Best options to lift and tighten? Add fat, Sculptra, Renuva, or PRP? (photo)

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.  That being said, yoi do not have anywhere near enough fat for fat transfer and an extremely large and cost-prohibitive volume of fillers would have to be used to significantly restore volume an lift to your buttock. Therefore you’re only reasonable surgical option is buttock implants. After implants have been placed and settle in to place for about 6 - 7 months, a lower buttock tuck may be of further benefit. Glad to help. 

It is very difficult to determine the exact size and shape implant you will require to best match your ideal butt image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your buttock will determine, in many cases, the maximal volume per implant profile that you can accommodate. Liposuction of your lower back and fat transfer is also helpful as an adjunct to implants. Using “want to be” photos however are useful if simply provided to the surgeon.

Dear glamgurl,it is hard to tell without an examination but based on your photos, it looks like you might benefit from skin tightening. I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Sculptra, Hyperdiluted Radiesse, and PDO threads are the best non-surgical options to improve texture and skin elasticity to tighten and lift the sagging tissue.

Hello dear!
Thanks for the pictures and provided information as well.
Based on your photos, you are a good candidate for butt implants, to fix your problem, and I think you'll get very good results. 
l recommend you to make an in-person consultation with a board certified plastic surgeon for a proper answer and to talk about your goals and anything you need to know.
Good luck :)

The best treatment would be adding volume.
You may not have enough fat for an ideal BBL but you may have enough fat to give some improvements.
Probably a better option than using fillers which should be exceedingly expensive.
Definitely skip PRP.
Radiofrequency treatment make us some skin tightening but can potentially lose fat volume as well.
If you have the money to spend it may be worth trying.
Keep your expectations low.
Best,
Mats Hagstrom M.D.