Hollows in buttocks - other than implants, what are the best options? (Photos)

Question

I’m 50 years old, 5’4” and weigh 58kg. I have hollows in my buttocks. They are further round than the hip dips and at an oblique angle look like I have saddle bags. I don’t want implants as I had breast implants removed due to BII. I’m not sure if they are still classed as hip dips. I don’t have a lot of fat. I have increased glute exercises. What are my options?

Miguel Mota, MD · Answer

Hi! Your only real option is liposuction with fat grafting. 360 Lipo will yield more than enough fat to correct your depressions. You are actually a very good candidate for fat grafting. Butt implants will not work.

Best of luck,
Dr. Miguel Mota

Best of luck,
Dr. Miguel Mota

Fernando Ovalle Jr., MD · Answer

Hello and thank you for your question.

Your hip dips appear amenable to fat grafting! Fat can be obtained from multiple donor regions if needed (i.e. abdomen, flanks, upper inner thighs, upper inner arms). Even in patients who "don't have a lot" there is enough to make a nice difference in a discrete region such as your hip dips as opposed to a large BBL. The next best step would in an person consultation with a board certified plastic surgeon. Thank you again and good luck on your journey!

Luis A. Mejia, MD · Answer

Dear SLP37, Thanks for sharing your pictures and concern, after evaluate your pictures you look like a great candidate for what is also know as Skinny BBL, liposucuction from abdomen, flanks, back and arms, will provide enough fat to fill those hollows provide and smooth and beautiful shape. Using the Ultrasound guided BBL your surgeon will easily knowthe right spot to place the fat and get rid of those hip dips and gluteal dips. Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia.

Daniel Barrett, MD · Answer

Dear SLP37,

based on your photos, you look like a good candidate for a BBL. Liposuction of your abdomen, back and flanks should give you more curves and hourglass shape and fat transfer to buttocks should give you more projection. I would suggest you to consult a board-certified plastic surgeon because 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

Ajaya Kashyap, MD · Answer

Thank you for your query.  Based on your photos, you appear to have  adequate fat for a fat transfer to improve the hollows on the sides of your buttocks, Fat harvesting through micro cannulas or Waterjet liposuction will preserve most of the fat as would skilful injections in multiple planes. Please find an experienced board certified Plastic surgeon who can examine you and help you with all your concerns . All the best!

Zoran Potparic, MD · Answer

Providing that you do not expect large hips it is very likely that fat grafting will provide good result. However, this needs to be done by a board certified plastic surgeon with experience in fat grafting. Good luck.

Rajaie Hazboun, MD, MBA · Answer

Thank you for posting your question here!my answer will be based on the limited information and pictures provided for a detailed and personalized plan please consult with your plastic surgeon in person.From your pictures you do seem to have little fat , I cannot confirm just based on the pictures if fat grafting would be possible but probably a small amount of fat obtained through liposuction and grafted in those areas should help soften the hollow areas, the liposuction to begin with will also help improve the overall shape by taking down the love handles, and saddlebags thus decreasing the concavity somewhat.you can also consider adding some biostimulators or structural adipose filler at a later date if you are still not satisfied with the outcome such as renuva, alloclae or sculptra . That being said those are all suggestions based on the limited information and your aversion to implants , for personalized plan I would recommend consulting with your surgeon in person.I hope this helps, best of luck!

Marvin F. Shienbaum, MD · Answer

Hollows in the buttocks, often referred to as "hip dips" or indentations on the sides of the upper thighs just below the hip bones, are a common concern. While implants are a surgical option to add permanent volume and smooth out these areas, several non-surgical treatments can offer significant improvement:

Here are some of the best non-surgical options for filling hollows in the buttocks:

1. Dermal Fillers (Off-Label Use):

How they work: Injectable dermal fillers, typically hyaluronic acid-based fillers designed for the body, can be used to add volume directly into the hollow areas. These fillers provide immediate results.   
Pros: Immediate volume enhancement, relatively minimally invasive, can be precisely placed to target the hollows.   
Cons: Temporary results (lasting from 12-24 months depending on the filler), can be costly due to the amount of product needed for the buttocks, potential for bruising and swelling. This is considered an "off-label" use as most hyaluronic acid fillers are FDA-approved for facial use.
Examples: Hyacorp, Lanluma, and other high-volume hyaluronic acid fillers.

2.Fat Transfer (Non-Surgical or Minimally Invasive):

How it works: This involves using liposuction to remove a small amount of fat from another area of your body (like the abdomen or thighs) and then injecting it into the hollows. While traditional fat transfer is surgical, some clinics offer minimally invasive techniques using smaller cannulas.
Pros: Natural-looking results as it uses your own tissue, can provide longer-lasting improvement compared to fillers (though some fat reabsorption is expected), can also contour the donor area.   
Cons: Still involves a liposuction component (though potentially less invasive), some downtime associated with liposuction, results can be unpredictable due to fat reabsorption, may require multiple sessions.