How can I prevent my butt from flattening after a lower body lift?

Question

I'm having the Lower body lift in a few weeks . I read that the LBL can make your butt flat after. does this happen to everyone or does it depend on how much buttock area you have before the LBL. how can I prevent this from happening to me, Thank you

J. Timothy Katzen, MD, FACS · Answer

Congratulations on your massive weight loss and taking me next step, namely a 360 circumferential lower body lift.  After a 360 circumferential lower body lift, it is not uncommon to have a flatter buttock. Most patients buttocks are made of fat.  The 360 circumferential lower bodylift removes skin and fat from the upper portion of the buttock.  In addition, in the front, the lower body lift pulls the abdomen down towards the beltline. However, in the back, the lower bodylift pulls the buttock up towards the belt line. Both removing skin and fat from the upper portion of the buttock and lifting the buttock upward can flatten the buttock.  After a 360 bodylift, buttock flattening depends on the amount of initial buttock fat and the amount of skin and fat removed.  There are three common methods I use in my massive weight loss patients to correct for a flatten buttock. One is performed at the same time as the 360 lower bodylift while the other two methods are done during a second procedure.After a 360 lower bodylift, one method to correct a flattened buttock with butt augmentation is fat transfer. Fat is suctioned from one area, filtered, and injected into the buttock. Typically, I perform buttock fat transfer while I am performing a medial thigh lift. It is the opportune time to perform this fat transfer.  During a medial thigh lift, fat is aspirated from the medial and lateral thigh and lower legs; typically, if the fat is used for transfer, this fat is thrown away.Another method to correct a flat buttock is with buttock augmentation with implants. Typically, I perform this when I am doing the medial thigh lift.  Buttock implants are made silicone and add significant shape to the buttock.  This procedure should not be performed at the same time as the 360 over body lift; there is too much tension in the flap and too much risk of infection and breakdown.Another method to correct a flat buttock is with a "turn down" flap. During the 360 lower body lift, skin is removed from the upper portion of the buttock flap.  This flap of fat and dermis is "turned down" on top of the buttock.  Then the incision is closed. This method is quite effective and uses your own tissue to augment your buttock.  However, this technique is challenging and I would suggest only going to a plastic surgeon with a significant amount of experience with this procedure. There can be a high complication rate.All in all, however, most patients are extremely happy with their body after a 360 lower  bodylift. Good luck with your 360 lower body lift.

Douglas L. Gervais, MD · Answer

Dear angelcee,  In many cases, a LBL will cause flattening in you buttocks. This is desired for some patients. In others who wish for a fuller look, autoaugmentation may be very helpful. Discuss this with your surgeon or consult with another surgeon to discuss options. Good luck. #Dr. Gervais

Kenneth Hughes, MD · Answer

There are several options here.   Fat transfer may be reasonable.  Autoaugmentation may be reasonable.  Buttock implants may be reasonable.  I perform all of these, so this is really what is best for you and what you want.Kenneth Hughes, MDLos Angeles, CA

David Shifrin, MD · Answer

Find a surgeon who can use the tissue as an auto augmentation instead of throwing it out. It's an advanced technique. I attached a link as an example of one I performed.Cheers

C. Bob Basu, MD, MPH, FACS · Answer

A buttock lift in many weight loss patients can flatten the buttock.  A very popular option for my patients is a buttock auto-augmentation procedure that can be done at the same time as a body lift.  In this procedure, I essentially utilize the skin and fat that would be normally thrown away in a body lift.  I keep this tissue attached to its blood supply, and I use this tissue and your own natural buttock "implant".   This is not a foreign body implant. The added volume comes from your own tissue.   This is also not fat grafting (brazilian buttock augmentation).  Please see a board certified PS experienced with this procedure to learn more about your options.Best wishes,Dr. BasuHouston, TX

Megan Jack, MD · Answer

Often after massive weight loss, the buttocks will lose volume and flatten and/or become somewhat saggy (ptotic).  There are a few options to help volumize the buttocks to establish a more normal, lifted appearance. One option during the body lift it to use some of the lower back/upper buttock soft tissue to augment the buttocks rather than discarding it--essentially repositioning your own tissue to build up the buttocks. The other option is to transfer fat from elsewhere on your body into the buttocks using liposuction.  Both options can be combined if needed for a nice buttock lift (typically in 2 procedures however).

Samir Shureih, MD · Answer

When doing circumferential lift which include buttock lift, The buttocks will flatten to a certain degree all the time. This should be discussed with the Surgeon.Samir Shureih MD.FACSsshureih@msn.com

James Hoyt, MD (retired) · Answer

Preventing your buttocks from flattening after a lower body lift typically involves a combination of maintaining a healthy lifestyle and exercise routine. Here are some tips”1. Follow a balanced diet: Maintain a diet rich in protein and nutrients to support muscle growth and overall health.2. Strength training: Incorporate exercises that target your glutes, such as squats, lunges, deadlifts, and hip thrusts. These exercises can help build and tone your buttocks.3. Cardiovascular exercise: Include cardio workouts to burn fat and maintain a healthy weight.4. Consult a fitness professional: Consider working with a professional trainer or physical therapist to develop a tailored workout plan.5. Stay hydrated: Proper hydration is essential for muscle health and overall well-being.6. Get enough rest: Adequate sleep and recovery are crucial for muscle growth and tissue repair.7. Avoid prolonged sitting: Try not to sit for long periods, and take breaks to stand and move around during the day.8. Manage your weight: Maintain a healthy weight to prevent excess fat accumulation in the buttocks.9. Consider bodywork and massage: Deep tissue massage and myofascial release can help maintain muscle health.10. Follow post-surgery guidelines: If you’ve had a lower body lift, adhere to your surgeon’s post-operative instructions to optimize your results.Remember that the recovery process may vary from person to person, so consult with a medical professional for guidance based on your specific situation.

Peter Fisher, MD (retired) · Answer

Hi and Thank you for your question.  What you here is correct. Most properly performed lower body lifts can and often do flatten your buttocks. If your buttocks are ptosis but still full then you should not have a problem. Check with your surgeon to see if he performs auto-augmentation Of the buttocks which uses your own fat and skin instead of discarding it.

How can I prevent my butt from flattening after a lower body lift?

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