Debbie: I have a question. I'm in my early 50s and I'm beginning to get these saggy inside fat things around my knees. What do you do about that?

Dr. Michael Salzhauer: I've done at least two of those cases in the last month. It's fairly common. People can be in perfectly good shape. In fact, the two women that I'm talking about were both rail thin, so to speak, but they just had extra skin and extra fat building up around their medial, the inner side of their knees. It can make an otherwise very attractive leg look less than perfect, and again that happens from gravity over time. Just like the skin on your forehead or your face sags over time, from gravity the skin on your inner thighs and knees can sag too, and it creates those extra wrinkles. Now the way we treat that is twofold. If it's just fat that sort of migrated down to that position, then we do liposuction, and that can be done through very tiny and conspicuous incisions, and it can flatten that area and really rejuvenate it a lot. You also get some skin tightening effects from the liposuction. Now, in other cases, we do what we call a direct skin excision where we cut an ellipse of skin out from that area. Now it does leave a scar going across the crease of the knee, but it does rejuvenate that area quite dramatically, as does any time you directly excise extra skin that's hanging. So those are the two ways we treat it. The more common way is the liposuction. Again, it's a great question. It's a very common problem.

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