Will a butt lift fix upper thigh sag? (Photos)

Question

I’m 33 years old 5 foot 5 and 130 pounds. I’ve had two pregnancies where I’ve lost a lot of weight -70 pounds. Skin is losing elasticity as I’ve gotten older. Im considering a lower butt lift to help with upper thigh sag. Am I a candidate? Is there anything else that could help? Dimpling more prevalent when I step or bend over. Pictures don’t do justice how bad it can look.

Laura Roider, MD · Answer

Thank you for sharing photos as part of your question. The area of concern (that you're pinching in the photos), is really more so part of your upper thigh than your buttock, often referred to as the Banana Roll. I would recommend considering a horizontal inner thigh lift. This would allow you to address the area of concern while removing and excess skin you have in your upper inner thigh as well. Typically, the scar extends from the anterior thigh/groin junction, continuing to the upper inner thigh, and ending at the lateral extent of your buttock crease.

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. So,  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. Beware, 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 and/or 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.

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.

George Marosan, MD · Answer

Thank you for your question and photos. As plastic surgeons, our first approach to the problem you posted is to cut and lift. All these will leave large scars, which will migrate below your crease over time, and you will have the same problem. I believe that what you assess as loose skin/fat due to the dimpling of the skin you see, is not excess. You have cellulite which creates the deep creases in the upper posterior and lateral thighs. I personally would treat this with the GoldIncision procedure, to detach the adhesions and inject biostimulators under the skin in these areas. This is done as an outpatient procedure under local anesthesia. No incisions, no cutting, no scars. Thighs are difficult and will require more than one treatment 60-90 days apart. BTW, you do have cellulite of the buttocks as well. I do not treat the thighs and buttocks at the same time. Buttocks require fewer treatments than the thighs. 
In the photo where you lift your buttock skin, you still have the cellulite. So, surgery will be a disappointment. See a board-certified plastic surgeon who understands the dynamics of this anatomical area. Remember, surgical scars are permanent. Good luck.

Gary M. Horndeski, MD · Answer

A buttocks lift can correct upper thigh sag. You would need a curvilinear transverse incision. The excess skin and fat is deepithelialized and rotated down to give you more projection and pull up the buttocks and upper thighs.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

Without in person consultation which will allow for evaluation of your skin/buttock support system it would be difficult to suggest right procedure. In person consultation with a board certified plastic surgeon familiar with both procedures is recommended. Good luck.

Mats Hagstrom, MD (license on probation) · Answer

⸻There are unfortunately limited reliable treatment options for your concern.The term “butt lift” is often confusing. In most cases, it refers to a BBL (Brazilian Butt Lift), which is a volume-enhancing procedure. Despite the name, it does not truly lift tissue &mdash; it increases projection by adding fat.The upper posterior thigh and lower buttock naturally contain excess skin to allow full hip extension and flexion. When standing, this skin appears redundant; when the hip is flexed, it tightens. After significant weight loss and with age-related loss of elasticity, this area commonly becomes more noticeable and difficult to correct.Skin excision procedures do exist, but they typically leave significant scars and often have modest patient satisfaction. Liposuction in this region is generally discouraged, as it does not correct the primary issue (skin redundancy) and may worsen contour irregularities.My best recommendation is to schedule in-person consultations with experienced plastic surgeons in your area. Bring photographs of your own body for reference &mdash; do not rely on memory alone. During the consultation, ask the surgeon to show before-and-after results specifically from patients of similar age and body characteristics.An experienced surgeon should have a substantial and relevant photo portfolio. A limited collection of before-and-after images should be considered a warning sign.Credentials alone do not guarantee equivalent skill or aesthetic judgment. Exceptional results require an exceptional surgeon; average experience typically produces average outcomes.Take your time, meet with multiple surgeons, and carefully evaluate your options before committing to a permanent body-contouring procedure. The time to be critical is before surgery, not after.I am not suggesting surgery is impossible or inappropriate &mdash; only that this particular area is inherently challenging and outcomes can vary, so caution is warranted.Best regards,Mats Hagstrom MD

Will a butt lift fix upper thigh sag? (Photos)

Answers (6)

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