Hard Fall, and now dent in buttock that hasn’t gone away (Photo)

Question

I slipped and fell while walking down flight of stairs and landed very hard and it was very painful. I was bruised very badly on my left buttock. And after some months, the scar went away but I now have a dent on my left cheek and it has been well over a year and it hasn’t gone away. I really want my normal shaped butt back. It looks so awkward and makes me feel embarrassed.

Dev Vibhakar, DO, FACS · Answer

Hello. It seems like you may have had local swelling/small hematoma after the incident that eventually led to fat necrosis (loss of fat cells) and scar tissue formation in that area. This results in an indented appearance that can be exaggerated with flexing/activation of your muscles. The best thing to do initially is massaging/cupping/myofascial scar treatment to help soften the area. This often helps that scar tissue from tethering. Once the tissue has softened up (typically over the course of a year) then you can consider options to “fill” in the area- typically with scar release (through SAFE Lipo Techniques) and small volume fat transfer. Hope this helpsDr. Dev

Ryan A. Stanton, MD · Answer

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

Unfortunately I see this outcome from a hard fall onto the buttock not infrequently. Because, by evidenced by the dent, there is significant scar tissue left behind, fat transfer (aka BBL) does not survive well and fillers (eg Sculptra and hyaluronic acids) are a complete waste of money. So, the only reliable and permanent option is a buttock implant to pop out the dent and provide long term natural buttock convexity.

Please note that an extremely few number of board certified plastic surgeons specialize in buttock or hip implants, so you may need to travel far and away from home to find this particular surgeon.  Glad to help.

Daniel Barrett, MD · Answer

Dear OhKay94,
it is hard to tell for sure without an examination. Based on your photo, it looks like you probably would benefit from fat transfer to fill the dent. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Fernando Ovalle Jr., MD · Answer

Hello and thank you for the question! Fat necrosis (fat cells that are damaged and replaced with scar tissue) is possible with focal trauma such as described. This can be hard to correct to "where nothing ever happened". However, there are different therapies, invasive and noninvasive that can break up/ soft scar tissue. Another option is to attempt fat grafting to this area to restore volume with your body's natural fat cells taken from somewhere else through liposuction. In person consultation with a board certified plastic surgeon would be the next best step in your journey!

Mats Hagstrom, MD (license on probation) · Answer

That injury sounds quite painful.
I’m guessing the trauma was sufficient to create tissue necrosis.
This leaves you with a twofold problem.
One is the loss of fat and the other is contractile Scar tissue That’s pulling in on the skin.
Grafting fat aka fat transfer may help to some degree, but if scar tissue is tethering the skin, then it may only give you partial improvements.
This may be more challenging to correct, and then people believe.
Talk to a few plastic surgeons in your community to see what they have to say.
Best,
Mats Hagström, MD

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