What can I do to target creasing and cellulite after a BBL and Liposuction? (photos)

Thank you for your question regarding how to target creasing and cellulite after a BBL and liposuction. Thank you also for your photos and your surgical history. Let’s break this down.

The area you’re referring to — where the buttocks meet the upper thighs — is known as the banana roll. This zone is notoriously tricky to liposuction, and if too much fat is removed, the skin can lose support and begin to crease, sag, or wrinkle, especially when standing or moving. Based on your photos and what you’ve described, this does not appear to be classic cellulite. Rather, it looks like a crease or skin indentation likely caused by over-suctioning during the liposuction of the banana roll. This creasing is often due to a loss of underlying fat volume and support in that area.

There are two main options if you're considering one more surgical procedure to fix the creasing:

Fat Transfer to the Banana Roll:
Most plastic surgeons would agree this is the least invasive and most effective first approach. Fat can be harvested from another area (such as the abdomen or flanks) and carefully injected into the creased areas to restore lost volume, smooth out the contour, and reduce the appearance of the fold. The goal is to soften the transition between the buttocks and the thighs by refilling the area that was over-liposuctioned.

Skin Resection (Banana Roll Excision):
This is a more invasive option, typically reserved for severe or resistant cases where there is significant skin redundancy. The procedure involves an incision placed along the natural crease under the buttocks, where an elliptical portion of skin and fat is removed. This excision can smooth the fold, but the scar placement must be carefully considered, as it will be visible when the buttocks are lifted or exposed.

If your main concern is creases rather than skin laxity, most surgeons would recommend trying fat grafting first before committing to a skin excision. Skin resection is generally only considered when sagging skin is also present and the patient accepts the trade-off of a scar for a smoother contour.

I hope this gives you clarity on your next steps. It sounds like you're motivated to fix this once and for all, and you deserve a result that makes you feel confident. Be sure to consult with an experienced, board-certified plastic surgeon who has performed many banana roll corrections and fat transfers. Always ask to see before-and-after photos of similar cases.

Sincerely,
Dr. Katzen

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

You may want to consider Aveli to address cellulite. The single treatment is done in the office and is FDA approved to improve cellulite of the buttocks. You can click the link to my website to learn more. I've also included a video discussing revision of a BBL.