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

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.

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.

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).  

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.

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.