Which procedure could help with my sagging flat butt? (photos)

Question

I'm approaching 50 and would like to fix the flatness and sagging skin on my butt. Squats are not helping. I'm 5'10" 140 pounds. Would the advice be something like a butt lift, BBL, J-plasma or something else? Thank you.

Dhaval M. Patel, MD · Answer

Thank you for your question and photos. From your photos, you are a good candidate for BBL. Liposuction will remove excess fat from unwanted areas. Fat transfer to your hips & buttocks will increase volume in your buttocks filling in hip dips and improve shape. Your expectations and health will dictate the best procedure(s) for you. I suggest a consultation with a board certified plastic surgeon to go over the options that best address your goals. Best of luck!

Dhaval Patel MD
Double Board Certified Plastic Surgeon
Chicago
South Barrington
Oakbrook
Orland Park SHOW LESS

Dhaval Patel MD 
Double Board Certified Plastic Surgeon 
Chicago 
South Barrington 
Oakbrook 
Orland Park SHOW LESS

Phillip Chang, MD · Answer

Hi tekken50

The procedure is performed to enhance the buttock by transferring fat from areas that you might not want it ( such as the abdomen, waist, and thighs ) to the buttock to give it a more uplifted, rounder, and shapelier appearance. For more information about this procedure, please visit our website.

Kenneth Hughes, MD · Answer

Hello, thank you for your question. An inferior buttock lift and BBL would probably yield the best result. Consult with a board certified plastic surgeon who performs this procedures often with great patient feedback.

Ryan A. Stanton, MD · Answer

For someone of your age, leanness, and high metabolism, your best chance for a relatively safe, predictable, and  long-term successful outcome is to restore volume and fullness with buttock implants. BBL, J-Plasma, Emsculpt, etc are sure failures and/or provide minuscule results on someone like you.  A lower buttock tuck may also be beneficial to better define and tighten the lower buttock fold. Glad to be of help.

Daniel Barrett, MD · Answer

Dear tekken50,
it is hard to tell for sure without an examination. Based on your photos, it doesn't look like you have a lot of extra fat. If you are considering a surgery, I would suggest you to 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

Giancarlo McEvenue, MD, FRCSC · Answer

Hello,
You currently have a BMI of 20.1 which puts you at the low end of normal. The simple solution that does not involve surgery is to put on weight to increase gluteal volume. This shuld be done with exercises that focus on the gluteals (squats, lunges etc) and with increasing your caloric intake. Once you are around BMI 24-25 you could then become candidate for a BBL which can transfer fat from other areas into your buttocks.SincerelyDr.G

Jonathan Kaplan, MD, MPH · Answer

Yes, you would benefit from a skinny BBL meaning we would take fat from all available fat sources - abdomen, flanks, arms, back, inner thighs - and inject the fat into the buttocks to give you the shape you want. Best of luck.

Mats Hagstrom, MD (license on probation) · Answer

Skin laxity is contributing to the way your body looks to some degree. My first hand experience with J plasma was pretty unimpressive. I have since sold the equipment because I really saw zero skin tightening improvement from this procedure and I would encourage you to not pursue that route.

You have very little subcutaneous fat in your buttocks.

You don’t have much subcutaneous fat on any of the body parts you showed in your picture. The BBL is probably the best procedure.

Something to consider is that the lack of subcutaneous fat in your case also means there is a pretty limited amount of tissue to serve as host tissue to support any fat graft.

Historically that was grafted into subcutaneous fat and the gluteus muscle but most plastic surgeons are now not grafting fat into the muscle though I’m sure it still happens either with intent or in advertently from time to time.

In your case an assessment needs to be made if you have sufficient amount of body fat for a fat transfer procedures and also how much of a results you’re looking to obtain?

It seems to me that your biggest need is to fill in the hip dips even more than the buttocks or perhaps the transition zone between your hip dip and buttocks.

I suggest having multiple in person consultations with local board-certified plastic surgeons who have a proven track record with this procedure.

Your body type is not typical for this procedure and in your case it is even more imperative to choose surgeons who have a proven track record.

In the end it may or may not be a worthwhile procedure to undergo.

To get the best outcome and experience  I suggest the following.

Stay local for elective surgical procedures.

Whenever possible schedule in person consultations with multiple providers.

During each consultation ask each provider to show all of their before and after pictures for this procedure. The goal is to see what average results look like and to get some idea of how many of these procedures each provider has performed.

Be careful of providers who don’t have evidence of extensive experience.

Read all the reviews on various physician review websites avoiding providers with any significant number of justified negative reviews. These are far more telling than those with an abundance of positive reviews.  Highly reviewed practices often encourage patients and have strong marketing campaigns.
Organic unmanipulated reviews tend to fall fairly equally among different physician review websites.

When in doubt slow down and scheduled more consultations.

Never schedule surgery during a consultation or until you’re finished all your scheduled consultations.

In your case I think you should have an honest discussion with each plastic surgeon you meet with in regards to grafting fat Into the gluteus muscle or not.  My best guess is that the great majority if not all the plastic surgeons will deny that they ever graft that into the gluteus muscle.  grafting fat into the gluteus muscle especially deep into the gluteus muscle has been associated with a complication called fat embolism which can be fatal and has been reported to happen and as many cases as one out of 3000.

In your case there is simply very little other tissue to graft into if an impressive result is going to be obtained.

There’s probably some healthy balance of doing this correctly balancing risk versus results in a correct manner.

This is something I think that should be discussed individually with each provider you talk to.

Best,

Mats Hagstrom MD

Which procedure could help with my sagging flat butt? (photos)

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