Buttocks Wedge Excision- Should the Extra Skin Be Removed or Fold in ?

The infragluteal area is a danger zone with liposuciton. If you have a bad result, please do not query internet opinions of liposuction surgeons, even if you provide photographs.  This is too important. You must seek a second opinion from an experienced liposuction surgeon to evaluate what, if any, is the best alternative treatment.  Excision could leave a bad scar, replacing one for another.
 

It sounds like you had a suboptimal liposuction result.  Most prudent and safe surgeons avoid excessive gluteal crease liposuction - to avert the problem that you're now dealing with.  Rather than proceeding with a wedge excision that will never look natural and leave you with a significant scar in a potentially visible area, I would recommend pursuing fat grafting instead, to try to augment and reestablish the fatty tissue that was removed in the first place.  Depending on the size of the problem, you may need multiple sessions to try to reconstruct the area.

Your concerns about excision are valid. The results has nothing to do with tool that your surgeon used, but with decision to remove fat from wrong idea. Fat grafting and going back to start point may help. There are a lot of non-plastic surgeon physicians that started doing laser lipo without proper training. We used to see bad results before, but now there many more bad results due to fly by liposuction centers that offer liposuction by non- qualified partitioners. Get second opinion by a board certified plastic surgeon.

Sadly, yet another "SmartLipo Victory".

A photograph would have been very useful here. I suspect the person who did the DumbLipo on your infragluteal crease was NOT a Plastic surgeon. Every Plastic surgeon knows that liposuction of the fat roll near the infragluteal crease is very tricky. Removing too much fat caused collapse of the buttock inferiorly with an abnormally deep fold.

In your case, not only did you have liposuction but the fat was cooked to 400 degrees with a laser fiber in a futile attempt to shrink skin. The result - large area of fat loss, scarring and collapse.

Correcting such areas is always tricky. without seeing it I cannot comment but whenever possible, I would attempt building the area up with several fat grafting sessions before taking a wedge out which mar result in an artificial result.