51, how to remove extremely saggy butt skin permanently? (Photos)

Question

My buttocks is extremely saggy. It causes me such distress that I don’t want to wear a swimsuit and I have nightmares about it. I want a permanent solution, not filler. I don’t want implants and was told I don’t have enough fat for a BBL/fat transfer. A few years ago I made the mistake of doing CoolSculpting and it was suggested that I do the “banana roll.” I don’t know if this is the reason for the extreme sag but I need to do something ASAP. I’m 51 years old. Thank you!

Luis A. Mejia, MD · Answer

Dear Dubaidream, thanks for sharing your pictures and question. Aftrer analize your pictures and desires you look like a great candidate for Butt Lift, this will permanent ger rid of this saggy skin and will allow your surgeon to improve your butt shape a little bit, Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia.

J. Timothy Katzen, MD, FACS · Answer

Hi dubaidream,

Thank you for your question regarding how to permanently remove extremely saggy butt skin. I appreciate your history and the two pictures you provided. I do not think CoolSculpting caused this issue. Since you mentioned no other surgeries or significant weight loss, it's unlikely that the CoolSculpting procedure, which targets fat in the banana roll area, is responsible. Now that we've assessed the situation, let's explore surgical solutions.

There are two primary options to address this area:

Option Number One: This involves an incision across the top of your buttocks, extending from your vertical buttock crease to the top of your hip on each side. A large, horizontally placed elliptical area of skin and fat would be removed from the upper third of the buttock. This procedure would lift the buttock and permanently eliminate the wrinkles in the banana roll area.

Option Number Two: This option entails making an incision underneath the buttock, where the buttock meets the back of the thigh. The incision would remove a crescent-shaped area of skin from the lower third of the buttock and the upper thigh. The resulting scar would rest within the crease between the buttock and the posterior thigh. Most plastic surgeons view this as a secondary choice.

In conclusion, the best solution to permanently remove extremely saggy butt skin would be an incision across the top of the buttock. Plastic surgeons refer to this procedure as a butt lift, posterior buttock lift, or a posterior body lift. I hope I have answered your question on how to permanently remove extremely saggy butt skin and provided useful solutions. Good luck.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Ryan A. Stanton, MD · Answer

Buttock “sagging” 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 be shortened but may appear more flat with just a buttock lift. A lower buttock tuck is usually then performed at six months following implants. 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. Please note, because an extremely few number of board certified plastic surgeons specialize in buttock implants and/or lower buttock tucks, you may have to travel away from your local area to seek consultation with this particular type of surgeon.  Glad to help.

John Michael Thomassen, MD · Answer

Even though your are thin, there is always some fat that can be harvested and then grafted in this area to improve the appearance without scars.  Even if just 100 cc is available this can make a significant improvement.

Zoran Potparic, MD · Answer

In patients like you we recommend a true butt lift; an incision is made transversaly in the area where buttock meets lower back and elipse of skin and fat tissue from that area is burried underneath the skin of upper butt, while mid and lower butt skin, together with fat tissue is pulled up. This creates nice volume augmentation of the upper and mid butt and also lift and correction of banana roll. In person consultation or teleconference with a board certified plastic surgeon familiar with this procedure is recommended. Good luck.

Mats Hagstrom, MD (license on probation) · Answer

Volume restoration would be the best and the best would be fair to transfer. Have you included pictures of the rest of your body we could’ve made an assessment to see if that could be harvested from Samaria. Plastic surgeons will have very different views on how much fat can be harvested, and there are areas that should be considered like arms, size upper back, full torso, etc. 
Perhaps you don’t have enough ad for an ideal perfect BBL, but you probably have enough to get a saddle improvement which is better than no improvement, considering there are no other good options.
The first picture has an incision mark that looks very consistent with previous liposuction. Are there other treatments you’ve had you did not include?
Liposuction and fat, transfer skills very dramatically among different plastic surgeons. The number of plastic surgeons have mastered. These procedures are in a small minority. To find the right provider requires having multiple in person consultations. I suggested patient start the process by having at least five in person consultations to find the right provider. There are no good alternatives other than fat grafting based on the criteria you’ve stated. Consider posting full body pictures wearing undergarments
Best,
Mats Hagstrom, MD

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