But since it’s a less talked about area, it can be hard to figure out where to start. As it turns out, there are an array of surgical and non-surgical treatment options to improve the contour and skin quality of the knees, and we are breaking them all down below.
How to Take Care of Your Knees
As with skin on any part of the body, it is far easier to prevent damage than it is to correct it. As such, your knees will benefit from a consistent skincare and sun care routine. “Sun avoidance and sun protection is key, while weekly physical or enzymatic exfoliation for more smooth supple skin helps keep a more youthful appearance,” Dr. Shamban explains.
And then there is the need for moisture — especially since the skin naturally becomes drier with age. “Similar to elbows or heels, [the knee] area needs considerable hydration, as it does not have a plump lipid layer amongst the network structures between skin and bone,” she continues. Need an upgrade? Check out our guide to the best body creams.
If you are serious about keeping your knees in shape, it’s not just about the skin. “Light weight-bearing activities for quadriceps will keep those muscles toned,” Dr. Shamban says. David Shafer, MD, a double board certified plastic and reconstructive surgeon and founder of Shafer Clinic Fifth Avenue in New York City, notes that proper diet and exercise and, for some, slow and steady weight loss can help minimize the need for aesthetic and functional knee treatments down the road. Additionally, some of the treatments that are employed to improve the appearance of the knees (think: Emsculpt®, NuEra®, and CoolSculpting®) “can also be used preventively to help head off any future issues,” he adds.
When to Seek Treatment for Aesthetic Knee Concerns
It can be hard to know if it’s time to see a provider about any cosmetic adjustment to your knees, especially since they can be a tricky area to self-examine. “There is no ‘ideal’ knee,” Dr. Shafer says. “In fact, the more you stare at your knees, the stranger they look.” And don’t feel bad if your knees have mostly been an afterthought. “Most people don't focus on their knees,” he admits. “But, as we age and the skin starts sagging or wrinkles start forming, the knees can start to be a focal point – especially when you’re wearing shorts and skirts or you’re at the beach.”
While aging is one cause of sagging knees (as we age, our skin loses collagen and elastin), genetics and weight loss also play a part. “People will say that their skin has always been loose, or, [when it comes to] weight loss, once the skin is expanded with extra bulk and then decompressed through weight loss, the skin can sag,” Dr. Shafer says.
If you find yourself paying more attention to your knees, Dr. Shamban recommends looking for “laxity, wrinkles, sagging, volume loss, or excess fat pockets on the sides or above the knee.” Those tend to be the aesthetic changes “that can distract the eye,” she notes.
The Best Candidates for Treatment
It’s important to speak with your provider about the pros and cons of an aesthetic knee procedure, but, barring any serious health issues, those with loose, sagging, and/or crepey skin will be a good candidate for treatment. With that said, Dr. Shamban says patients with extremely thin skin are unlikely to get a good result. Additionally, if you have had prior knee surgeries, you may need to address any scar tissue prior to undergoing another treatment.
It’s also important to consider the time commitment. While non-surgical treatments often have little to no downtime, they also don’t usually offer dramatic results. Surgical procedures can have a more significant impact, but that comes with a longer recovery. “Surgical knee treatments need a time period of healing and decreased activity,” Dr. Shafer cautions. “So, runners, rock climbers, and other similar athletes may want to hold off until they have time to heal.”
Aesthetic Procedures for Younger-Looking Knees
When it comes to treating the knee, both Dr. Shamban and Dr. Shafer agree that the most effective option tends to be a multi-modal approach that is customized to a patient’s unique goals and anatomy. With that in mind, below are some of the best non-surgical and surgical treatment options for addressing cosmetic knee concerns:
- CoolSculpting®: Also known as cryolipolysis, this non-invasive procedure freezes away excess fat. Fat cells are permanently destroyed in targeted areas, like the knees, which can improve contour.
- Emsculpt®: This popular body contouring treatment uses high-intensity focused electromagnetic energy (HIFEM) to help build and tone muscles for functional strength and a more sculpted appearance.
- Morpheus8: Microneedling and radiofrequency (RF) join forces in this multitasking treatment option that can be used to stimulate collagen production and firm the skin.
- NuEra®: Depending on your concerns, this radiofrequency procedure can be used to eliminate fat, tighten the skin, and reduce cellulite.
- Renuva®: This injectable is often referred to as an off-the-shelf alternative to fat transfer because it works by triggering the body to create more of its own fat in targeted areas. In this case, it can gradually improve age-related volume loss in the knee area.
- Sculptra®: Another injectable, Sculptra® is a bio-stimulating poly-L-lactic acid (PLLA) filler that can improve skin quality and contour by stimulating collagen production.
- Thread Lift: Just as this suturing technique is used to sculpt the face, it can be used for an instant and longer-term knee lift. While the results are subtle compared to surgery, it supports collagen building with minimal downtime and no scarring.
- SmartLipo®: This laser-assisted liposuction technique removes unwanted fat. The laser component speeds up the fat removal process and minimizes damage to surrounding tissue, in addition to offering some skin contracture for a tightening effect.
- Thigh Lift: The most invasive option of the group, a thigh lift surgery can remove excess skin and/or fat from the upper leg for a more contoured knee area.
Recovering from Aesthetic Knee Treatments
While the non-surgical treatment options have little to no downtime, surgical treatments, like SmartLipo® and a thigh lift, do require some recovery time. Bruising and swelling are common side effects for the first couple of weeks. Activity is often limited during the initial healing period, and your surgeon will let you know when they can resume. While results are immediate and permanent, they will fully reveal themselves over the course of three to six months.
For non-invasive treatments, results will usually start to be noticeable in about four to six weeks, though it can take three months or more to enjoy maximum benefit. As for how long results last, it depends on the number of sessions (an initial series may be needed), the patient’s lifestyle, and the severity of the condition prior to treatment. Dr. Shafer notes that you should expect to repeat non-invasive treatments, and Dr. Shamban says the maintenance cycle is typically about 12 to 16 months.
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