What can I do to address glutes ptosis? (Photos)

Thank you for sharing your progress and concerns.
After significant weight loss, especially 17 kg, some degree of skin laxity and volume loss in areas like the lower buttocks is common, and at 32, your skin still has good potential for some natural retraction, though it may not fully “bounce back” to its previous firmness. Since you’ve maintained muscle through strength training, this helps support the area but doesn’t replace lost volume or tighten loose skin completely. If you want to avoid a full Brazilian Butt Lift (BBL), a targeted fat transfer to the hollow “pocket” area can be a good option to restore volume and improve contour, providing a subtle lift without the more extensive surgery. In some cases, combining fat transfer with non-surgical skin tightening treatments or a minor surgical lift may enhance results if skin laxity is more pronounced.

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

Buttock “sagging” and/or loose skin is usually a combination of loss of volume or deflation (after weight loss, liposuction, or post-BBL) and/or the effect of aging and gravity. So, I personally first treat patients like you by restoring volume to the buttock with a buttock implant. This will create a more desirable smooth and rounded perky buttock profile. If not adding volume with an implant, the buttock will most certainly always appear more flat if just a buttock lift from above is performed. On the other hand, an “autologous buttock lift” usually provides very little volume and projection, and almost nothing to the lower 2/3rds of the buttock.

A lower buttock tuck is usually then performed at six months following implants. Coincidentally, a lower buttock tuck also doubles as a thigh lift, removing loose wrinkled skin from this area as well. In this sequence, the implants have fully settled into final position so that any remaining loose skin can be most accurately identified and removed with the lower buttock tuck. Any “non-surgical” treatment or device as well as exercise, unfortunately, will have little to no effect on this problem area. Furthermore, fat transfer and “fillers” perform very poorly in this area and usually result in just a waste of hard earned money.

Please note, because an extremely few number of board certified plastic surgeons specialize in buttock implants, you may have to travel away from your local area to seek consultation with this particular type of surgeon. Getting it done right the first time around is not only the best chance for success, but also will save you from a lot of headaches and money in the future. Glad to help.