What can be done about multiple gluteal folds, and buttocks and thighs joined together? (Photo)

This is a great question and I'll be frank, there are no easy answers.  The option with a reasonable chance for improvement with the lowest chance of problems is to do a fat transfer with some careful infragluteal liposuctioning.  If done by an experienced surgeon, you should see improvement but it is not easy to create a single crisp infragluteal fold.  Excision procedures in this region can work but aren't usually the first option.  

I would at least get a consultation for a BBL.  It may give you contour enhancement that you'll be happy with.  Reconstruction of the fold is also an option but truly I have only heard of the procedure and have not done it myself.  Best Wishes!!

While your photos are helpful, I would recommend an in person consultation with a board certified plastic surgeon to get a concrete recommendation. In general with patients looking to improve the shape of the buttocks, fat grafting to make it look it's best. Fat grafting gives you the most flexibility when sculpting the buttocks. In my practice, I've seen that an implant can enhance the volume of the buttocks and works well for patients who already like the shape. 

Hello dear!
Thanks for the question and provided information as well.
Based on your pictures, you are a good candidate for liposuction with BBL, and I think you'll get very good results. 
Liposuction allows your plastic surgeon to transform your entire shape. You can improve your abdomen, hips, back and flanks, and of course your buttock, to give you a beautiful heart shape.
In general, you need to be physically healthy and at a stable weight, have realistic expectations, be a non-smoker and your BMI needs to be 30 or less.
l recommend you to make an appointment with a board certified plastic surgeon to talk about your goals and anything you need to know.
Good luck :)
 

In a case like yours I would do a thorough examination to determine how much fat could be harvested from other areas of your body. Fit individuals can be a challenge but frequently small amount of fat can be taken from multiple areas. Depending upon how much fat is available the area of your concern can be improved slightly or perhaps corrected significantly. The fat will give your buttocks more shape and volume and help to define a separation between the lower buttock and back of the thigh. Additional fat could be used to taper into the depressions located on the sides of your thighs as well. The skin line you have may be reduced to some degree by the additional volume but will probably remain to some degree. You need to have a thorough evaluation with a surgeon who can determine if you have enough fat to transfer. Choose your surgeon wisely so that what fat you do have is put to good use.  Best of Luck   Dr Harrell

You are a great candidate for buttocks enhancement using buttocks implant augmentation; you may have your lower lateral thighs and flanks liposuctioned to correct all of your concerns. Please see examples below.

Your overall shape and contour could improve substantially from my Brazilian butt lift.The folds and creases are much more difficult to fix.That is because they represent skin folds and have nothing to do with  volume or fat distribution.They may improve somewhat with fat transfer but liposuction by itself rarely if ever fixes infra gluteal folds or what is often referred to as the banana roll.I suggest you consult with one or more board-certified plastic surgeon who specializes in body contouring.Best,Mats Hagstrom M.D.