How Can I Get A Better Defined And Symmetric Lower Buttock Crease?

Q: Dr. Eppley, I am interested in having the surgery of gluteal crease correction. I do not need a buttock lift per se but a correction of buttock crease. I am 5 ‘9″ tall & very thin & had a thigh lift years ago which was not done very well & gave me a lower uneven shaped buttock crease which makes my buty look loger than it should and the crease needs to be higher. I want to make the crease more even and have it round and higher. I have sent you pictures to study. I just recently had the crease corrected three weeks ago but this surgeon made the same mistake and just followed the original surgeon’s incision marks which were completely wrong and so it has not been corrected and still pretty much looks the same and the right cheek is also lower than left. I should have much better results for what I paid. I am so very disappointed. The top portion of my butt looks normal and  round, but now I have loose skin and square/pointy shape at side view hanging down lower than the butt. The incisions/scars needed to be redone in the right position and be made more even, rounder and higher and the bit of loose skin on back of thighs needs to be excised and lifted. Have you ever seen anything like this done before? Do you have experience correcting this issue and think you could correct it and make it look much better and completely normal? This disfigurement has made me very self conscious & sad.

A: Thank you for sending your pictures and describing your concerns. I think you are spot on and  I am completely bewildered as to what was actually done doing your recent procedure. I am going to assume that the size of the fresh incisions/scars that I see are the extent of the skin resection/crease creation? I will assume for now they are. If so, they are far too limited to adequately address the creation of a more complete lower buttock crease, create a distinct break between the lower buttocks and the upper thighs, and get rid of the bulge or overhang that you have. Perhaps you were unreceptive to a more complete or longer incision ??? At any rate, the lack of a distinct buttock/thigh demarcation, improved lower buttock crease/shape symmetry and elimination of the transitional bulge can be done by a longer and more wide excision of skin and fat with a tuck down to the gluteal fascia. This can be trememdously effective for your type of problem provided you can accept a longer but well placed scar. One of the keys to a lower buttock lift/crease creation is to not have the side part of the scar extend into the visible lateral thigh area.

Dr. Barry Eppley