Hello, and thank you for your question regarding whether a 360 circumferential abdominoplasty will make your buttocks flat. Based on the information provided, the impact on your buttock shape and volume largely depends on how much buttock tissue you have prior to the procedure and the techniques your plastic surgeon uses during surgery. During a 360 circumferential lower body lift, a surgical technique known as the propeller flap can be used to preserve and enhance buttock volume. This involves creating a propeller-shaped flap of tissue from the top portion of your buttocks. The top layer of skin is removed from this flap, and the remaining fat and tissue are rotated and secured to add fullness to the central buttocks. This method can significantly improve the shape and volume of the buttocks without requiring additional procedures. If additional enhancement is desired, fat from areas such as the hips or abdomen can be harvested through liposuction, washed, and injected into the buttocks for volume enhancement, similar to a Brazilian Butt Lift (BBL). Alternatively, buttock implants can be placed during or after the body lift to achieve a more dramatic result. Non-surgical options like Sculptra injections may also be considered to add volume gradually. This can be done in the office but may require multiple sessions to achieve the desired results. Lastly, incorporating targeted exercises such as stair climbing, squats, or lunges can naturally build muscle mass and improve the appearance of your buttocks over time. It’s important to communicate your goals clearly with your plastic surgeon to ensure your desired results are achieved while preserving or enhancing your buttock shape. You have options, and with the right approach, you can maintain a beautiful contour post-surgery. Sincerely, Dr. Katzen