Your Questions
Your Questions
Q: Dr. Eppley, I am interested in a new procedure that I have read about known as a knee lift. I have ugly rolls of skin just above my kneecaps that I just hate. They make me look like I have old lady knees. I know there is a scar but I think that would be a lot better than what I have now. How is a knee lift done and what is the cost?
A: Like all body areas, the knees do show the signs of aging. The constant flexion and extension of the knee eventually causes loose skin to appear in folds or rolls above the kneecap. These suprapatellar skin folds can also be exaggerated by the downward descent of the thigh skin which pushes down against the fixed skin on the kneecap.
A surgical knee lift involves the direct excision of these folds of knee skin and leaves behind a curved suprapatellar scar. The creation of this scar in a visible area is the primary reason why it is infrequently performed. This is done through a crescent-shaped excisional pattern. The key to creating the best knee lift scar possible is precise placement of the excision location and to not remove too much skin. Since the width and appearance of scars is highly influenced by the tension they are under. too much skin removal across a joint that repeatedly flexes will lead to a wide and very visible scar.
The knee lift is done under local or IV sedation anesthesia. Long-term suture support is needed to resist the stretching of knee flexion and to help keep the scar as narrow as possible. The knee incisions are taped and ace wraps applied. Patients only need to avoid bending their knees greater than 90 degrees for a month after surgery. Other than that ther are no specific physical restrictions.
For the woman who considers a scar trade-off better than unsightly knee skin rolls, the knee lift can be a very satisfying procedure. Whether done under local or IV sedation anesthesia, the total cost is in the $4000 range.
Dr. Barry Eppley
Indianapolis, Indiana
Q: I am very interested in a knee lift. I have had liposculpture around the front of my knee and thigh with the hope it would remove the wrinkly look I have around my knees. I am 48 yrs old therefore the loss of skin elasticity has effected the look of my knees. I am desperate for some advice of where I can go to improve this part of my body. I have considered a thigh lift but have been advised that it is not possible to lift my problem area because there is a long distance between my knees and upper thighs.
A: The loose skin and wrinkles above and around the knee area is a difficult problem. As you have discovered, deflating thin older skin by liposuction will usually just create more loose skin. Like anywhere else on the body where there is loose skin, it is possible to do some form of a lift. Essentially a knee lift is the direct removal of skin above the knee cap area. This is actually a fairly simple procedure in concept but is flawed by the creation of a scar. While lifts are done in many areas of the body and they all create scars, the knee lift is unusual in its location. It is placed in an area that is directly exposed to high degree of motion and a high angle of potential flexion…which puts stretching forces on the scar in a perpendicular direction. This will likely result in noticeable scar widening. Whether such a scar is a better aesthetic result than the wrinkly skin around the knee is a critical question. While I would have to see how ‘bad’ your knees look now, I would be suspicious that this may not be a good aesthetic trade-off.
Dr. Barry Eppley
Indianapolis, Indiana
Q: I am interested in getting an inner thigh and knee lift procedure but am concerned about the scarring. I have looked on the internet but pictures of these type of scars seem hard to find. Do you have any suggestions about how I should make the decision for this kind of surgery?
A: Body contouring of almost any kind always results in scars. Short of scars on the face or breasts, most scars that result from body contouring procedures will not look as good as they do on these two areas. Regardless of even seeing good scar outcomes from these procedures, that does not mean that yours will turn out as well.
Therefore, the decision to go forth with any type of ‘leg lift’ should be based on the acceptance that the scarring will not be as good as you would like it. Scars are the lower extremities are never great. They are faced with too much tension and movement after surgery that always stretches them out to some degree. You have to decide which is more acceptable, the loose skin or the scars. If you can not accept the concept of scars or have any hesitancy about them, then you should not do the procedure.
My approach to scarring in body contouring surgery is…it is always about trading off one problem for another. The operation is good one for you if the trade-off into scars is better in your mind that the excess skin problem that you had before.
Quite frankly, mentally going through this thought process is better than looking at pictures of scars from the procedure. The people that are truly happy with the results from this type of body contouring procedure don’t care what the scars look like because they hate what they have now. That is the attitude to have the scarring, no matter how it looks it is better than this loose hanging skin that I have now.
Dr. Barry Eppley
Indianapolis, Indiana