How can I correct these fat bulges on my buttocks? (Photos)

Thank you for providing such a thorough background. First, congratulations on your weight loss and your commitment to maintaining a healthy lifestyle. It’s clear that you’ve put in significant work, and it's completely valid to feel frustrated when certain areas—like stubborn fat bulges or contour irregularities—don’t respond the way we hope, especially after pregnancy and major body changes.

Based on your description, the fat pockets you're seeing on the buttocks are likely a combination of localized adipose tissue, possible mild skin laxity, and changes in fat distribution post-weight loss and childbirth. These can be particularly resistant to further improvement through exercise and diet alone.

Non-Surgical & Minimally Invasive Options:
1. Body Contouring Devices (e.g., Emsculpt, CoolSculpting, SculpSure)
Emsculpt uses high-intensity focused electromagnetic energy to stimulate muscle growth and tighten the area. This could improve muscle definition and mildly enhance fat contour.

CoolSculpting or SculpSure target localized fat via cryolipolysis or laser lipolysis, respectively. These are non-invasive but may require multiple sessions and work best on small, pinchable fat pockets.

2. Injectable Deoxycholic Acid (e.g., Kybella, Off-label Use)
Though FDA-approved for submental fat, it’s sometimes used off-label for small localized fat deposits elsewhere. Results are modest and depend heavily on the area treated and skin quality.

Surgical Options (More Definitive):
1. Liposuction (Traditional or Laser-Assisted)
For more prominent or resistant fat bulges, targeted liposuction is the most effective and lasting option. It allows for precision contouring of the buttock area, especially when shaping the “hip dip” or smoothing uneven fat pads.

Laser-assisted liposuction (e.g., SmartLipo) may also improve mild skin tightening, which can be beneficial if there's any laxity from prior weight loss.

2. Fat Grafting / BBL (Brazilian Butt Lift)
In some cases, reshaping the buttocks with fat transfer—removing fat from unwanted areas and re-injecting it to enhance contour—can create a rounder, more balanced silhouette.

This can also improve transitions between the lower back, buttocks, and upper thighs for a smoother overall shape.

3. Skin Tightening (If Laxity Is a Factor)
If skin laxity is contributing, surgical or energy-based tightening procedures may be needed. Options include radiofrequency-assisted liposuction (e.g., BodyTite) or Renuvion (J-Plasma) for skin contraction without large incisions.

Long-Term Maintenance:
While surgical fat removal is permanent, new fat can develop if there are major changes in weight or metabolism. Continued strength training and lifestyle habits will help maintain results.

Consider working with a provider who blends aesthetic contouring and function-focused planning, especially if preserving gluteal muscle volume is a goal.

Final Thoughts:
At 40 and with your strong fitness foundation, you're in an excellent position to benefit from both non-invasive and surgical options depending on your comfort level, downtime, and goals. The key is customizing the approach to your anatomy and ensuring your expectations align with the procedure’s capabilities.

You're not alone in this challenge—body contouring after weight loss and childbirth often requires targeted support to refine the final result you've worked hard to achieve.

This is a very difficult issue to correct as depicted in your one post photo. Best of virtual consult with I usually offer a combination of therapies which is Endo delays to the access areas and some type of filler fat raft or aloe fat raft to The dented area. This could take more than one session each session ranges from $1500-$2500 again best of virtual consult with.

This is not an easy or straightforward thing to improve.
To get an understanding of what’s involved I suggest looking for a YouTube video called the Miami thong lift by Dr. Medieta. Video explains the problem and suggested treatment fairly well kind.
It’s not an easy or straightforward condition to treat.
Many plastic surgeons may not have experience with it.
I don’t think this can be corrected with liposuction and or fat transfer.
Best,
Mats Hagstrom MD