What options I have to either remove or lift up sagging inner butt cheeks? (Photos)

Hi Thrifty4017,
Thank you for your question regarding options to remove or lift sagging inner buttock cheeks, and for providing your pictures and history. You have two main options:
Option One - Butt/Posterior Body Lift:
Involves an incision across the top of the buttocks, from one hip to the other, crossing the vertical gluteal cleft. Known as the “little M scar” or “seagull wing” scar, this procedure lifts the buttocks and elevates the skin between the legs.
This approach typically offers the best result in terms of lifting but has a more visible scar.
Option Two - Infra Gluteal Approach:
This method involves an incision in the banana roll area, underneath the buttocks. The infra gluteal approach focuses on removing excess skin from the lower part of the buttocks.
It offers a concealed scar but might not address the sagging as effectively as the first option.
Overall, the first option is likely to give you the best lift, although it comes with a more noticeable scar. The second option provides a less visible scar but may not be as comprehensive in treating the sagging area.
I hope this clarifies your options for addressing sagging inner buttock cheeks.
Sincerely,
Dr. Katzen

Buttock “sagging” is usually a combination of loss of volume or deflation (after weight loss 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 (yes, this is your best option and a relatively safe option when performed by an experienced specialist). This will create a more desirable smooth and rounded perky buttock profile. If not adding volume with an implant, the buttock will be shortened but may appear more flat with just a buttock lift. On the other hand, if any sagging remains, a lower buttock tuck can then performed at six months following implants. 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. Glad to help.

It is an interesting question and very difficult issue to correct. Usually, an incision is placed in medial portion of the crease and entire square bulk is shaped, lifted and fixed to the ischial bone. Very fine procedure that should be done by someone experienced in this, relatively rare surgical correction. Very likely that one could harvest enough fat from your torso to provide for small augmentation of buttocks. Hope this helps. Good luck.

The best treatment for this is well described on a YouTube video by Dr. mendieta in Miami Florida. I believe that YouTube video is called the Miami Thong Lift.
That video does a better job of describing the condition and the treatment options than anything I’ve seen anybody write on the subject.
Finding providers who have experienced and can do the procedure consistently with quality result is a different story. Have a lot of consultations and specifically ask providers to shell before and after pictures of patients with similar looking bodies and what the results look like long-term after.
Your condition cannot be corrected with a BBL or by adding volume.
It needs to be done with skin excision which will leave a scar and has certain drawbacks.
Weather the procedure in the end is worth it or if you can find a provider who can do it successfully is another story.
Whenever possible try to stay local and avoid a virtual consultations instead of opting for in person consultations whenever possible.
You may have to consult with a fair number providers before you find someone who can do this correctly for you.Look for doctors who do a lot of gluteal augmentation in general.
Best,
Mats Hagstrom MD