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Knee sag can afflict all individuals, regardless of physical condition. This looseness of the skin stems from a loss of elastic fibers, collagen, and muscle mass, which naturally occurs as we age.
The skin on any part of your body which is forced to bend and stretch repeatedly, such as the knees and elbows, becomes scaly, cracked, and wrinkled-looking as you age. In addition, these parts often have to support the weight of your entire body (from leaning, kneeling, etc.), exacerbating their condition. With time, these areas tend to show more dryness and wrinkles than the rest of your skin.
To prevent the skin on your knees from wrinkling and sagging, exfoliate them regularly and keep them well moisturized. Try using a rich cream with wholesome emollients like shea butter and emu oil to soften skin.
Above the knee is a muscle called the VMO (vastus medialis obliquus), part of the quadricep and just above and inside the knee cap. Keeping it strong and well padded is the best trick to not only firm existing sag but also keep further sagging at bay.
The best body lotions for dehydrated knees will help drive moisture through the skin barrier. Look for formulas containing urea or ammonium lactate. Other beneficial ingredients to seek out include keratin (a protein that is a major component in skin, hair, nails and teeth) and bisabolol.
To improve the appearance of wrinkled knees, make a habit of exfoliating, which will revitalize them on a cellular level. Scrub your knees in the shower with a loofah, scrub, or body brush to slough off dead skin cells. Since the skin on the knees is thicker than elsewhere to help protect the joints, a good glycolic cream can also help exfoliate if used regularly (try every other day).
Always follow up exfoliation with moisturizing. Conventional body lotions are rarely emollient enough for knees and elbows, so go for the richest creams possible. A number of brands offer targeted products to treat the knee, elbow, and foot areas specifically.
Ultrasonic is another way to firm sagging skin above the knees. Ultrasonic and infrared LED modes are great for firming the skin above the knee — the EMS pulse settings help to tone that VMO muscle.
One of the best ways to tighten and tone the area above your knees is by exercising. Firming the target area requires you to develop the muscles above your knee cap, thus rebuilding elastic fibers. Simple exercises such as squats or walking lunges are easy and fast — just 20 a day will have a significant impact over time. Leg extensions are the most basic and efficient knee-toning exercise. You don't need a leg-extension machine at the gym — just strap on ankle weights, sit on a stable chair or bench, and raise and lower your legs. Yoga and Pilates are excellent choices for keeping knees strong and flexible without putting the body under duress; sign up for a class or learn the basic moves and practice at home. Bar exercise, such as Burr Leonard's Bar Method, involve thigh-chiseling and leg-shaping exercises that will have your knees firm and sculpted in a matter of weeks.
A last option for extreme cases of excess skin around your knees is surgery. An invasive surgical procedure, dubbed the "knee lift," involves an incision where the skin on the front of the thigh begins to fold above the knee cap. This surgery can leave a large, prominent scar and is advised against except in the case of medical need (i.e., if a patient has lost over 30% of their body weight and has huge amounts of loose skin).
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