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Case Study: Liposuction of the Knees


Background:  As liposuction has evolved over the past thirty years, it has undergone numerous developments most of them technological. But besides improvements in how effectively fat can be extracted, the use of liposuction has been applied to every conceivable body part from the neck down to the ankles. The development and use of small cannulas has enabled liposuction to be used in even the smallest fat collections. Smaller fat extractions have been termed liposculpture, implying subtle reshaping rather than just large volume reduction.

The legs are a frequent site of liposuction surgery. While many women do not like the appearance of their legs and often wished they were smaller overall, circumferential leg reduction by liposuction is not a practical or highly successful approach. Most leg liposuction is about changing its silhouette with reduction of the outer thighs (saddle bags), inner thighs and knees. Fat reduction is these areas can make the leg more shapely, although not always thinner or smaller.

The knee makes a valuable contribution to the shape or outline of the inner leg. Ideally, the line of the inner leg makes a small break or bulge as it crosses the knee. It then turns inward below the knee to separate it from the outward convexity of the upper part of the calf muscle. If a line is drawn from the upper inner thigh down to the bulge of the inner calf muscle, the size of the knee should not pass beyond that line. Large fat collections of the knee make it bulge outward and obscure the shape of the patella over the central knee.

Case Study: This 40 year-old female was undergoing multiple body contouring procedures including breast augmentation and a tummy tuck. But she never liked the shape of her legs, being embarrassed by her ‘knobby’ and unsightly knees. She did not want to wear any dresses or shorts that exposed her knees. In addition to the other procedures, she opted for liposuction of her knees and inner thighs to get a more shapely appearance.

Under general anesthesia, the knees and inner thighs were infiltrated with a Hunstad solution. The other body procedures were completed first, giving the solution plenty of time for maximal vasoconstriction. From a small incision in a popliteal skin crease in the inner knee, a 3mm cannula was used to remove over 75ccs from both inner knee areas. Focus was made to create a deeper indentation below the knee above the calf muscle. Medial patellar fat was also extracted. The inner thigh was then liposuctioned from different incisions above the knee.

After liposuction, the knees were dressed with reston foam and ace wraps. The foam was removed the next day but the ace wrapping continued for two weeks after surgery. The knees had persistent swelling and stiffness which took six weeks to go away completely. The change in the shape of the knees was visible , giving them a more shapely appearance between the inner thigh and the calfs.

While the knee is a small area, liposuction can very effectively and quickly make for a dramatic change. It needs to be done aggressively, removing fat and working the cannula right up to the underside of the skin to get a good result. Fat removal should also be done above the inner knee in the patellar area and downward below the knee to create a more shapely inner knee profile.

Case Highlights:

1)  The knee is one of the smallest areas on the body to liposuction but can have a dramatic effect on the shape of the inner leg.

2) Liposuction of the knee is unique because it is the only area on the body that fat removal is done across a moveable joint.

3) Recovery from knee liposuction is prolonged with swelling and stiffness of the knees for up to six weeks after surgery.

Dr. Barry Eppley

Indianapolis, Indiana

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Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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