Hello, and thank you for your question regarding how to improve the sagging appearance of your buttocks. Based on your description, it sounds like you are looking for a posterior buttock lift, rather than a Brazilian Butt Lift (BBL). A posterior buttock lift is a surgical procedure designed to lift and tighten the buttocks, removing excess skin and improving overall shape and contour. Unlike a BBL, which primarily adds volume through fat transfer, a buttock lift focuses on removing excess skin and repositioning the existing tissue for a firmer, lifted appearance. During a posterior buttock lift, an incision is made across the upper buttocks, just below the lower back. A butterfly or peanut-shaped section of excess skin and fat is removed, and the remaining tissue is lifted and secured in a higher, tighter position. This effectively eliminates buttock sagging, wrinkles, and loose skin, creating a smoother, more youthful appearance. This procedure is commonly performed as part of a lower body lift but can also be done as a standalone surgery if you do not need a tummy tuck or thigh lift. It is particularly beneficial for patients who have experienced significant weight loss or who naturally have loose or drooping buttock skin. A posterior buttock lift is performed under general anesthesia and typically takes 2-4 hours, depending on the extent of correction needed. Recovery time varies, but most patients can return to light activity within 2-3 weeks and resume more strenuous activities after 6-8 weeks. If you are looking for a lifted, tighter buttock without adding volume, a posterior buttock lift is likely your best option. I recommend consulting with an experienced, board-certified plastic surgeon who specializes in body contouring procedures to discuss your goals in detail and determine the best surgical plan for you. I hope this helps answer your question. Best of luck with your journey! PS. Look at these before and after photos. The back side shows what a buttock lift looks like :) Sincerely, Dr. Katzen