Can fat & skin be removed without implants/fat injections? (Photo)

Question

I have recently lost weight & have noticed the loss of shape in my bum. Could you please recommend procedures to help w/the sagging skin/dimpling in my bum, upper thighs, & legs? I know it's difficult to remove cellulite, but is it possible to smooth out? I don't mind the top of my bottom; is it possible to just remove the extra fat on the bottom w/o implants? P.S. I have also attached a pictures of my stomach, as I wish to combine surgeries. Previous c-sect/hysterectomy Thank you

Semih Yildiz, MD, FEPOBRAS · Answer

In the visible posterior photo, the main issues appear to be lower buttock and upper-thigh laxity with dimpling rather than simply a small pocket of removable fat. Liposuction can reduce fat, but in an area with loose skin or cellulite it can also make sagging or surface irregularity more obvious, so “just removing fat from the bottom” may not give the smoother lifted shape you want.

Without implants or fat transfer, improvement usually comes from lifting and tightening rather than adding volume. Depending on your exam, options may include a lower body lift, buttock lift, posterior thigh lift, selective liposuction, or a tummy tuck if the abdomen also has loose skin from weight loss and prior C-section/hysterectomy scars. Cellulite can often be softened, but it is rarely erased completely. A board-certified plastic surgeon should assess skin quality, buttock support, scar position, and whether combining abdomen and lower-body contouring is safe for you.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding if fat and skin can be removed without implants/fat injections. Thank you for your history and your pictures. These can excise the excess skin and fat from your lower buttock. There are two approaches an incision can be made underneath the buttocks or inside the thigh. Or an incision can be made across the top of the buttock. When an incision is created underneath the buttock, the targeted area is the lower buttock, a crescent skin area, and fat is directly removed from the lower buttock. When an incision is made on top of the buttock, the buttock is lifted, and the wrinkles are eliminated. These can be combined with abdominal procedures, but I am not sure which abdominal procedure you are seeking. Please clarify. If you do not want buttock augmentation, you do not need buttock implants or injections. Buttock implants or fat injections are for patients who want their buttocks to be more significant. Thank you for your question regarding if fat and skin can be removed without implants/fat injections.

Michele A. Shermak, MD · Answer

Hello!
Gold standard answer is a lower backlift/buttock lift continuous with your abdominoplasty, which most definitely could be a "mini" with no belly button scar. The backlift will pull the skin up and over your existing buttock tissue so will reshape the buttocks in a great way. The incision above the buttocks may be in a gull wing shape or straight across the upper buttocks, depending on your surgeon.
Best of luck to  you!

Zoran Potparic, MD · Answer

Most likely that possible approach to a buttocks problem would be fat grafting and use of skin tightening devices based on radiofrequency or J plasma. That also includes treatment of abdomen. Hope it helps.

John Paul Tutela, MD · Answer

Thanks much for reaching out. It was significant amount of excess skin and not enough fat rest of your body qualify for fat transfer.  An implant would help fill out the skin laxity it is probably your best option. Also cutting the skin out directly in the banana role has many problems, including opening up and very poor scarring. However, that will also take out the skin in that area, but it may come with too much risk.

Leland Webb, MD · Answer

One of the ways to combat the sagging skin that can occur with weight loss is to add volume back in the form of Fat grafting . The hardest part here is the small amount of fat remaining. Furthermore, I do agree with you that implants in this area are fraught with difficulty. Nevertheless, if you discuss your goals with a board-certified plastic surgeon, they may find that they can harvest some fat for Fat grafting to provide you with some additional volume in this area. There are other options to include a lift in this area, however, this is a more comprehensive surgery with scarring. Have that conversation with a board-certified plastic surgeon and I think you can find a good option. We are happy to help in any way we can.

Connie Hiers, MD, FACS · Answer

For your buttocks, I recommend nonsurgical EMSculpt to help build and tone your muscle and help fill out your buttock.  Your breasts would do well with a lift and augmentation if you want something fuller.

Camille Cash, MD · Answer

There are options to address the various areas that you mentioned.  You can consider Aveli which is a treatment designed especially for cellullite.  You can also consider liposuction with J Plasma for skin tightening.  See a board certified plastic surgeon near you to learn more.

Kevin Tehrani, MD, FACS · Answer

Thank you for your question and posting appropriate pictures. You are a good candidate for skinny BBL procedures where liposuction using WAL or body jet is used to maximize graft take in addition to Acell. Fat from your the bottom of your bum, inner,  outer thighs, and possibly other areas like arms or front of your thighs can be used. Best to have a virtual consultation to discuss options.

Darryl J. Blinski, MD · Answer

Nice posted photos. Seems you need sub skin aggressive lipo of posterior buttock/thighs with specialized taping, Aveli cellulite releases, fat grafting yo buttock and areas of cellulite with skin only TT and muscle repair. Fee $15,000
Best to virtual consult with ….

Can fat & skin be removed without implants/fat injections? (Photo)

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