How to Eliminate Wrinkles Under Buttocks After Major Weight Loss? Surgical vs. Non-Surgical Options? (Photo)

Allow me to answer your question as best i can based upon your photo. 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” 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 with just a buttock lift from above. 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.

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.

Non-surgical options are not effective. You will need a buttocks lift. I use the extra skin and fat to make a flap to make more posterior projection of the buttocks. This will lift the buttocks higher but may not be able to eliminate all the wrinkles. You may also benefit from a medial thigh lift or a lateral thigh lift.

Best Wishes,

Gary Horndeski, M.D.

In patients who have experienced significant weight loss, skin elasticity is often compromised more severely than in those with age-related changes or minor fluctuations. The wrinkles and creases under your buttocks are primarily due to excess, stretched skin — not something that can be corrected with exercise alone.

Only on the basis of in person evaluation one could give you good advice. Options are: thigh lift with incision and scar in gluteal crease or both buttock and thigh lift with same incision plus incision above buttock. Hope this helps.

Congratulations on your weight loss. Unfortunately I don't think there is anything you can do surgically or non-surgically to resolve the laxity. Working out in the gym while wonderful to do won't fix it either because it is not possible to hypertrophy muscles enough to take up this lax skin.