Hello, thank you for your questions about to do for some random 57 yo female's saggy buttock, hanging back skin, saggy abdomen with loose muscle, and saggy breasts. For the buttock, I would suggest either fat transfer to the buttock or a posterior body lift. The fat transfer to the buttocks will augment the buttocks and fill some of the buttock wrinkles. The posterior body lift will definitely remove almost all of the buttock wrinkles. In regards, to be saggy upper mid back skin folds, I would suggest a vertical torsoplasty, horizontal torsoplasty or brastraplasty. During this a horizontal torsoplasty procedure, an incision is made across the back, following the bra strap line The horizontal torsoplasty is a very effective plastic surgery technique to remove upper back skin. The vertical torsoplasty is another alternative treatment for upper back skin. The benefit of the vertical torsoplasty is that an incision is made from the armpit down the side of the chest. The benefit to this procedure is that the scar is hidden when the arm is by your side. In regards to the abdomen, there are two main issues. In regards to the "pooching out", this is due to muscle weakness. If this bothers you, the only way to fix muscle weakness is with sutures plication. This entails suturing the muscles together. This can be accomplished during a tummy tuck or a mini tummy tuck. In regards to the specific abdomen in the pictures, I would suggest abdominal liposuction. I would suggest collecting your abdominal fat, and any other pockets of fat throughout your body, and using this fat for fat transfer to your breasts. Since you do not want breast implants, autologous fat transfer to the breasts would be the best way to augment your breasts. Fat transfer to the breast is a healthy alternative to breast implants, if you have enough donor fat. I hope that I have answered your questions about what to do with the body in the the pictures. Before you make any decisions regarding plastic surgery, I would suggest you seek consultation with an expert. Please seek an experienced, board-certified, plastic surgeon. Travel out of state if you must to find such an expert. If you have any more questions regarding plastic surgery in general, please contact my office. Sincerely, Dr. Katzen. (Certified by the American Board of Plastic Surgery and member of the American Society Plastic Surgeons, International Society of Aesthetic Plastic Surgery, American Academy of Cosmetic Surgery, and Fellow of American College of Surgeons and American Board for Metabolic and Bariatric Surgery, Awardee: RealSelf 100.)
