Double Gluteal fold - skin tightening options? (Photo)

Question

I’m 25, exercise lower body 3 times a week, eat healthy however still have a double gluteal fold. I understand surgery is risky and removing fat can make the butt drop but I was wondering if skin tightening could be an option to improve the double gluteal fold, particularly on the right side. It makes me feel so insecure I’d really like to do anything I can to improve it without making it worse

Arif Eroglu, MD · Answer

HelloThere is a double subgluteal fold on both of your buttocks, with one side being more prominent and longer. The subgluteal fold is caused by the tight adhesion of the skin to the underlying tissue. First, the adhesion between the skin fold and the underlying tissue should be released using subcision or a V dissector. After that, fat injection into the area is necessary. This method may reduce or even completely eliminate the false fold above.

Anna Chacon, MD, FAAD · Answer

Hello,

Thank you for reaching out and for your thoughtful question.

A double gluteal fold can be a frustrating aesthetic concern, especially when you’re already taking great care of your body with exercise and healthy eating. This condition is often related to skin laxity, soft tissue structure, or how fat is distributed in the gluteal area — and it's more common than you think.

If you’re looking to avoid surgery, there are several non-invasive and minimally invasive skin tightening options that may help improve the appearance of a double gluteal fold, particularly if one side is more prominent:

Radiofrequency (RF) Devices
Treatments like Morpheus8, Profound RF, or Thermage use radiofrequency to stimulate collagen and elastin production, helping to tighten the skin and improve contour over time. These are effective for mild to moderate laxity and have little to no downtime.

Microneedling with RF
This combines microneedling with radiofrequency energy to deeply stimulate collagen remodeling. It’s often used for facial skin but can be customized for body areas, including the gluteal folds.

Ultrasound-Based Treatments (Ultherapy)
Focused ultrasound energy can reach deeper layers of the skin and soft tissue to tighten and lift. While commonly used on the face and neck, it can also be considered for off-label use in areas like the glutes.

Injectables for Contouring
In some cases, biostimulatory injectables like Sculptra can help improve volume loss or asymmetry and provide a subtle lift when injected into the gluteal region. This may indirectly soften the appearance of a double fold.

Topical Firming Agents and Retinoids
Though less powerful than procedural options, high-quality topical treatments that include retinol or peptides can improve skin texture and elasticity when used consistently.

Lifestyle Factors
Ensuring optimal hydration, avoiding excessive weight fluctuations, and incorporating gluteal-targeted strength training can support long-term skin tone and firmness.

For more significant or persistent cases, a personalized approach combining therapies may yield the best outcome, all while preserving volume and avoiding a surgical route.

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Falguni Patel, MD, FACOG · Answer

We have treated many patients in our office with similar issue that you have depicted. Morpheus8 with low RF setting would work well to reduce the appearance of the fold and tighten the skin without destroying natural fat in your glutes. This may require 1-3 sessions over time to achieve the result you desire.

Camille Cash, MD · Answer

Morpheus8 is an option to help improve the appearance of the gluteal fold.  This treatment combines RF technology with microneedling to improve overall skin tone and texture.  Typically three sessions are recommended for optimal results.

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