Am I A Good Candidate Fior A Lower Buttock Lift?

Q: Dr. Eppley, had traditional liposuction done  to remove saddlebags. There was a massive amount of swelling and bruising afterwards, but as it went down it became evident that the surgeon removed way too much fat. He left with me two very large dents on the hips and a ton of excess skin on my butt that folds over the back of my thighs and bulges out on the sides. The surgeon denied there was a problem and said this was a good result. I knew that was not true so I consulted 2 other surgeons and both said additional liposuction, fat transfer, and a butt lift would be the only solution, but that would leave me with a large scar across my back. One surgeon said I didn’t have enough fat to fill in the dents, but I do have fat in my flanks and my lower butt and thighs. After much research, I found you and I’m hoping I’d be a good candidate for a lower buttock lift. My main goal for surgery would be to remove the lumps bulging out from the sides, fix the indents, and remove the excess skin. I’d also like the appearance of the gluteal fold to be fixed so that I don’t have a square lower butt with the fold extending all the way out to my thighs. I want the fold line to be much shorter and arch upwards, out towards my outer thigh (kind of like a boat anchor). 

A:Thank you for your inquiry, detailing your surgical history as well as your present concerns to which I can say the following:

1) While a lower buttock lift is the only solution to your buttock sagging/ptosis I do have concerns about the location or appearance of the outer half of that buttock lift scar. If you look at where the greatest extent of your buttock ptosis is it is in the outer half more than the medial half. To adequately improve the lateral buttock fullness the scar line is going to have to come out of where your existing infragluteal crease is and make it very visible.  (as you have aptly described as a boat anchor change) Also to get rid of that fullness it would have to go far more laterally than I think most patients would prefer. This does not mean that it cannot be done but you have to be mindful of a basic aesthetic principle and a lower buttock lift in you would be a classic example of it. Meaning many aesthetic surgeries are merely trading off one problem for another. Thus you have to be certain that you like the other problem much better than the problem that you currently have. Whether a visible scar or how your buttock appears now is better can only be a judgment made by you.

2) When it comes to filling in the dents/over resected areas I do not see where you have fat to harvest to have adequate volume for injection. But given the lack of any other treatment options, and being mindful of not creating additional over resected areas from the fat harvest, fat injections would be your only treatment option.

Dr. Barry Eppley

World-Renowned Plastic Surgeon