Double Butt Cheek After Scar Revision

I had a lipo scar that was placed under my ass cheek about .5 cm too far down to match the buttocks' natural crease. A revision made it nicer but 6 months after it still is hard to my massaging touch...and looks a bit rough. How can I make this not fold under when I walk, giving me an apparent "second ass cheek"?

Doctor Answers 2

Liposuction entrance scar contraction

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This sounds like an area of scar contraction. While the skin scar may have been revised to a more favorable location, the deeper subcutaneous tissue has a track of scar underneath from the liposuction. This now acts as a band, indenting the scar with walking. After 6 months, the scar from the revision is not yet mature and it is still possible that the contracture may yet improve with time. It is reasonable at this point to consider steroid injections and allow for more time. If it persists at a year after the last revision, then I would consider surgical release and little bit of fat grafting to prevent recurrent scar contracture. 

Liposuction and the buttock crease

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The crease under the buttock is a result of a tissue connection between the undersurface of the skin and deeper structures. When performing liposuction the cannula needs to be introduced at the outer edge of the crease to avoid disrupting the connection. If the connection is disrupted the buttock fat can drift downward and look like a "second ass cheek". Without a photo or examination it is hard to say if that is the case here. If the connection is disrupted I do not know of any reliable way to recreate it.

Aaron Stone, MD
Los Angeles Plastic Surgeon

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