Demi Moore is no stranger to plastic surgery. At 44, she has plump lips, a wrinkle-free face, breasts that seem to defy gravity, and - dare we forget - hot hubby Ashton Kutcher who, at 29, is 15 years Demi's junior. In June of 2003, CBS News reported that Demi had $330,000 of plastic surgery including a facelift and liposuction. Many speculate that the former wife of Bruce Willis also underwent knee lift surgery to remove loose skin around the top of her knees, another telltale sign of aging.

Dr. Al S. Aly, a cosmetic surgeon at Mercy Hospital in Iowa City, and an expert on knee lifts, cast his Did She or Didn't She vote during a phone interview. "It would be a stretch for me to believe that somebody of Demi Moore's stature and body type would have a knee lift," he explains. "The scarring from this procedure can be so visible that body lifts (which leave scars in the bikini area) and thigh lifts (which leave scars between the legs) are far more popular options to tighten up the lower body."

Weight loss and sun exposure can result in lose skin around the knees, but it can also happen over time, as skin loses elasticity. (Case in point: Melanie Griffith, who could use some serious tightening up in the area.) During the surgery, a curved incision is made above the knee, where excess skin is removed. This is a highly visible place for an incision. And since this area of the body supports a great deal of tension, scarring can become quite dense and wide.

According to Dr. Laurie Casas, Associate Professor of Surgery at Northwestern University Feinberg School of Medicine, the two-hour procedure may cost anywhere from $4,000 to $8,000 in the United States.

Dr. Aly, who edited Body Contouring After Massive Weight Loss, says that knee lifts are usually performed only on patients who have had massive weight loss, patients that make up what he calls "the fastest growing subspecialty of plastic surgery." Because of their special needs, these patients are sometimes more willing to undergo surgeries that will leave noticeable scars.

Dr. Laurie Casas concurs. She explains that people usually only undergo a knee lift when the skin that hangs over the knees becomes a functional problem that can only be attacked directly where the skin hangs. If the problem can be fixed in any other way, and an incision can be made in a less visible location, that would be far preferable for most patients.

"The knee lift is like robbing Peter to pay Paul," Casas says "since, in order to keep the scar quiet, and really improve the appearance of the knee, the knee should be braced for six weeks. However," she adds, "most patients are only able to rest the knee for a couple of weeks." Dr. Aly also notes that even though the first weeks are essential, scars may take as long as a year to form. In other words, knees need to be rested as much as possible for as long as possible, and they have to be kept out of the sun, making knee lift surgery a very difficult procedure to manage.