I did 2 rounds of Venus Bliss with zero result. What butt procedure do I need? (Photos)

Question

I'm having a hard time figuring out the right procedure for me. I did 2 rounds of Venus Bliss with zero result. I've researched BBLs, Thong Lifts, and banana roll removal and am still unsure best option for my concerns. Photos attached. I know a have a lot of areas that could be fixed with lipo and fat transfer, but I want to know what will specifically fix the circled areas.

Rajaie Hazboun, MD, MBA · Answer

Thank you for posting your question here!My answer is based on the limited information and pictures provided, for a detailed and bespoke plan I would recommend consulting with your plastic surgeon in person.
The circles include the banana roll area and some posterior thigh cellulite. Fro the cellulite aspect of it the best treatment on the market right now in the states and the only FDA approved one is Avelli which works great!, as for the banana roll are the treatment of the area is tricky , the fat in that area is usually described in literature as being the pillar that holds the buttock in place and that over resection of the fat in that area can lead to buttock sagging. Sometimes judicious liposuction can work , but you have to keep in mind that there is a risk of buttock sagging which if it happens you can have a lower buttock tuck. The other thing that can improve the aesthetics of the area is restoring buttock volume and improving fat distribution which is usually done with fat grafting (BBL) or an implant .I hope this helps, best of luck!

J. Timothy Katzen, MD, FACS · Answer

Hi Sociable293681, Thank you for your question regarding what to do for your buttocks after two rounds of Venus Bliss with zero result, and what butt procedure do you need?  Thank you for your history and pictures.  A consultation would be mandatory before any surgery could be suggested.  However, we can analyze your pictures.  You have cutis pleonasmus (excess skin) and dermatocholosis (loose skin) of your upper posterior thighs.  You do not have lipodystrophy (excess fat) in your buttocks.  Your buttock shape looks good; the main tissue issue appears to be the extra skin at the top of your thighs.  The only way to remove excess posterior thigh skin is with an incision.  You would not want to transfer fat to the back of the thighs; the results would look disproportionate.  Alternatively, undergoing more banana roll liposuction would make this area worse, not better.  Also, a BBL and a thong lift affect the butt, not the problem area, namely the banana roll.  Therefore, most plastic surgeons would agree that you need an infra-gluteal fold posterior thigh lift (IGFPTFL).  There are many types of thigh lifts.  However, based on your pictures, most plastic surgeons would recommend a crescent or infra-gluteal roll approach.  The infra-gluteal roll is also called a "banana roll."  An infra-gluteal fold posterior thigh lift is performed under general anesthesia and takes about 2 to 3 hours to complete.  During an infra-gluteal posterior thigh lift, an incision is made in the "banana roll' from the lateral thigh and extending into the groin.  Then, tissue dissection is carried down the back of the thigh.  The posterior thigh is then advanced upwards and towards the fold.  The posterior thigh flap is anchored to the pelvic periosteum and pelvic wall fascia with permanent sutures.  This surgical maneuver minimizes tension on the infra-gluteal incision, thereby decreasing the risk of wound opening and scar spread.  After anchoring the flap, a crescent area of skin and fat is removed.  The remaining incision is closed in layers.  Usually, drains are not necessary.  Allow yourself a 3- to 4-week recovery.  During your recovery, you must remain flat on your abdomen.  This position minimizes the chances of wound openings.  Also, avoid sitting or bending at the back to prevent opening the wound.  
Good luck.  Most plastic surgeons offer free virtual or in-office physical consultations.  Therefore, explore what other plastic surgeons have to say.  I hope that I have answered your question regarding a butt lift.  If you have any more questions regarding an infra-gluteal fold posterior thigh lift or buttock lift, contact an experienced plastic surgeon. Please seek an experienced, board-certified plastic surgeon with significant experience in butt lifts.  Make sure they have performed many buttock lift surgeries and have the before-and-after pictures to prove it.  Carefully examine their before-and-after photos and review their RealSelf profile.   
If you cannot find an experienced plastic surgeon in your neighborhood, consider traveling out of state.  Sincerely, Dr. Katzen. (Plastic Surgeon, President of  the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

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.

First and foremost, i’m very sorry to hear that you wasted good money after a bad use of  Venus Bliss for this particular area of concern.  Venus Bliss and any other “minimally invasive skin tightening device/procedure” are not effective for this problem.

Here is what i can tell you, buttock “sagging” 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 with just a buttock lift from above. A lower buttock tuck is usually then performed at six months following implants. Coincidentally, a lower buttock tuck also doubles as a thigh lift, by also removing any loose skin and folds from the back of the upper thigh. 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. Please note, because an extremely few number of board certified plastic surgeons specialize in buttock implants, 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.

Luis A. Mejia, MD · Answer

Dear Sociable293681, thanks you for sharing your concerns and pictures, after evaluate your case you will be benefit from a Liposuction on your abdomen, flanks and back, ultrasound guided BBL and an inferior cut to get rid of the '' Banana rolls'' under your buttocks, this will provide you an amazing shape and smooth results. Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia.

Gary M. Horndeski, MD · Answer

You will need a lateral thigh lift, which pulls the greatest amount laterally and will define the buttocks crease better.  I do not recommend liposuction as the skin will hang and look even worse.

Best Wishes,

Gary Horndeski, M.D.

George Marosan, MD · Answer

Thank you for your question and photos. Based on your photos and circled areas, you are a great candidate for the GoldIncision procedure. The areas circled, are deep fibrous attachments of the skin to the muscle fascia. The GoldIncision procedure is done awake under local anesthesia and involves injection of biostimulators and detachment of the fibrous attachments. I am the only licensed plastic surgeon in the US for this procedure. Liposuction and fat grafting will not work for the circled areas, matter of fact you can expect a worse outcome. You already found out that Venus Bliss will never correct this. There's no downtime with the GoldIncision, patients can fly out in 1-2 days if out of town. A second touchup treatment is done at 90 days at no charge if needed.

Zoran Potparic, MD · Answer

Based on these photos a combination of liposuction and fat grafting would be an option to consider. In person consultation with a board certified plastic surgeon with good reputation in body contouring surgery is recommended. Good luck.

Arif Eroglu, MD · Answer

Hello
I would recommend Controlled Vaser Liposuction for the hips and banana fold, and Renuvion J Plasma to reduce skin laxity.

Mats Hagstrom, MD (license on probation) · Answer

When you signed up for Venus Bliss, did the providers show you any before and after pictures of previous patients who had similar problems in the before pictures? The areas you’ve pointed out a really difficult to fix and in reality that really is no good treatment for those areas.
Neither Liposuction nor a fat transfer is good at treating those particular areas.
 Before signing up for any more procedure, especially surgery, which can make things worse. You should always insist that the provider shows you and impressive collection of before, and after pictures of previous patients who has similar body characteristics.
An experience provider should have no shortage of before, and after pictures if they claim their treatment can fix these problems.
The problems need to be in the same anatomic areas because those areas are really hard to fix.
 Personally I’d probably not recommend any treatment for you.
I know you want to improve your body I think spending money on things that don’t help or potentially make things worse less option than trying when the potential outcome is not good.
Not everybody or every part of the body is good for either liposuction, fat transfer or both.
Best,
Mats Hagstrom MD

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