I need to the reduce banana rolls and the size of my buttocks. What can be done? This is a tricky one!

Question

I had previous lipo that lead to very bad outer thigh creases extending from my buttocks. Originally in my surgery I just requested the outer thigh lipo but when I came around was told that the surgeon had taken from my lower buttocks, upper and my flanks. I am fairly slim, train a lot but have a large bum naturally. I am trying to reduce the size while lifting and am told due to the previous surgery this can only be done via lower body lift which would lead to scarring.

Marc DuPéré, MD · Answer

Thank you for your question.This is not an easy problem. I am sorry there was miscommunication or misunderstanding between yourself and your surgeon.Most agree that a younger buttock has only a small inner crease with no extension laterally. But as we get older, the crease becomes longer and more pronouced.Liposuction to the banana rolls will commonly accentuate the line so it is a matter of chosing the better evil: the banana rolls versus a longer crease. And that varies between patients.One could consider fat grafting to your outer crease with perhaps a small improvement.If the size of your buttocks is still concerning you, perhaps more liposuction to your buttocks and excision of skin via a lower buttock crease incision, as first published in the plastic surgery litterature by Professor Pitanguy - a 'reversed' butt lift. You do end up with an incision but you already have a crease now.Last option - and maybe the better one - is to do nothing - you do look great from the pictures you shared with us.Let us know if this information was useful.

Best regards,

Dr. Marc DuPéré, Toronto aesthetic plastic surgeon and body
surgeon

Best regards,

Dr. Marc DuPéré, Toronto aesthetic plastic surgeon and body
surgeon

J. Timothy Katzen, MD, FACS · Answer

Hi Kim,Thank you for your question and your pictures.You said you are " trying to reduce banana rolls and the size of your buttocks" and "trying to reduce the size while lifting".  In your situation, you have excess buttock skin and fat.  Previously much of the buttock fat had been removed with liposuction.The only way to reduce the size of the buttock now is by excising excess buttock skin. Since your abdomen is flat, I would not suggest an abdominoplasty, nor the anterior portion of the 360 circumferential lower body lift.  To remove excess buttock skin,  I would suggest a posterior body lift.  In a posterior body lift, an incision is placed on the superior portion of the buttock. The resulting scar would be camouflaged by the clothing you are wearing in the picture. The posterior body lift  incision would extend from the top of the hip to the top of the vertical buttock cleft and extent to the other hip.  Tissue dissection would extend from this incision to the middle of the buttock.  The excess buttock skin and fat is pulled vertically.  Excess buttock skin and fat would be removed. The posterior body lift procedure would reduce the size the buttock, smooth buttock wrinkles, and eliminate the banana roll.I hope this answers your question regarding illumination of banana roll through  a posterior body lift.Sincerely, Dr. Katzen

Larry S. Nichter, MD, MS, FACS · Answer

Reducing your banana rolls, posterior upper thigh excess fat, if done properly and conservatively should give you improvement without making your buttocks drop.

Paul E. Chasan, MD, FACS · Answer

Thank you for your inquiry. In your case, the problem is limited to the inferior pole of your buttock. I have a significant experience in treating this area with an infragluteal thigh lift. That is removing the skin on the bottom of the buttock. I only perform a posterior body lift as mentioned below if there is significant laxity of other parts of the buttock. Please see the link below.

Juan Carlos Fuentes, MD · Answer

In your case reducing the buttocks in size and the banana rolls, is not a good idea, as then the fold below the buttocks will be deeper and the visual effect on the buttocks, is that they will look more saggy.

Vasdev Rai, MD · Answer

Thigh -buttock lift and a direct excision of your banana rolls will be needed.  Both surgeries leave behind scars. It is strictly your choice to accept those scars or accept yourself as you are.

Sam T. Hamra, MD (retired) · Answer

Unfortunately due to your previous surgeries there is only two ways to reduce your bottom. One is by doing a lower body lift. But without an exam it's hard to tell if there is enough looseness because of the flank and buttock liposuction. It may be difficult to lift and remove any skin. The other is by taking a wedge of skin at the buttock fold. Both of these options can only resolve your problem, but they do require an incision.

Peter Fisher, MD (retired) · Answer

Hello and thank you for your question. There are a lot of techniques to try to accomplish what you want and I am fairly good at most. I will however tell you that none will give you a result that you would be happy with. If you consulted with me I would have to tell you not to do anything as you well may land up looking worse.Peter Fisher M.D P.s In other words you look great already.

I need to the reduce banana rolls and the size of my buttocks. What can be done? This is a tricky one!

Answers (8)

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