Loose skin, deflated butt after weight loss. Can I have procedures on thighs and buttocks at the same time? (Photos)

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, 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.

You will need 2 procedures but I would not do them at the same time. I would do a medial thigh lift to correct the skin of your inner thighs, which is excessive and there is very little fat present. Then, on a separate occasion, I would do a butt lift or posterior thigh lift with flap transposition. The excess skin and fat that is normally resected with a butt lift is formed into a flap to give you more posterior fullness of the buttocks.

Best Wishes,

Gary Horndeski, M.D.

Over 30 years ago we developed a technique of buttock lift and flap augmentation. This involves lifting the buttock using an incision above upper border of buttocks, lifting the skin off the buttock muscles and using the skin flap from just above buttock (which would otherwise be discarded) to fill and augment central and upper portion of buttocks. This creates nice contour and volume improvement and eliminates flat butt appearance. Good luck.