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While liposuction can be performed on almost any body area below the neck, little mention is ever made of fat removal from the knee. Yet, in my practice, I regularly perform knee liposuction particularly when the inner thighs are being treated. Most female patients can benefit from knee liposuction if it is done judiciously and in consideration of the line and flow of the inner thigh down into the calf area. Knee liposuction can produce very rewarding results that can make patients more comfortable in shorts and above the knee dresses and skirts.

The knee sits at an important esthetic juncture between the thigh and the calfs. The most important esthetic line is in the inner aspect in which a straight or mildly curving line should run from the inner thighs down to the top of the calf before it bows out again. If the inner knee fat bulges outward, it disrupts this esthetic line giving one the appearance of knobby or chunky knees.While the top and outer aspect of the knee also makes up the knee unit, little can be successfully done with those areas compared to the inside of the knee.

Liposuction of the knee is very straightforward to do. But the technique is critical if too much fat is not to be removed or irregularities and indentation of the overlying skin is not the result. A very small cannula is used with a small stab incision just behind the inner aspect of the knee in the popliteal crease. While the knee must be bent to do the procedure, it is important to regularly check the progress of fat removal by re-straightening the leg and checking how the inner esthetic line is progressing. When done as a stand alone procedure, it is important to make a gradual transition up into the inner thigh so there is not a demarcation line between the inner knee and the inner thigh. I find it esthetically important to also make sure that the liposuction is carried down into the upper calf area so I slight inward curve is placed before it bows back out again into the upper calf area.

I have found that knee liposuction can make a dramatic difference in the knee area and can get rid of the handful of fat in the inner knee that many women have. Even somw women with thin thighs and shapely calfs can still have a slight inner knee bulge. This area is clearly not metabolically active no no amount of diet and exercise can remove it. I usually have my patients wear a knee wrap or knee brace for a week or so until they feel comfottable without wearing it. The biggest issue with knee liposuction is that, because it is a flexion area, stiffness in the knee can be expected for 4 to 6 weeks after surgery when bending. Normal physical activities, including running, can be resumed three weeks after surgery.

Dr. Barry Eppley

Indianapolis, Indiana

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