What I can do to help smooth out dents and have a rounder shape without having surgery? (Photos)

Thank you for the question and pictures. You may be unhappy with the look of your derriere and want more volume and firmness. A Sculptra BBL can help you have a firmer, more lifted butt by stimulating the natural production of collagen, causing the skin to become thicker and adding subtle volume. This treatment may be appropriate for those who would like to enhance the appearance of the butt, but do not have enough excess fat to perform a standard Brazilian butt lift with natural fat transfer. Unsightly dimples will become smoother, and your butt will be subtly lifted as the skin firms and thickens. The results are long-lasting and do not involve the longer recovery time associated with natural fat transfer to the butt.

Getting the results you want is going to be more difficult. You have cellulite and cellulite is difficult to treat. The best way I can describe the impact that cellulite has is the demonstrate skin on the hand.
Areas on the body that can tolerate a lot of pressure tend to have connective tissue that stabilizes the skin to the underlying muscle fascia. If you take the hand for example you can pinch the skin and pull it up like a tent on the back of your hand. If you’re not try that in the middle of your palm you’ll recognize that the skin is stuck and will not project at all.
This is exactly what’s happening to the skin of your buttocks. The surrounding areas have less connective tissue and are expanding with increased subcutaneous fat while the areas with more connective tissue will not budge and stay the same distance creating a bumpy appearance like tufted furniture. Simply adding volume tends to make the problem worse because it’s not treating the problem which is connective tissue bands pulling on the skin. This is why patients who have bad cellulite should avoid having procedures like the BBL.
Nonsurgical treatments are generally based at cutting the connective tissue bands either with a semi surgical approach called subcision which is sometimes done with a device called Celfina. There’s also a relatively new injectable drug on the market that dissolves connective tissue but honestly I have a little faith that this will turn out to be a great option.
In your situation gaining weight is likely to make your condition worse but losing weight will also probably not improve the condition that much. there simply is no great treatment for cellulite.
Be careful of providers who claim they can correct this with injecting fat or fillers without showing you clear evidence of previous successful work. any results from fat transfer need to be at least three months out to be legitimate.
It’s possible that conservative liposuction of the surrounding areas could help match the inner lower buttocks but overall the improvement would be fairly marginal and I question if anybody would see it as highly successful.
There may be other providers who know things I don’t but I can tell you that I’ve been a board-certified plastic surgeon for 25 years I’ve done over 8000 liposuction and fat transfer procedures and my practice has been devoted exclusively to Liposuction and fat transfer for the last decade.
I have more experience working with fat and body contouring than most surgeons will ever have in their lifetime.
Your situation is difficult and there’s no easy treatment.
Some improvements can almost always be had with conservative trial and error appropriate treatments but whether this is worth it or not and the amount of improvement is justified can vary greatly between individuals.
Should you choose to move forward with any type of surgical treatment and the choice of provider becomes critical.
In regards to non-surgical treatments there are none and I would suggest not wasting your money on any thing offered or advertised to help your cause.
Best,
Mats Hagstrom MD

Looks as though you would benefit from the rounding and plumping from your own natural fat. Remove fat from were you don’t want it and add it to were you want it!
It is great to repurpose fat for the breast, buttocks and lips!
Best. DrBrecht
Seattle, Wa