Butt Lift with Incision in Crease - Some Surgeons Say Results Are Horrific. Why?

Question

I'm so confused. Several board certified plastic surgeons have told me butt lifts should never be done with the incision in the crease because it disrupts the shape of the buttocks, the skin eventually hangs loose from buttock to back-of-thigh with no demarcation between them, and it looks deformed and hideous. Others have told me they do it all the time with great results and that putting the incision in the crease is the best procedure because the scar is virtually hidden there. Who is right?

Rigo J. Mendoza, MD · Answer

I think what you need to realize is that with the inferior gluteal incision, you are not really lifting the buttocks. You are improving only the lower part and getting rid of some of the overhand. You will not get any improvement in the upper 2/3 of the buttock. To lift the entire buttocks, you need an incision above the buttocks - by removing skin here, you can pull up the entire buttock. also, sometimes, if you just need more volume, you made get enough improvement with a Brazilian butt lift which is basically adding fat to the buttocks and filling up the skin envelope. This will give the buttock a little elevation as well.

Joseph Michaels, MD · Answer

The gluteal crease is very difficult to recreate and an incision in the area can disrupt the crease blunting this border between the buttock and the posterior thigh. The two main issues with an incision in the crease is that it won't actually give your buttock a true lift and second it will often be visible in a bathing suit. Depending on how much of lift is required, an incision similar to a lower body lift can be used. This incision runs across the top of the buttock, but can be easily designed to be hidden below the underwear line. If a minimal lift is required, an incision can be hidden on either side of the intergluteal cleft (groove between the buttocks).

Frank Agullo, MD · Answer

Very few patients are candidates for a buttock lift through an infragluteal crease. The improvement in overall shape is minimal. Most patients are better candidates for a lift in the supragluteal area with autologous augmentation. From El Paso.

Shahin Javaheri, MD · Answer

No, incision in the crease is not the way to do this operation. I am assuming that by the crease you mean the area between the upper posterior thigh and the buttocks. This is not the way to do this operation. There are better ways, that hide incisions. An implant may be placed, and even better is fat grafting.

Navin K. Singh, MD · Answer

To continue to add to the controversy, several plastic surgeons have stated that they don't do the incision in the gluteal crease, but I do, and have had good results with it.  With hiking up the back of the thigh tissues (like pulling up a pair of pants), we are able to add tissue (Auto-Augmentation) to the buttock, and recreate a sharp crease that hides in the overhang of the buttock.

	There are often many approaches or techniques to solve a given problem, and sometimes well-trained and good surgeons can have different approaches.  Ultimately, when you are in a consultation with a doctor, ask him or her to share some sample patient before/afters with you, and you will be the judge.

Steven Wallach, MD · Answer

A buttock lift is best done with the incision just above the buttock cheeks. I would not recommend in the fold.

Mark Preston, MD · Answer

Over the years I have tried different approaches to gluteal lift and I believe you will have better results with an incision placed above. A few points to remember:

	
		Scars may not heal perfectly, so you will want this scar hidden under your swim suit
	
		Every day you will sit on a gluteal crease scar which may not be comfortable
	
		You will not be able to "lift" your butt from below, in fact the gluteal crease approach will tend to pull it down
	
		Consider strategically adding volume at the surgery with an autologous fat graft

Douglas J. Mackenzie, MD · Answer

A procedure to recontour the buttock with an incision in the crease between the thigh and buttock would seem to make sense. The problem is, these scars often widen, and the fold looses it's shape, and there is surprisingly little beneficial effect on the buttock shape anyway. I have seen awful results of this procedure, and it is not something that can be easily fixed. Other options could be an approach above the buttock, which may be continuous with a lower body lift or belt lipectomy type procedure. This approach may not seem intuitive, but gives a great improvement to buttock contour. You may also be a candidate for buttock augmentation with fat injection for example. It really depends on your individual anatomy. Get two or three opinions before doing anything.

Samir Shureih, MD · Answer

Buttock lift through a scar in the buttock crease will disrupt the supporting structures in the posterior thigh-buttock area. The scar will migrate down  and will be visible with a swim suite. Other methods which have been used in the past for a buttock lift is to put the scar obliquly across the buttock. Recently the scar is put in the upper curve of the buttock.

	You have to choose the scar that suites your life style and can live with.

Butt Lift with Incision in Crease - Some Surgeons Say Results Are Horrific. Why?

Answers (9)