While performing gluteal sculpting on a regular basis, I have noticed that the different degrees of buttock sagginess require different approaches and surgical techniques. A traditional excisional butt lift is very different from what the fat transfer and famous Brazilian butt lift entail. In the traditional butt lift, long scars are strategically placed around the gluteal contour to actually lift the buttocks and at the same time preserve soft tissue to augment them.
The range of problems that can be solved with a buttock lift requires careful analysis in order to tailor the solution using the most appropriate surgical techniques. The degree of sagginess, skin tone and laxity, amount of deflation of the buttocks, and location of the deformity are just a few of the many factors that must be taken into consideration. I use several techniques to achieve beautiful results which include the following:
- Upper buttock lift
- Lateral buttock lift
- Butterfly buttock lift
- Lower buttock lift
The upper buttock lift is one of the oldest procedures and is mostly used for those patients who have lost a lot of weight after a bariatric surgery. This is the only and most effective way to lift the buttock when the excess skin is severe. In this procedure, a long incision is done that follows the upper buttock contour. The buttocks are undermined and the excess skin and tissue are used to anchor the buttocks to the bone or deep tissue to avoid displacement of the scar and early sagginess of the soft tissues. In addition, the excess tissue is used to augment the buttocks. This procedure is like performing a tummy tuck in which a long scar is performed to remove the excess tissue but the scar is not a straight line; instead, it follows the superior roundness of the buttocks.
The lateral buttock lift is a technique that I use to enhance the buttocks when mainly the deformity of the buttocks is located on the sides and hips and the degree of sagginess of the butt is moderate. The incision is located around the hip buttock junction and the length of the incision is much shorter.
The butterfly buttock lift is a procedure that is very useful to enhance the buttocks in those cases where there is mild to moderate sagginess on the central buttocks. The incision follows the gluteal crease and extends to the sides following the junction of the lower back with the gluteus. This approach to buttock rejuvenation improves the actual sagginess but does not significantly lift the inferior gluteal crease.
The lower buttock lift is the procedure that I use to correct moderate ptosis in the are of the infragluteal fold by creating a new fold. In addition, it helps to correct the “banana role” in those patients who complain having either a double infragluteal fold or excess sagginess.
Regardless of the technique used, there are certain factors that are important to consider for a successful surgery:
- Scars can be long with these procedures and it all depends on the severity of each particular case. If you are not willing to accept scars, you will not be a good candidate for surgery.
- Preserving the tissue to sculpt the buttock. Even though it is intuitive to think that the excess skin should be excised, I have found that it is better to use this tissue to actually augment the buttocks. Most patients with excess sagginess of the buttocks also have deflation of the buttocks and using the patients’ own tissue will create a more aesthetically beautiful behind.
- Part of the excessive tissue is anchored to the hipbone and / or deep fascia of the back. This will make the results long lasting, and also avoid wide and malpositioned scars.
- Butt implant should be considered at the same time the butt lift is performed to improve the countour and projection of the buttocks in those patients to whom the actual procedure fails to increase the butt size.
In general, there is no single technique that will solve the different buttock pathologies. For this reason, I do a very thorough and meticulous physical exam and multiple modifications to accomplish the best results.