It’s time to love your legs again!
Whether that means enjoying summer chafe-free, ditching the sarong, or feeling confident in a tennis skirt, you deserve to feel confident and comfortable living your best life. Reflections can help you reveal your best legs, thighs, and knees with a variety of excellent treatments, including the latest in both surgical and non-surgical treatments for cellulite, excess fat, loose and sagging skin, stretch marks, discoloration, wrinkles, and more! Our legs, thighs, and knees treatments are provided by a team of cosmetic physicians and plastic surgeons, in an elevated and relaxing environment within either of our 2 office locations in New Jersey.
- How do I get rid of wrinkles on my knees?
Wrinkles at the top of the knees can be treated a few different ways, including skin tightening treatments (Ultherapy, Exilis Ultra, ThermiTight or Smartlipo's skin tightening laser), threads, biostimulatory fillers (hyperdilute Radiesse), or with a thigh lift surgery.
- What is the best treatment for cellulite on thighs?
This depends upon what type of cellulite we're talking about. For individual dimples, Qwo injections work best. For an overall wavy appearance to skin, Exilis Ultra works best. For small pockets of fat that bulge out of the skin, typically Kybella or SculpSure is best. For larger pockets of fat (saddlebags), liposuction surgery works best.
- How can I tighten sagging skin on my thighs?
Exilis Ultra and thigh lift surgery are the 2 best ways to tighten and lift sagging skin on the thighs. Anyone with stretch marks is going to find non-surgical options provide very limited results for skin tightening, as stretch marks indicate deep damage within the skin that will not allow it to respond as strongly with those treatments.
This page goes into detail about:
- Fat (knee fat, inner thighs, outer thighs, and saddlebags) & Cellulite
- Sagging Skin, Loose Skin, Wrinkly Skin, & Stretch Marks
- Keratosis Pilaris (Strawberry Legs)
- Dark Discoloration on the Thighs
For information on these topics, though, please use these links:
Excess Fat & Cellulite
Excess fat and cellulite on the thighs are related, as fat cells enlarge wherever they exist as we gain weight, and cellulite is made more visible both by the fat cells trapped within the skin’s layers becoming larger and bulging, as well as fat making dimples appear more pronounced.More About the Causes & Treatments for Cellulite
Sagging Skin, Wrinkles, & Stretch Marks
Sagging skin on the legs generally takes one of two forms:
- sagging inner thighs
- wrinkles on the knee
Depending upon which one you’re experiencing, the treatments are quite different. For more information on knee wrinkles, please click the button below.More About Knee Wrinkles
Inner Thigh Sagging
Inner thigh sagging is typically due to excess weight that stretched out the skin. Sometimes that weight puts too much pressure on the skin and creates stretch marks as well, in that case, the skin has been severely damaged and you’re unlikely to get good results from non-surgical techniques.
Younger, healthier patients with only mild to moderate skin laxity see the best results from non-surgical treatments, compared to other patients. However, some other types of patients may realize they would be happy with a moderate or subtle improvement, and would prefer to avoid surgery. We’re happy to be able to offer both, and will work to find the best option to make you happy!
Discoloration: Darkness, Strawberry Legs (KP or Ketarosis Pilaris)
Darkness in the inner thighs and groin that is velvety in texture can be a sign of diabetes, and discoloration can in general be a cause of concern for skin infections, vitamin deficiencies, and potentially other more rare diagnoses. It’s important to have this assessed by a medical doctor as it may not be only a cosmetic concern. After our doctors have examined you and reviewed your medical history to be sure there’s no deeper issue at play, we can use prescription skin lighteners and/or lasers to target and remove this darkness.
We can help you to remove both KP and darkness from your thighs – but you should be forewarned these conditions are usually chronic and may flare up again. It is very difficult, if not impossible, to cure the underlying causes of these concerns.
Ketarosis pilaris (KP) is often called “strawberry legs” or “chicken skin” because it can create these rough, red bumps at each of the hair follicles it affects. Typically this condition is incurable and lasts your entire lifetime. It can be made much better for many people with chemical exfoliants and specific moisturizing lotions – both prescription strength and over-the-counter. For those, however, who end up with lots of scarring and redness, laser treatment can help improve the appearance of the skin. We generally limit our treatment of this disease to cosmetic improvements for those few patients with severe scarring and refer management of the disease to dermatologists who are better qualified to do that.
- Removing Fat
- Tightening & Removing Loose, Sagging Skin
- Saddlebags & Hip Dips: Body Contouring
- Treating Cellulite on Thighs
- Stretch Marks on the Thigh
CoolSculpting & SculpSure
CoolSculpting is a popular nonsurgical treatment which makes use of a proprietary process called cryolipolysis to freeze away unwanted fat. The body naturally flushes away these frozen fat cells, and they are permanently removed. This treatment works best for those looking for spot reduction of curved, pinchable fat with no downtime. Unfortunately, the CoolSculpting handpieces might either not fit your curves OR this procedure can sometimes work a bit too well in the inner thigh area, so it’s critical that an experienced provider do your consultation and evaluate this procedure for your legs, individually.
