What procedure will fix an uneven gluteal fold? (Photos)

Question

In 2023 i got a skinny BBL, i always had a double butt crease butt because i was too skinny and my butt was too flat, the 2nd crease was always hollow. After my BBL fat was filled into the hollow crease on ONE side and made me have a doubke butt crease on one side only. From 2024 - 2026 i got cool sculpting, RF, RF microneedling multiple times to ‘melt the fat’ away from the 2nd butt crease. 2025 I finally decided i needed to do something surgical, so i got lipo to remove it, then i noticed it elongated my butt crease making it look even more noticeable, yes it’s super pretty and i love how my butt looks on that side, but the other side looks literally gone, like i have no butt. Few weeks after the lipo i got 10ml HA filler put into the other side (left side) to hopefully fill in the butt crease, obviously it didn’t do anything. Recently i decided to go big, i got 200ml butt filler done on the left side to fill in the hollow 2nd butt crease and.… boy it looks really, really bad. What are my options now? Should i dissolve my butt filler completely and do lipo to also create an elongated butt crease? Because i’m already down €13.000 euros and I’m literally a student I have no savings left, idk what else to do

Daniel Barrett, MD · Answer

Dear sandyhernandez1009,

it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. 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

Yily De Los Santos, MD · Answer

What you’re describing sounds less like a simple “fat problem” at this point and more like a contour and structural imbalance created after multiple treatments to the same area.

The difficulty with the gluteal fold is that it is a natural anatomical transition — not just a line of fat. Once that area has been repeatedly treated with fat transfer, CoolSculpting, RF, liposuction, and large amounts of filler, the tissues can become uneven, scarred, or distorted in how they contract and reflect light.

Based on your description, I would be very cautious about continuing to add more filler or aggressively removing more volume without a very detailed in-person evaluation. More volume is not always the answer, especially if the issue is now asymmetry in skin attachment and contour rather than simple hollowing.

If the filler currently looks obviously distorted, dissolving at least part of it may be reasonable before making any additional decisions. Otherwise it becomes very difficult to truly evaluate your natural anatomy underneath.

What procedure will fix an uneven gluteal fold? (Photos)

Answers (2)

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