Square infra gluteal crease from fat deposits - what can be done? (Photos)

Question

Hello. My butt has always been pretty square, but as l've gotten older, two lumps of fat have formed at my infragluteal crease. Right now my weight is fairly low (5'4", 115lb), but when I gain weight the lumps pictured get larger and more pronounced. Fat-loss does not make them go away, at my lowest weight of 105 they were still there. I’ve struggled to find photos of this exact issue on other people, it seems like the vast majority of people have a crease that amoothly curves upward. Ive never had procedures done to my buttock area, and ideally I’d rather “fix” this than try to disguise it with other procedures. Would a small amount of liposculpting help? I understand removing too much fat results in loose skin, and would not be opposed to a gradual process over 2-3 very minimal sessions. Is there anything that can be done?

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. The droop of the bottom of the buttock along with a square shaped central buttock are very common and vexing problems that I have been addressing for many years. In fact, I just published a white paper on this topic. You are an excellent candidate for a Thong Lift. Please visit my website to see the results. You have very similar anatomy and should be able to have an excellent result. Best wishes to you.

Ryan A. Stanton, MD · Answer

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

Buttock “sagging” and/or loose skin is usually a combination of loss of volume or deflation (after weight loss, liposuction, or post-BBL) and/or the effect of aging and gravity. In your case, as is common in others too, the two lumps of fat are result of deflation of the buttock and a ligament going from a bone to the skin, allowing the buttock skin and fat nearer to the buttock crack to descend lower creating the “lump“ effect.

I personally first treat patients like you by restoring volume to the buttock with a buttock implant. This will create a more desirable smooth and rounded perky buttock profile. If not adding volume with an implant, the buttock will most certainly always appear more flat if just a buttock lift from above is performed. On the other hand, an “autologous buttock lift” usually provides very little volume and projection, and almost nothing to the lower 2/3rds of the buttock.

A lower buttock tuck is usually then performed at six months following implants. Coincidentally, a lower buttock tuck also doubles as a thigh lift, removing loose wrinkled skin from this area as well. In this sequence, the implants have fully settled into final position so that any remaining loose skin can be most accurately identified and removed with the lower buttock tuck. Any “non-surgical” treatment or device as well as exercise, unfortunately, will have little to no effect on this problem area. Furthermore, fat transfer and “fillers” perform very poorly in this area and usually result in just a waste of hard earned money. Liposuction also, will surely fail and only make things worse.

Please note, because an extremely few number of board certified plastic surgeons specialize in buttock implants or buttock tucks you may have to travel away from your local area to seek consultation with this particular type of surgeon.  Getting it done right the first time around is not only the best chance for success, but also will save you from a lot of headaches and money in the future. Glad to help.

Zoran Potparic, MD · Answer

One of the ways to correct square shape is to create a new crease and remove portion of the skin and fat tissue by means of surgical excision. This will create a scar hidden within the buttock crease,  which is for the most part invisible. Liposuction only would not create such an improvement.  Good luck.

Square infra gluteal crease from fat deposits - what can be done? (Photos)

Answers (3)

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