Are butt implants my only option?

Some before and after photos would be helpful to review. That being said at 5’4”, 113 lbs, it is highly likely that buttock implants were your only reliable and permanent option from the beginning.

You are in good company with many others who had high hopes for BBL but instead received disappointing results (lumpiness, unevenness, lack of projection in the central and/or lower buttock, post-deflation sagging, etc.) as most of the fat melts away, especially in “skinny BBL“ cases.. It is not quite as much the quality of the doctor nor liposuction technique but rather the quality of the procedure that is a large part of the problem. Thus, going back for round 2 BBL most often produces the same disappointing results but at another financial loss. Buttock implants indeed provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the buttock and often smoothing out lumpiness. Please keep in mind that an extremely few number of board-certified plastic surgeons specialize in buttock implants so be sure to consult with one that is reputable and experienced. Unfortunately you may have to travel long and far away from home to find this particular surgeon. Glad to help.

Without posted photos very hard to advise. I would try the combination of Radeisse/Sculptra before surgery of butt implants. Best to virtual consult with...

What you describe sounds very unusual.
How many before and after pictures did this provider show you during your consultation?
How many skinny BBL results did they show you during your consultation?
Including pictures would allow us to make an assessment. If you don’t have before and after pictures then ask your surgeon to forward the ones they took.
Gluteal implants are not going to restore you’re an even fat distribution.
Most plastic surgeons do not offer gluteal implants and for good reason.
There are a handful of surgeons in this country who specialize exclusively on gluteal implants and if you’re going to have the procedure you need to be in the hands of one of those few surgeons who do them on a very regular basis.
The key to success seems to be exclusively intramuscular placement of implants choosing implant size that is conservative and one that clearly anatomically fits inside your gluteus muscle.
Augmenting your gluteus muscle with a solid silicone implant is not going to change your fat distribution.
Again, without pictures we can’t really make an assessment.
Generally speaking I am not an advocate of gluteal implants and generally steer people away from them.
If someone is going to get them then they need to find one of those few surgeons who really has mastered the procedure. There are not a lot of them. When doing consult for any cosmetic surgical procedure you should ask providers to open up their portfolio of before and after pictures and asked to see the entire collection or at least as many pictures as the provider is willing to.
Asked to see pictures of patients who have similar body characteristics to your own.
An experienced provider should have no difficulty showing you at least 50 sets of before and after pictures of commonly performed procedures.
Like I mentioned earlier must plastic surgeons don’t even do the procedure so for those who do them regularly having 50 sets of the before and after pictures should be no problem at all.
For someone who specializes in one particular procedure having hundreds or thousands of before and after pictures would be expected.
For gluteal implants I would approach the procedure with extreme caution and be extremely selective of your provider.
There are lots of examples on this website of patients who have major issues after gluteal augmentation with implants.
I see very few people posting with long-term quality results
There may be an argument that there’s no reason to post if everything is going well but I see far more problems than I do success stories when it comes to gluteal implants.
Sometimes accepting the body we were given is the right way to go.
Best,
Mats Hagstrom MD