What procedures would fix my butt shape? (Photo)

Question

Hi i got a 360 and thigh lift around 3 years ago. I love everything but noticed by butt still feels unfinished. I am unsure what treatments to do. I workout 4-5 times a week via weight lifting and want to see what my potential options are. Skin feels thick when i pinch it but yeah again wondering if i need to add more volume, a posterior butt lift revision after the 360, scar revision, radiase, bbl?

J. Timothy Katzen, MD, FACS · Answer

Hello, Polite 957127, in Riverside, California. Thank you for your question regarding what procedures would improve your butt shape. Thank you for your history and your picture. From your picture, it appears that you have had a 360 circumferential lower body lift. Your picture shows that you still have excess skin in the medial (inner) third and lower third of your buttocks. Treatment really depends on what you’re looking to achieve. If you’re looking for a bigger butt, proceed with a BBL. A BBL will add fat to the buttock, increase the volume of the buttock, and hopefully fill in the wrinkles near the butt crease and the lower portion of the buttock. If you do not want the buttocks to be bigger, consider a revision posterior butt lift. During a posterior butt lift, an incision is made slightly above the body lift. Upper buttock skin is dissected, lifted, and removed. During the posterior butt lift, the 360 circumferential lower body lift scar will be removed. Most plastic surgeons would suggest doing liposuction of your love handles. Liposuction of the love handles will give you more of a waistline and yield fat for transfer to the buttocks. Most plastic surgeons would agree that radiase will not significantly help your butt cheeks. Other options include injections of Alloclae or cadaver fat. The filler can increase the volume of the buttock if you don’t have fat. However, from your pictures, it appears you do have some fat in the love handle region. However, if you don't have enough fat or want more fat transferred than you have to give, Alloclae may be a suitable option. Alternatively, you could combine the fat transfer to a lower portion of the buttock and the buttock lift to be performed at the same time; this procedure is achievable. Your recovery after the fat transfer would be on your abdomen with your buttocks in the air, protecting the fat cells from compression. Most plastic surgeons think it would be difficult just with weight training, exercise, and diet to tighten the buttock skin in the picture you provided. Good luck. I hope my response answers your question about procedures to fix your butt shape. 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.

Buttock “sagging” and/or loose skin 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 if just a buttock lift from above is performed. On the other hand, an “autologous buttock lift” usually provides very little volume and projection, and almost nothing to the lower 2/3rds of the buttock.

A lower buttock tuck is usually then performed at six months following implants. Coincidentally, a lower buttock tuck also doubles as a thigh lift, removing loose wrinkled skin from this area as well. 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.

Any “non-surgical” treatment or device as well as exercise, unfortunately, will have little to no effect on this problem area. Furthermore, fat transfer and “fillers” perform very poorly in this area and usually result in just a waste of hard earned money.

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

Gary M. Horndeski, MD · Answer

It appears that the circumferential lift did not cross the midline posteriorly and you have excess hanging skin medially. You would benefit from a revision of the lift. This can be done with removal of the fat and skin or possibly with a flap to transfer fat to give your buttocks more projection.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Manuel Diaz, MD · Answer

Hi. Based on your photo and the fact that you are already three years out from your previous surgeries, I would consider a revision BBL with fat transfer. This could add volume strategically to the areas that still look somewhat deficient and help create a rounder, smoother, and more complete contour without necessarily making the buttocks dramatically larger. Revision fat grafting is commonly used to address insufficient volume and contour irregularities after previous procedures.
Because you have already had a 360 lift and thigh lift, an in-person examination would be important to evaluate your skin quality, scar tissue, and available donor fat before deciding exactly how much improvement can be achieved.

Mats Hagstrom, MD (license on probation) · Answer

I’m guessing you have a history of significant weight loss based on the previous procedures you’ve had.
I don’t think there’s any procedure that’s going togive you the outcome you’re hoping for.
You may just have to accept this for what it is and realize the other procedures had improvements that may not be possible on the buttocks.
I know that’s not very helpful but I think it’s good to understand limitations order to make a decision of procedures that may not give the benefit you’re hoping for.
Best,
Mats Hagstrom MD

What procedures would fix my butt shape? (Photo)

Answers (5)

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