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

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?

Doctor Answers 9

Butt Lift Incisions

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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.

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

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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.

Rigo Mendoza, MD
Tampa Plastic Surgeon
4.4 out of 5 stars 40 reviews

Butt lift

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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.

Shahin Javaheri, MD
San Francisco Plastic Surgeon
4.4 out of 5 stars 6 reviews

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Buttock lift

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

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Lift with your hips

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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

Mark Preston, MD
Columbus Plastic Surgeon

Buttock lift through gluteal crease

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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.

Beware of buttock lift incisions in the crease

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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.

Buttock lift

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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.

Samir Shureih, MD
Baltimore Plastic Surgeon

Buttock lift incisions in the crease

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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).  

Joseph Michaels, MD
Bethesda Plastic Surgeon
4.9 out of 5 stars 57 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.