Inner butt cheeks droop causing a dent/dip in the bottom of my cheeks. What causes this and can it be fixed? (photo)

Question

39-year-old female 5’7” 135 lbs. I have always had “bottom heavy” butt, but over the past couple of years, I’ve noticed this weird dent just to the outside of my inner butt cheeks. What causes this? I can’t tell if it’s because my inner butt cheeks droop or something to do with the location of the dent itself.

Ryan A. Stanton, MD · Answer

Allow me to answer your question as best i can based upon your single photo. 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.

The lower buttock dents you describe, are the result of multiple factors: A) this is the area that sustains the most direct pressure when sitting, because there is a underlying bone there, thus the fat layer tends to thin out there first, B) there exist a ligament from this bone to the skin that helps suspend the skin  while the surrounding fat pads of the lower buttock cheek descends (sags) over time and aging.  Unfortunately, fat grafting to this area tends to fail miserably. When the process becomes more severe, you can consider restoring volume with a buttock implant and/or undergoing a lower buttock tuck.

Please note, because an extremely few number of board certified plastic surgeons specialize in buttock implants or lower 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.

Daniel Barrett, MD · Answer

Dear jwjethompson,

it is hard to tell for sure without an examination. 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

Ajaya Kashyap, MD · Answer

Thank you for your query. A small amount of fat grafting with a radio frequency tightening should work well for Improving the contours of the area. Please find an experienced board certified Plastic surgeon who can examine you and help[ you with all your concerns. All the best!

Chet Mays, MD · Answer

Thank you for your inquiry!  There are options for you.  Depending on what is causing the dent, Aveli or a small amount of fat transfer to the area would help.   We would love to sit down with you and discuss your concerns. Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

Mathew A. Plant, MD, FRCSC · Answer

Excellent question. This is an indentation from cumulative time spent on a toilet over your 39 years on this planet. The pressure of your body causes the tissue to compress at the inner ring of the toilet bowl and forces the other tissues to herniate through medially. This can be fixed as part of a Brazilian butt lift procedure if your surgeon recognizes the problem and specifically delivers fat to the area to correct the indentation. In some cases this is so severe that it can't be fully corrected without releasing the scar tissue first but in these photos it appears as though yours would likely correct with just a fat transfer. Hope that helps!

Inner butt cheeks droop causing a dent/dip in the bottom of my cheeks. What causes this and can it be fixed? (photo)

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