Hello, Thank you for reaching out with your question and providing detailed information along with your pictures. Based on your description and the images, it seems that you are experiencing a common concern among weight loss patients – the loss of the infra-gluteal fold and excess skin and fat in the upper third of the posterior thigh and lateral thigh. Wedge Excision Procedure: For your specific case, a wedge excision of the infra-gluteal fold and lateral thigh is recommended. This involves creating an incision in the infra-gluteal fold, extending over the hip, and removing a wedge-shaped section of tissue. This excision resembles the shape of a football. Benefits of the Procedure: This surgery will effectively lift the posterior thigh, recreate the infra-gluteal fold, and eliminate excess skin and fat in the lateral thigh. It's a comprehensive approach to address the concerns in these areas. Common in Weight Loss Patients: The issue you're facing is typical in individuals who have undergone significant weight loss. The procedure, sometimes referred to as saddlebag removal, is well-established and frequently performed on weight loss patients. Expectations and Recovery: It's important to have realistic expectations and understand the recovery process. Post-surgery, you may experience swelling and will need to follow specific aftercare instructions to ensure optimal healing and results. Consultation with a Plastic Surgeon: As always, a detailed consultation with a board-certified plastic surgeon is crucial. They can assess your specific needs, discuss potential risks, and tailor the procedure to achieve the best possible outcome. In summary, a wedge excision in the infra-gluteal and lateral thigh region appears to be a suitable solution for your situation. This procedure should address the loss of the infra-gluteal fold and excess tissue in the posterior and lateral thigh areas. Good luck with your decision and the potential procedure. Sincerely,