What would you do to make my square, "dirty diaper" buttocks round and pretty? (Photo)

Question

I am a massive weight loss woman who underwent upper/lower body lift and thigh lift. My surgeon said he would make my buttocks round and pretty but they are square and a "dirty diaper" meaning that the cleft is at the wrong angle. I also lost projection. My surgeon offered to lift me more but said the gain will be minimal. The cleft angle bothers me most of all. And I fear losing more projection. Plus my tailbone has not fat and hurts 9-mos post op. What would you do to correct my butt?

Ryan A. Stanton, MD · Answer

A square flat buttock is a common problem after lower body lift surgery.  To remedy this, I have had the best success with placing buttock implants for enhanced projection and shape.  Please read on for more info:Allow me to share
with you some information that you may not hear elsewhere. There are only two
proven safe and relatively effective methods for Buttock Augmentation and Hip
Augmentation: 1) Autologous Fat Transfer (using your own fat, transferring from
one area of the body to the other) and 2) Buttock/Hip Implants (semi-solid
silicone rubber implants that cannot rupture &/or leak). Both are very good
options so what it comes down to, like any surgery, is proper patient
selection.  Depending upon the
amount of your current fat reserves and their distribution, you may or may not
be a reasonable candidate for fat transfer.  Indeed because at least 50+ %
of the fat transferred will melt away within a year, most patients are not good
candidates because they lack an adequate amount of fat to harvest. Another tip
is that if you purposely gain weight (i.e. fat) for the procedure, the fat you
lose first as you get back to your baseline weight is that very same fat that
was transferred into your buttock...so don't fall victim to this
recommendation.  Although using your own fat is relatively safe, the one
serious complication that can rarely (< 1%) happen is "fat
embolism" in which some of the fat gets into the blood stream and travels
up into the lungs, heart, and/or brain causing serious problems. This
complication is more likely to happen with the larger amount of fat being
transferred. This is even more likely to happen when using fillers like PMMA
and hyaluronic acids. Also fillers, when injected in large quantities, have a
relatively high tendency to migrate away from the original area they were
placed and tend to stimulate a lot of inflammation and a subsequent disastrous
amount of scar tissue/hardening.Thus buttock/hip
implants become a very good, safe, and long term reliable option for most
patients seeking buttock augmentation (at least in my practice). I prefer to
insert the buttock implants through a 2 inch long incision over the tailbone
(concealed within the crevice between the buttock cheeks) and the hip implants
through a ~ 1 inch incision just below the beltline above the hip region. The
buttock implant should always be placed under or within the gluteus maximus
muscle. In this position, the implant is less palpable, less visible, and does
not sag or shift/migrate over time unlike implants placed on top of the muscle.
Therefore it is extremely important to seek consultation with a board certified
plastic surgeon who specializes in this procedure (in fact both implants and
fat transfer so that s/he is not bias). And in this case too, at least in my
surgical practice, the infection rate is minimized to ~5% and the infection rate is minimized
to ~2%.
I generally do not recommend fat
grafting at the same time as placing buttock implant because of a
significantly increased risk of infection.  For fat to survive it
must be grafted into muscle, however that is also where the implant sits. 
Thus, if fat is injected into the implant or implant pocket then it will
die and almost assuredly get infected - necessitating removal of the implant as
well. Because
of this risk, I frequently avoid fat grafting into a buttock that has an
implantBecause of all this, I strongly recommend consulting
with a board certified plastic surgeon that performs both procedures and not just the
Brazilian buttock lift so that s/he can provide you with an unbiased
recommendation for surgery with realistic long term results.Again, like any surgery, the key to a
satisfactory outcome is both patient education and a skilled board certified
surgeon specialist.

Ozge Ergun, MD · Answer

Thanks for the question. Based on them a torso liposuction and buttock reshaping can be done with liposuction and you will achieve a very good result. I wish you all the best.

Kenneth Hughes, MD · Answer

I have been able to liposuction enough fat to perform the Brazilian buttlift even in thin people and massive weight loss patients.  You could also consider buttock implants.  I perform hundreds of buttock augmentations each year.Kenneth Hughes, MDLos Angeles, CA

Tania Medina de Garcia, MD · Answer

Hello dear!
Thanks for the question and provided information as well.
Based on your pictures, you are a good candidate for liposuction with BBL, and I think you'll get very good results. 
Liposuction allows your plastic surgeon to transform your entire shape. You can improve your abdomen, back and flanks, and of course your buttock, to give you a beautiful heart shape.
In general, you need to be physically healthy and at a stable weight, have realistic expectations, be a non-smoker and your BMI needs to be 30 or less.
l recommend you to make an appointment with a board certified plastic surgeon to talk about your goals and anything you need to know.
Good luck :)

Luis E. Redondo, MD · Answer

Congratulation on your weight loss, first thing first, you would never change your shape with a butt lift, Butt lift will only do that, lift your buttocks, and you have a pretty nice result. Now what is missing is to "fill" that area and shape it, i would suggest intramuscular implants for increasing volume and projection and fat transfer to get the shape you desires, none of the techniques by itself will reshape and fill your buttocks to meke it "round and pretty" as you mention before.Find a Board Certified Plastic Surgeon with trainig and experience on Buttocks enhancement who combine techniques and get the result you wish.Best of luck,Dr. Luis Redondo

What would you do to make my square, "dirty diaper" buttocks round and pretty? (Photo)

Answers (8)

Answer: What would you do to make my square, "dirty diaper" buttocks round and pretty?

Answer: What would you do to make my square, "dirty diaper" buttocks round and pretty?

Answer: Round Buttocks after body lift

Answer: Round Buttocks after body lift

Recommended reading

Everything you need to know about Butt Augmentation

Our mission is to create a world where every investment in modern beauty is Worth It.

What would you do to make my square, "dirty diaper" buttocks round and pretty? (Photo)

Answers (8)

Answer: What would you do to make my square, "dirty diaper" buttocks round and pretty?

Answer: What would you do to make my square, "dirty diaper" buttocks round and pretty?

Answer: Round Buttocks after body lift

Answer: Round Buttocks after body lift

Browse related questions

Recommended reading

Everything you need to know about Butt Augmentation

Our mission is to create a world where every investment in modern beauty is Worth It.