Hollywood’s Knee Anxiety: Ironing Out Those "Kninkles"

Kninkles Illo - S 2015
Illustration by: Lars Leetaru

Kninkles Illo - S 2015

From Demi Moore to Jennifer Lopez, celebs rush to unwind the clock on leg joints, while Beverly Hills derms and surgeons happily offer a plethora of fixes and devices to the age-betraying areas.

This story first appeared in the July 31 issue of The Hollywood Reporter magazine. To receive the magazine, click here to subscribe.

Those eyes! Those lips! That cleavage!" But those knees? You know Hollywood has jumped the shark on its addiction to perfection when the focus has shifted from erogenous zones to a humble utilitarian joint. But when it comes to the town's actresses, power execs and wealthy wives, what else is there left to fix? Telltale signs of aging competently have been eradicated (sometimes overly so) in the marquee body parts, so science and vanity have moved on to less fetishized, subtler but still age-betraying areas: the hands, neck and, yes, knees.

Now that tabloids and blogs have shown the skin and tissue surrounding the patella are, like the rest of our bodies, subject to discoloration by sun damage, dimpling and fat pouches, it has become clear that not even all A-listers have the bee's knees. Catherine Zeta-Jones, Cher and Sharon Stone have been called out for "kninkles," or knee wrinkles -- and Demi Moore is rumored to have had an $8,000 knee-lift in 2012 to firm and smooth saggy knees.

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Luckily, noninvasive to mildly invasive radio-frequency and laser treatments have created plenty of options for L.A.'s airbrushed aristocracy, says dermatologist Simon Ourian of Beverly Hills' Epione medical center, who has "noticed a rising demand for knee smoothing." He recommends radio-frequency (RF) treatments that target fat as liposuction does, but with little downtime and scarring: "UltraShape harnesses acoustic waves of energy that hit fat under the skin in short pulses." The device doesn't even touch your knee. The pulses break down fat deposits -- a result of laissez-faire diet and exercise -- which then are metabolized ($900 to $1,200 a treatment; usually three are needed). Other less invasive options include Vanquish, which uses hot and cold RF waves to dissolve fat in four sessions ($400 to $600 each), and VelaShape III, which melts fat quicker using infrared, RF and massage rollers ($200 to $600 a treatment; three to six do the trick).

The VelaShape III is a third-generation device that works faster and deeper than previous radio-frequency devices.

Dermatologist Peter Kopelson attacks knee fat with two noninvasive modalities: Kybella (a newly FDA-approved fat-liquifying injectable; from $2,000) and the Titan infrared device ($1,200 for a one-time treatment). Kybella initially was approved to dissolve double chins, but Kopelson says: "We can use it to treat localized areas like the insides of the knees. If any loose skin remains, Titan heats, firms and tightens skin." He adds that this produces youthful knees, "a perfect complement to toned calves and Louboutins."

To reverse elasticity loss from sun and age, Ourian uses Coolaser, which he helped develop. One to three sessions of quick, minimally painful pulses ($2,000 to $4,000 each) lessen any (God forbid) fatty appearance. He also can inject placenta stem cells mixed with your blood (from $2,000), a treatment used on burn victims, as a one-off to produce collagen rapidly, but the procedure is mildly invasive.

To go further, "the erbium ($500 to $700) or CO2-type lasers ($1,500 to $2,000) produce a tightening effect," says plastic surgeon Leif Rogers, who believes the more invasive RF devices work even better: "Thermi is a probe under the skin that heats; you have to be numbed, but it's only one treatment ($3,500 to $4,500). You don't see results for three months, but you will be very happy." The South Korean company Lutronic has a RF device that uses a tiny grid of micro needles. A doctor can fine-tune how deep to go (usually 3.5 millimeters) to produce collagen ($1,500 to $2,000). Warns Rogers, "Lutronic and Thermi do break the skin, so they are a little more invasive." In other words, table the bikini for a few days.

Knees before and after radio-frequency treatments by Ourian.

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And knee-lifts exist but involve scarring that can't be hidden. "I don't do knees," says plastic surgeon Lawrence Koplin. "The scar can widen each time the knee is bent." Rogers is not entirely opposed to knee-lifts ($7,000 to $10,000) "for older people, who form less scars."

For discoloration and scars, Rogers recommends bleaching creams over lasers, which require repeated treatments: "Hydroquinone is the most effective. I prescribe 4 percent, but you can go to 20 for severe darkening."

Celebrity trainer Ashley Borden (clients have included Reese Witherspoon, Taraji P. Henson and Ryan Gosling) advises this trick to reduce fat knees: "rolling out," or stretching leg muscles over a foam roller. "The muscle above and around the kneecaps is tight, so more fat gets collected there," she says. "Rolling out opens muscles and gets blood flow to the top of the knees. You have to be consistent, but you will see a result right away." For the lazy, there's always concealer: Makeup artist Scott Barnes (Jennifer Lopez, Kate Hudson) mixes Dermablend Leg and Body Cover ($31) with his Body Bling Original bronzing lotion ($42). "It makes knees appear thinner and covers a multitude of sins," he says, including spider veins and bumpy skin.

So far, men's legs have not become objects of obsession. Outside of the NBA and Wimbledon, you don't see a lot of them -- though star basketball players like recent NBA draftee Rondae Hollis-Jefferson have caught the anxiety bug, donning high socks, tights and compression garments to cover unsightly knees.

As for the ladies, there's always a very simple, easy solution: pants.