Horrible butt dents - how can I fix them? Can they be fixed using fat grafting? (photos)

Question

I am 27 (female) and I have these horrible dents on the upper and lower part of my butt and they make me feel really insecure. They are even visible through cloths. I have a lean body and don’t think I would be a suitable candidate for BBL. I don't want to go as far as a butt implant, but what about fat transfer? can these dents be fixed using fat grafting?

Gianfranco Frojo, MD · Answer

I believe that fat grafting the areas with the fat that you do have would be an adequate treatment to address these dents. I would recommend seeing a board-certified or board-eligible plastic surgeon with aesthetic surgery training and experience to tackle this type of problem in a safe and efficient manner. Best of luck!

Alan Gonzalez, MD, FACS · Answer

Hello @AC690, Thank you for your question. There are surgical an non surgical options. You could have gluteal lipomolding and improve the overall form of the glutes or a non surgical procedure called sub-incision that is made with a small cannula to release the fibers that have oppressed the part of the skin that are with dents and then a seeding of very diluted radiesse is done to generate more collagen and elastin to improve the depression in the skin. For more information and recommendations, it is best to consult with one or several board certified plastic surgeons. Best wishes! Alan Gonzalez MD, FACS.

Finny George, MD · Answer

Hi, thank you for sharing your question. You have the option of fat grafting or Sculptra to help improve these dents. I hope this helps.

Emmanuel Mallol Cotes, MD · Answer

Thank you for your question. Yes based on the pictures those dents can be fix after the fat transfer to the buttocks and hips, to mold them and get better volume, contour and butt projection, is that we know as "Brazilian Butt Lift" (BBL).

Kind regards,
Dr. Emmanuel Mallol Cotes.-

Kind regards,
Dr. Emmanuel Mallol Cotes.-

Daniel Barrett, MD · Answer

Dear AC690,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from fat transfer. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Andre P. Marshall, MD · Answer

Hi AC690, 
Scars and dents are rarely fully reversible with just fat transfer. You may benefit from scar release/revision and fat transfer at the same time. I would not anticipate 100% correction but I do believe you would see modest improvement. As long as your goals are realistic you would likely be a good candidate. The goal is not perfection, but improvement. You would have enough fat with a lean frame to make these changes most likely, however a formal consult/exam with a board certified plastic surgeon is ideal prior to any official recommendation. Best wishes,

John A. Kotis, DO, FACS, FACOS · Answer

Hi
I see many patients in Chicago with a similar problem. I would recommend fat transfer or even better Renuva fat injections into the dents over the gluteal region. Renuva is synthesized fat with the DNA and adipocytes removed. It is a filler which is designed for soft tissue defects such as these. I would recommend being seen by a board certified plastic surgeon. I wish you the best of luck

Darryl J. Blinski, MD · Answer

Thanks for posting your series of photos. How did you get these dents? You will need 2-3 surgery or injection sessions. I would start with lipo surgery/fat or skinny BBL with directed sub cision release of dents, FEE $6,500. Sessions 2 may be injections of combination of Radeisse/Sculptra 6 vials, FEE $3,000. Please call me ASAP. 
Regards Dr Blinski 
On ING drfixitmiami 
Off 305 598 0091

Douglas Taranow, DO, FACOS · Answer

You are indeed lean, but have ample fat at your flanks and lower back to have either specific fat grafting to the dents, or s BBL procedure. 
Best wishes 
Dr. Taranow

Mats Hagstrom, MD (license on probation) · Answer

Unless something happened or you have another explanation these are basically a more severe version of cellulite. that condition is caused by connective tissue pulling on the skin and simply adding volume will not allow the indented skin to project but will allow surrounding tissues to project instead of making the condition worse.
The treatment must release the tethering connective tissue that’s pulling down the skin. Think of it as a tufted piece of furniture. there are some new devices coming on the market and various treatments for cellulite. Time will tell how well this work. The basic procedure to cut connective tissue under the skin is called Subsicion. this in conjunction with a small amount of grafted fat or use of filler in conjunction it’s probably the only way to correct this and in the end it may still only be a partial correction.
Simply adding volume by itself will most likely not work well at all and anyone who suggests it should be asked to show a nice collection of before and after pictures of previous cases.
Read up on cellulite so you have a good understanding of what cellulite is and the underlying mechanism and you’ll understand why simply adding volume by itself without Subsicion will not work.
Some providers have experience and do these kind of treatments most plastic surgeons do not. You may find more dermatologist and deal with it than the plastic surgeons. You should ask to see proof of quality outcomes before committing to having surgery.
Best,
Mats Hagstrom MD

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