SculpSure is a laser fat reduction treatment that, like CoolSculpting, requires no surgery or downtime, and produces very similar results to what CoolSculpting does. Flat treatment panels are placed on the body and alternate between warming and cooling laser energy, which is absorbed by the fat cells. This treatment works best for those looking for spot reduction of flat areas with no downtime.
Kybella is an injectable treatment that destroys fat cells using deoxycholic acid. Kybella was initially developed to reduce fat from the double chin area, but it can be used to spot-reduce all over the body, and it’s gained a reputation as one of the most effective treatments for that little pocket of fat on the back of the thighs just below the butt, sometimes called the “banana roll.” This area can be tricky to treat, because surgical fat removal, liposuction, detaches the skin from the fascia, and in the case of this particular area, that detachment can lead to a really saggy behind and poor healing. So it’s not usually recommended. Kybella can dissolve that fat without creating these issues, in just a few series of injections.
Surgical Options: Laser Lipo, Liposuction, & Thigh Lift
Liposuction has been one of the most popular plastic surgery procedures for several decades now because it produces the very best and complete fat removal results. During liposuction, fat cells are suctioned away using a cannula inserted through a small incision in the body. The incision points are very small – about the size of the eraser on a no. 2 pencil – so there really aren’t big scars from this procedure, and it’s usually performed under local anesthesia at our offices, which also makes for a faster recovery and lower cost.
In the legs, if you need skin tightening and fat reduction, Smartlipo or Vaser can be really good liposuction choices, because they will cause some skin tightening in addition to full removal of fat. However, if your skin is damaged by stretch marks or very thin, liposuction and a thigh lift may be a better fit. Our plastic surgeon is quite skilled at these procedures.
If sagging or loose skin is a concern, removing excess fat through procedures like liposuction or SculpSure can exacerbate the problem, because to some degree, the extra fat is supporting that skin, and when it’s all removed, skin that’s completely lost its elasticity will droop. Skin with stretch marks and skin that’s very thin is generally unable to rebound and snap back after all of the fat is removed. Fortunately, there are several skin tightening procedures available. We discuss stretch mark treatments in more detail in their own section below.
Thigh Lift Surgery
A thigh lift is a surgical procedure that reduces excess skin around the thighs. Thigh lift incisions are generally made around the groin or inner thighs so that scarring is well hidden. Newer techniques hide the incision along the back of the thigh in the lower butt crease, which allows for a longer excision line, which leads to smoother and more complete tailoring of the results, and which also leads to an incision that has less pressure on it (per inch), leading to better scar healing, and the scar is hidden in a crease, which always allows for a more discreet and camouflaged scar.
ThermiTight or Smartlipo
ThermiTight and SmartLipo offer the best and most complete noon-surgical skin tightening (as opposed to removing excess skin, and potentially stretching thin skin even tighter – which will only lead to more drooping later). While ThermiTight uses radiofrequency energy, Smartlipo uses laser energy, but they essentially work the same way: heating the collagen layer precisely from below to remodel and restore skin’s tightness, firmness, and elasticity. Because these treatments are delivered from underneath the skin, they are much more intense than a laser resurfacing or RF microneedling treatment. Smartlipo is always performed as a part of a liposuction procedure, and ThermiTight can be performed at the same time as liposuction or on its own.
Non-Invasive Skin Tightening Treatments: Exilis Ultra, Ultherapy, & Thermage
Exilis Ultra combines ultrasound and radiofrequency energy to produce a skin tightening effect without needles or downtime. The ultrasound and radiofrequency waves are administered to the skin’s surface and penetrate deep into the skin, heating collagen fibers and causing them to contract. This procedure is by far our least expensive option – and the results are actually really great – but they won’t last as long as the results from some of our other options. That having been said, results that show up in a few weeks, are affordable, and make a big impact is just what many of our patients need to feel confident for shore season or a big event.
Thermage and Ultherapy can be used on the body – and we do have these technologies in our office – however, they seem to work less well for this treatment area than Exilis Ultra, and are more expensive. So we don’t typically recommend them.
There are three basic approaches of reducing the appearance of saddlebags or hip dips: reducing areas of excess fat, filling in sunken areas, or a combination of the two to create an even contour.
Liposuction, Brazilian Butt Lift, or Fat Transfer to Hips
Our plastic surgeon, Dr. Fodero, provides fat transfer under general anesthesia to create smooth contours to the hips and buttocks.
You can determine whether you want to augment these areas, too, or simply smooth out hip dips or violin hips.
