Very saggy glutes/butt after weight loss (Photo)

Question

Hello all, thank you in advance. Around 2 years ago, I rapidly gained over 40kg due to difficulties with mental health and stress. The weight fell off after I recovered but unfortunately my glutes are extremely saggy. I am 22, 5’8 ~125lbs. I don’t want necessarily more size, just improved shape and removal of the sagging areas. Please could you advise me on what could be suitable to reach my goals?

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding sagging glutes after significant weight loss. Thank you as well for your history and your pictures.

From the images provided, it appears that your left infragluteal fold (where the buttock meets the upper thigh) is lower than the right, which creates visible asymmetry. If this asymmetry is confirmed during an in-person physical examination, the most effective solution would likely be a posterior buttock or posterior body lift. During this procedure, an incision is made across the upper portion of the buttocks, and skin and fat are lifted and removed. In your case, more tissue would be removed from the left side to create symmetry and improve the overall shape and contour of your gluteal area.

Additionally, your photos show excess skin and tissue in the upper inner thigh, which is a common concern after major weight loss. If this is confirmed during a physical exam, you may benefit from a thigh lift — more specifically, a modified vertical medial thigh lift. This involves an incision starting in the groin and extending partially down the inner thigh. A wedge of skin and fat is removed, and the remaining tissue is tightened to smooth and contour the thigh.

Depending on your overall health, lab results, and lifestyle (particularly non-smoking status), these procedures can often be performed together in a single stage. Many patients who have undergone massive weight loss choose to combine a posterior body lift with a thigh lift to address both the sagging buttocks and the loose thigh tissue, achieving a more balanced and youthful lower body contour.

Since you're 22, at a stable weight, and appear to be in good health, you may be an excellent candidate for these procedures — but a thorough in-person consultation with a board-certified plastic surgeon experienced in post-weight loss body contouring is essential to confirm your candidacy.

Thank you again for your thoughtful question. I hope this gives you helpful insight into how to improve the shape of your glutes and thighs after weight loss.

Sincerely,
Dr. J. Timothy Katzen, MD, MBA, FASMBS, FICS
(Certified by the American Board of Plastic Surgery and President of the American Board of Bariatric Plastic Surgeons)

Luis Suarez, MD · Answer

We would need additional pictures in order to evaluate, however, by the information that has been presented if you do happen to fluctuate with your weight, it could have caused for loose skin to appear in certain areas if that is the case and your lower back skin has loose skin. What would be a good option would be a posterior tuck. This will help eliminate any loose skin and give you a butt lift to be able to improve the area.

Daniel Barrett, MD · Answer

Dear perfectbiscuit123,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

You will need an inner thigh lift to address the excess skin and help shape the buttocks.  I don't think with the amount of excess skin that tightening options alone would be sufficient.  See a board certified plastic surgeon near you to learn more.

Daniel P. Markmann, MD · Answer

Thank you for your question and including photos.   The best thing to do is an inner thigh lift/buttocks wedge excision.   This is a scar in the crease under your buttocks.  The excess skin is removed and the remaining skin is pulled up.   This will remove the loose drooping skin and give you one crease on each thigh instead of 3

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