Dents in both sides of the butt, look like panty lines? 31yrs, 5'7/152lbs. (Photos)

Question

Weight resides in hips/butt/thighs. I work out 4-5 days a week (cardio/weights) for about 1.5hrs/session. I've always had trouble developing muscle in my glutes despite many years of being an athlete and weightlifting. I do plenty of glute exercises. Cellulite is getting worse regardless of low fat diet and these dents are becoming more prominent. They are especially bad when walking/flexing. It's as if they are hollow and no muscle development at all. What does this look like and can it be fixed?

Jason Emer, MD · Answer

this is volume loss and sagging, you wil need fillers + trusculpt FLEx. fat grafting if you have enough.

Sculptra with the right dilution doesn't cause nodules in the buttock and is very safe.  It should be  combined with RF treatments to get the sculptra to work even better/stimulate it to produce collagen such as venus legacy / exilis ultra / thermage / inmode forma or contoura.  We often will add bellafill or renuva to certain areas to improve indentations or the buttock roll to get more definition and softening or to improve overall size and shape.  Smooth novathreads do very well to improve laxity of the buttock as well non surgically.  Just know that sculptra takes numerous treatments and vials, its a large expense and must be maintained at least 2 times a year after a series of treatments for the best result.  Dr. Emer.

Zoran Potparic, MD · Answer

Deep buttock creases and flatness can be improved with fat grafting; cellulite will not. Initial improvement may be noticed due to swelling but this is not of a long duration. Reliable remedies for cellulite treatment are still to be found.

Daniel Barrett, MD · Answer

Dear libby850,
based on your photos, you look like a good candidate for a BBL. Liposuction of your abdomen, back and flanks should give you more curves and hourglass shape and fat transfer to buttocks should give you more projection. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Liposuction in the flank areas above the dents to remove the excess fat could be helpful. If needed, fat could also be transferred to the dents. Enodomologie treatments with radiofrequency can be helpful for cellulite.

Douglas Taranow, DO, FACOS · Answer

Libby,
You have several issues going on.  The lack of fullness may be addressed with a BBL (fat transfer). This will be contingent is examining you to make sure you have adequate donor fat. 
Secondly, you have cellulite.   Some of this may be helped (not alleviated or cured) with release (subcision) and smaller fat grafting. 
Dr T

Darryl J. Blinski, MD · Answer

You have 2 different anatomic issues. #1. "dents" are the limited sub dermal/sub cutaneous fat layers you were genetically and/or environmentally given. Best Tx is fat grafting (BBL), but you need to gain weight to have enough donor fat to transfer. Also injections of Sculptra or combination of HA+Sculptra is an option. #2. Cellulite - in your case I would wait for the QWO injections to become available.

Arian Mowlavi, MD, FACS (license on probation) · Answer

This can be resolved using high definition VASER liposuction and renuvion skin tightening. Fat can be harvested from anywhere on your body and grafted into your buttock to improve shape, volume and projection. How much depends on you and your goals. The Gold Standard for superior liposuction results requires use of the advanced technology of ultrasound assisted VASER liposuction. As an official trainer of VASER liposuction, I perform full body liposuction cases every week. VASER liposuction has been the only modality that has consistently resulted in outstanding liposuction outcomes. VASER liposuction ensures a smooth contour regardless of degree of excess fat by virtue of being able to remove any and all remaining fat comprehensively and uniformly. If skin redundancy is observed, Renuvion technology can be simultaneously applied to tighten your skin to optimize your overall contour outcome. A Skype or FaceTime consultation with a VASER specialist will help you get an accurate recommendation and pricing.

Respectfully,
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Mats Hagstrom, MD (license on probation) · Answer

Cellulite is difficult to treat. The best treatment option is subsicion.  That can be done with a device called Celfina.

Best,

Mats Hagstrom MD

Dents in both sides of the butt, look like panty lines? 31yrs, 5'7/152lbs. (Photos)

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