Some patients will find they will be happy with their shape if they can just remove excess fat from specific areas – and in that case, they may be happy with liposuction alone. Liposuction can be done under general anesthesia or under local anesthesia (laser lipo) for this treatment area, depending upon the individual patient’s candidacy.
Coolsculpting or Sculpsure
CoolSculpting and Sculpsure are nonsurgical options to reduce fatty deposits in the saddlebags. These procedures each permanently remove fat cells without requiring incisions, surgery, or downtime.
Sculptra is an injectable agent that can be used in some cases to fill in hip dips for a more even contour and even to enlarge the buttocks. This is an ideal option for those who really don’t have excess fat in this region, but rather want to smooth out their silhouette and have a natural indentation between the hip and thigh.
Treating cellulite on the thighs largely depends on the root cause of the uneven appearance. Often, treating cellulite is achieved by strengthening and tightening the skin, reducing fat, cutting the tethers between skin and fascia that create deep dimples, or some combination of the three.
We have a page that dives deeper into the subject of cellulite and its treatments, as well as a page that discusses the underlying causes of cellulite and which treatments are best suited for each cause or type (dimples vs. wavy skin, etc.).
Sculptra can be used in some cellulite cases to create a more even skin tone by gradually increasing the thickness of the skin. This firmer and thicker skin reduces the appearance of cellulite. This injectable procedure has no downtime.
Qwo is a new type of injectable treatment that severs the fibrous tethers that create deep dimples with an injectable procedure. Previously, this was only possible with surgical procedures that usually lead to significant and painful bruising.
Exilis Ultra tightens the skin and creates firmer collagen fibers using a combination of ultrasound and radiofrequency energy. This treatment really only works for cellulite that’s caused by aging and is at its source a skin laxity problem. This generally manifests as a wavy, diffuse texture throughout large portions of the thigh during or after menopause.
Skin Rejuvenation Treatments
Laser skin treatments are one of the most common methods of treating stretch marks. Laser treatments repair broken blood vessels and damaged fibers in the skin while stimulating new collagen. Pulsed dye lasers like Vbeam Perfecta are better-suited to removing red or purple coloring, while Fraxel Re:Store Dual or RF microneedling, especially when enhanced with plasma therapy, are best at restoring normal skin texture and elasticity by remodeling collagen support from below.
Our New Jersey offices have a reputation for the best, most natural results. We achieve those results by having a collaborative team of cosmetic physicians and plastic surgeons, all of whom have areas of specialty and focus that overlap so we can offer patients all of the best treatment options – not just one or two.
When you’re choosing to treat various concerns or symptoms regarding your thighs, it’s important that your doctor offers and has ample experience with a variety of treatment options. There are many cosmetic options available, ranging from injectables to no-downtime laser treatments to liposuction to thigh lift surgery, and each treatment is suited best to a handful of unique concerns. A professional with a wider range of experience is best able to pick the right choice for you, while others may just suggest the only treatment they offer. Below, we break down the best treatment options for each type of concern.
You’ll notice the majority of the treatments listed above are actually non-surgical or minimally invasive, meaning there are very small incisions, a low risk of scarring, and no need for general anesthesia. There’s a reason for that: thigh lifts are often chosen as a last resort for more extreme symptoms because they result in visible scars and require a highly-skilled plastic surgeon to execute them well. Few people are truly good candidates for thigh lifts; most patients are better suited to a nonsurgical option.
- How can I lighten my dark thighs?
Darkness on the thighs, particularly around the bikini line and on the inner thighs, is a reaction to friction and/or heat. People who experience this kind of hyperpigmentation reaction are unlikely to be able to get and maintain any clearance of this darkness on their thighs unless they can also stop the thighs from overheating and rubbing together. For this reason, it might be important to either lose weight or have a fat reduction treatment in this area, as a part of your treatment (although that will not remove existing pigmentation). To remove the darkness, you’ll need either lasers or skin lighteners, or a combination of the two. Hydroquinone can be effective, as can a Q-Switched Yag Laser. However, because people with this condition have already proven their skin is sensitive and can react poorly to irritation, using lasers or prescription-strength lighteners requires a gentle approach and the nuance a provider acquires over decades of treating complex skin concerns.
- How do I stop crepey knees?
As you age and the skin on your knees becomes thinner and more crepe-like, you have some options of helping to slow the process but little hope of completely reversing it.
Paradoxical adipose hyperplasia(PAH) with CoolSculpting – How Much Risk...Read More
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With One Of Our Physicians
Dr. Renata Wix-Harris has extensive experience as a general surgeon and work in the plastic surgery department has helped to her to become an excellent laser liposuction surgeon. She is also skilled at laser and energy-based skin therapies, injectables, and non-invasive body contouring.