Plastic surgeons aim for “perfection” because it is just in their general nature ( this is definitely a desirable quality of an excellent plastic surgeon), not to mention, this is what is often expected of most patients. That being said, although certain scars are less invasive or less visible, they are often not used because they also result in much less of an improved/desirable/acceptable outcome. Here is what I typically tell patients regarding buttock lift queries and concerns: Buttock “sagging” is usually a combination of loss of volume or deflation (after weight loss 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. 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.