Low buttocks and upper thigh wrinkles and cellulite - how can I treat this? (Photo)

Question

I am a petite woman, 150 cm tall and weighing 46 kg. I have previously had bulimia, and now the skin on my buttocks and upper thighs just below the buttocks is wrinkled, cellulite-prone, and not firm. I believe that treating the fat deposits is very difficult because my buttocks are already quite large, so I am not considering a BBL. Additionally, my thighs are fine; only the area under the buttocks is wrinkled. I have saddlebag fat, but it doesn't bother me too much. I just want firmer lower buttocks and thighs. Which procedure, surgical or non-surgical, would you recommend?

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Anna Chacon, MD, FAAD · Answer

Thank you for sharing the details and photos—it really helps to understand your situation. From what you’re describing, the main concerns are wrinkling, skin laxity, and cellulite in the area just below your buttocks, rather than the buttocks or thighs themselves. Given your petite frame and low body weight, the challenges here are skin quality and firmness, rather than fat volume.

For non-surgical options, the focus is on tightening the skin and improving texture:

Radiofrequency or ultrasound-based treatments (like Thermage or Ultherapy) can stimulate collagen and provide mild lifting and firming over several sessions.

Laser or microneedling with radiofrequency can help smooth wrinkles and improve the appearance of cellulite.

Cellulite-specific treatments (like subcision or certain energy-based devices) can target the dimpling without affecting overall volume.

Surgical options exist, but they are usually considered when there is significant skin laxity:

A lower body lift or buttock lift can remove excess skin and improve firmness, but for someone with minimal extra skin or fat, this might be more aggressive than needed.

Liposuction in this area isn’t typically recommended for someone who already has low body fat, as it could worsen skin laxity rather than improve it.

Overall, in your case, non-surgical skin tightening and cellulite-smoothing treatments are usually the safest and most effective starting point. These won’t drastically increase volume, but they can improve firmness and reduce wrinkling over time.

It’s understandable to want improvement without aggressive procedures, and with careful planning, noticeable results are achievable even in delicate areas like the lower buttocks.

Low buttocks and upper thigh wrinkles and cellulite - how can I treat this? (Photo)

Answers (2)

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