Which surgical procedure would address my sagging lower butt? (photos)

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 most certainly always 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. Getting it done right the first time around is not only the best chance for success, but also will save you from a lot of headaches and money in the future. Glad to help.

I recommend a buttocks lift. This is done by using the excess skin of the back to make it into a flap and then advancing the buttocks over the flap. This gives more posterior projection without the use of fat transfers or foreign bodies. When done, the scar will be concealed within the bathing suit line.

Best Wishes,

Gary Horndeski, M.D.

Thank you for posting your question here!My Answer will be based on the limited information and pictures provided, for a detailed and bespoke plan please consult with a plastic surgeon in person.
From the images provided , you do seem to have some skin laxity and sagging , this can be addressed with a surgical buttock lift , which when couple with autoaugmentation can give you god results . Other options can include a thong lift, or implant for projection with a lower buttock tuck. I would recommend that you consult with your plastic surgeon in person so they can examine you and come up with a personalized plan that works for you.
I hope this helps, best of luck!

It's best to consult with a board-certified plastic surgeon who specializes in body contouring procedures. They can assess your specific needs and recommend the most suitable surgical option for addressing your sagging lower butt.

Here are some potential surgical procedures that might be considered, but it's crucial to have a personalized consultation with a surgeon:

Buttock Lift: This procedure removes excess skin and fat from the buttocks, repositioning the remaining tissue to create a firmer, more lifted appearance.

Brazilian Butt Lift (BBL): This involves liposuction to remove fat from areas like the abdomen, thighs, or back, and then transferring that fat to the buttocks to enhance volume and shape.

Lower Body Lift: This more extensive procedure addresses sagging skin and fat in the lower abdomen, flanks, and buttocks, creating a more contoured and toned appearance.

Remember, choosing the right procedure depends on factors like the extent of sagging, your desired outcome, and your overall health and fitness. A qualified surgeon will be able to guide you through the decision-making process and ensure you achieve the results you're looking for.

In regards to treatments that going to have a big impact or make you look much better I would say they’re really aren’t any.
You have a subcutaneous fat distribution that has very little fat on your lower extremities and the transition from your buttocks to your thighs is dependent on sufficient volume to look good.
Fat grafting would be the treatment of choice but in order for this to work, there has to be a sufficient layer of tissue to graft into.
In other words, the people who need the procedure the most end up not being good candidates for it.
I’m afraid only very thin layers of fat would survive fat grafting in your case and for this reason only very small improvements are possible and it’s a pretty involved procedure so in the nutshell, I think my recommendation would be to not move forward with surgery.
There may be plenty of plastic surgeons who are far more optimistic.
Recognize that this is how we make a living.
Before, even contemplating having any surgical intervention, you should ask the providers to show you as sufficient collection of before, and after pictures of previous patients who have very similar body characteristics to your own.
You need to bring pictures of yourself to use as reference.
Close attention to how thick the subcutaneous fat layer is on the example pictures.
I don’t think you’re going to see any long-term quality results on people who had the same characteristics.
Finally recognize that early fat transfer results Can look very impressive but early results do not represent long-term final results.
In order for after pictures to be representative for fat grafting surgery they need to be at least 3 to 6 months from the date of surgery.
Best,
Mats Hagstrom MD