Problem
Lipodystrophy describes the abnormal or excess fat deposits that are indications for liposuction surgery. It may not, strictly speaking, be the correct term to use since an abnormality of fat metabolism or biochemistry is not being described. The author is simply using it to describe an excessive and unattractive fat collection that is the result of heredity, lifestyle, and nutritional habits. While localized obesity may be a more appropriate term, custom has led to the use of lipodystrophy for the fat collections patients present with.
Lipodystrophy of the thighs and/or knees occurs in the presence of either abnormal localized collections of fat of several areas of the thighs (outer thigh or saddlebag, upper inner thigh at thigh-groin junction, entire inner thigh, anterior thigh, posterior thigh) and/or knees (medial, medial anterior, lateral anterior, posterior) or excess fat of the circumferential thigh.

Etiology
Without extensively exploring the subject of fat metabolism, one can accurately state that at some time in late childhood, the total number of lipocytes (fat cells) of each individual becomes fixed. New fat cells are not made over the course of one's lifespan. Both the general distribution of these cells and their proclivity to enlarge with weight gain and reduce with loss is genetically predetermined. The pattern is uniquely individual.
Interpreted in another way, each of us is born with a unique figure, body habitus, and metabolism, as unique as our fingerprints. Perfect physique and perfect distribution of fat and muscle are uncommon. Especially among women, disproportionate fat distribution of the thighs and/or knees is a common occurrence: a result of heredity, lifestyle, and hormones.

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