Bum Reshaping - uneven shape and loose skin. Is there any procedure that can help with this? (photos)

Question

Hello I'm 43 years old and have lost 115lbs from my highest weight through diet and exercise. I've had a mommy makeover and thought lift. My bum and back of legs are my biggest concern now because of the uneven shape and loose skin. Is there any procedure that can help with this?

J. Timothy Katzen, MD, FACS · Answer

Hi LEESAMP,
Thank you for reaching out with your question about options for reshaping your buttocks due to uneven shape and loose skin. I appreciate the history and pictures you've provided.
After reviewing your pictures, it seems you've previously had a 360 circumferential lower body lift, which typically includes a tummy tuck, hip lift and reduction, and buttock lift and reduction.
To address your concerns about the loose skin and asymmetry of your buttocks, there are a couple of procedures to consider:
Autologous Fat Transfer or Brazilian Butt Lift (BBL):
This procedure involves harvesting fat from other areas of your body, such as your waistline or thighs, and transferring it to your buttocks. It can effectively correct uneven shapes and loose skin.
However, it's important to note that a BBL will increase the size of your buttocks.
Revision of the Posterior Aspect of the 360 Circumferential Lower Body Lift:
If you prefer not to increase the size of your buttocks, a revision surgery might be more suitable. This would involve utilizing the existing incision from your previous surgery to lift, reshape, and remove excess skin and fat from the upper buttock area for a more defined shape.
For the indentation on your right cheek, specialized techniques to release scar tissue may be required, possibly combined with a small amount of fat transfer for optimal smoothing and shaping.
In summary, you have options to enhance the appearance of your buttocks. A BBL could provide a fuller look while addressing unevenness, or a revision surgery could refine and reshape without significantly altering the size. Your choice will depend on your aesthetic goals and preferences.
I hope this helps clarify the available procedures for your buttock reshaping needs. Wishing you the best as you consider your options.
Sincerely,
Dr. Katzen

Ryan A. Stanton, MD · Answer

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” 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 be shortened but may appear more flat with just a buttock lift. A lower buttock tuck is usually then performed at six months following implants. 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.

A lower buttock tuck is kind of like a tummy tuck for the buttock in that it removes the banana rolls and/or loose sagging skin from not only the lower buttock but also the back of the thigh to tighten both areas and create a more defined buttock crease.  In doing so it also aesthetically shortens and/or rounds out the buttock cheek. It is ideal for those patients that have had significant weight loss or fluctuations, changes from fillers injected, banana rolls, banana roll liposuction complications, multiple pregnancies, or who’s derrieres have succumb to the dreaded effects of gravity and aging. It is also effective for those whom feel their buttock cheek is naturally too long or square and just want it proportionately shortened and rounded, respectively.

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.  Glad to help.

George Lefkovits, MD - Account Suspended · Answer

The photos show an asymmetry between the buttocks as well as suggest some looseness of skin. You need to be examined physically by a Board Certified plastic surgeon with lots of experience performing buttock augmentation. Good luck!

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