What is my best option to fix saggy excess skin on gluteal fold after liposuction to reduce Brazilian Butt Lift? (photos)

Buttock “sagging” is usually a combination of loss of volume or deflation and/or the effect of aging and gravity. If adding volume to the buttock overall is not first indicated then I usually recommend going straight to a lower buttock tuck.

A buttock tuck is kind of like a tummy tuck for the buttock in that it removes the banana rolls and/or loose sagging skin from not only the lower buttock but also the back of the thigh to tighten both areas and create a more defined buttock crease. In doing so it also aesthetically shortens and/or rounds out the buttock cheek. It is ideal for those patients that have had significant weight loss or fluctuations, changes from fillers injected, banana rolls, banana roll liposuction complications, multiple pregnancies, or who’s derrieres have succumb to the dreaded effects of gravity and aging. It is also effective for those whom feel their buttock cheek is naturally too long or square and just want it proportionately shortened and rounded, respectively. Please keep in mind that a relatively few number of board certified plastic surgeons have experience performing this procedure, so you may have to travel far and away from home to find this particular type of surgeon. Glad to help.

That is very challenging correction and involves recreation of crease underneath gluteal area. Some patients have that kind of "deformity", others may develop that as a result of repeated gluteal surgeries. You should discuss correction with your surgeon or seek second opinion. Good luck.

Dear Concreteeuphoria,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

This situation is to very frequent in patients asking for to large of buttock from fat grafting. Reduction via liposuction is a tricky surgery. Based upon your posted photos your results appear quite good. Did you have a week of specialized taping in inferior buttock? I bet not. The J-Plasma really added NOTHING! It does not great effect the shrinkage of tissue as advertised. After virtual consult my guess is the only options are: 1. Repeat superficial lipo with 1 month of taping; 2. Direct excision with resultant scar.

Having already had two procedures makes your situation complicated.

I believe fat was inappropriately removed from your thighs but it is wrong for me to second guess or judge procedures I was not part of.

Each round of surgery makes the situation more difficult because of distorted anatomy and development of scar tissue.

Treatment options basically come down to further Liposuction(potentially of your buttocks) grafting fat two areas erroneously treated with liposuction, Or doing a direct skin excision leaving a scar.

At this point options may be somewhat limited because of your complicated history.

Keep expectations realistic and find the most experienced and talented plastic surgeon in your community for Liposuction and fat transfer procedures.

Best,

Mats Hagstrom MD