Hello 34HtoB, Thank you for your question regarding what procedure to improve your shape after your lower body lift with dermal flap. Since you are 15 months postop from your lower body lift with your dermal flap, I think you can now start to consider revision surgery. The area that concerns me most is the last picture of the pictures you submitted. This is your posterior picture. This shows a left hip which is much lower than your right hip. There is also a concavity above the left hip resulting in a deep, left hip dip. This seems more severe on your left side compared to your right side. I would suggest a revision body lift. This would entail an incision, but not completely 360 around your body. However, this would include an incision over each hip to raise each hip. During the hip lift, the left hip would be raised more than the right hip. Also, during the same procedure, I would suggest liposuction of the love handles and abdomen. I would use this fat for transfer to the buttocks. ThIs transferred fat would even out the indentations and augment the upper 1/3 to upper 1/2 of your misshapen and uneven buttocks. This can be done in conjunction with your hip dip lifts. I hope this answer helps to clarify what to do with your body lift results. I specialize in reconstructive plastic surgery after weight loss. If you have any more questions regarding the lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy please contact my office. Since the body lift is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience performing the lower body lift. Do your research. Make sure they have performed at least 100 circumferential lower body lift surgeries and have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. If you cannot find an experienced, lower body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic 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 and RealSelf Hall of Fame.)