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Archive for the ‘buttock lifts’ Category

Case Study – Buttock Lifts for Sagging Buttocks

Monday, November 14th, 2016


Background: The buttocks are prone to a variety of sagging conditions, most commonly caused by weight loss and age. Besides loss of buttock projection from loss of volume, the lower buttocks can drop. What type of drop or sag that cab occur depends on the position of the infraguteal fold.

If the infragluteal fold is intact and at a good level, the buttock sag is marked by the lower tissues hanging over the fold. The other form of buttock sagging is when the infragluteal fold has has lost its attachment to the fascia and drops. This causes a vertical elongation of the buttocks which further contributes to any existing loss of outward projection.

Understanding the type of buttock sag determines what type of buttock procedure is needed for correction and how is performed. Technically a buttock tuck removes overhanging buttock tissue with an intact infragluteal fold. Although looking similar a lower buttock lift raises and re-establishes the infragluteal fold.

lower-buttock-sag-dr-barry-eppley-indianapolisCase Study: This 56 year-old female presented for a lower buttock lift. It could be seen that she had a drop of her infragluteal folds allowing the entire lower buttocks to hang lower.

lower-buttock-lift-design-dr-barry-eppley-indianapolislower-buttock-lift-comparison-dr-barry-eppley-indianapolisIn the upright position the elliptical pattern of the buttock lifts were marked before surgery. Under general anesthesia and in the prone position, an elliptical pattern of skin along the marks as well as a wedge of fat was taken down to the gluteal fascia. Using a three point suture technique, the dermal edges of the skin was sutured down to the gluteal fascia in an elevated infragluteal fold level. The difference between the lifted side and the unaltered side can be appreciated.

lower-buttock-lifts-intraop-result-dr-barry-eppley-indianapolislower-buttock-lifts-intraop-result-oblique-view-dr-barry-eppley-indianapolisThe buttock lifts were closed in a fine line with subcuticular sutures along the new infraguteal fold levels. Glued on tapes were applied as the only dressings.

Buttock lifts and buttock tucks sound very similar and they are in many ways. The difference comes down to management of the infragluteal fold, whether to maintain the one that exists or to re-create a higher one.


1) Lower buttock ptosis is when either the buttock tissue hangs over the infraguteal fold or the infragluteal fold has been lost or dropped.

2) A lower buttock lift is when the inragluteal fold is raised and reattached to the gluteal fascia.

3) A lower buttock tuck is when the excess tissue that hangs over the infragluteal fold  is removed.

Dr. Barry Eppley

Indianapolis, Indiana

Options in Buttock Lift Surgery in Extreme Weight Loss

Sunday, December 28th, 2008

Like the rest of the body after a lot of weight loss, the buttock area is not spared. While this is usually not at the top of the list of desired body changes, it can become the focus after other more higher priority areas such as the abdomen, arms, and breasts are addressed.

 Under the normal aging process, the buttocks do sag over time, more in some people than others. After extreme weight loss, this sagging is greatly exaggerated.  The deflation of the buttocks creates folds of loose hanging skin that either fold over the lower buttock crease or cause the buttocks to shift lower as a whole unit. In women, this sagging effect is usually much greater than in men as they generally have  more buttock skin and fat to begin with.

Lifting of the buttocks can be done with several different methods, approaching the problem from either above or below depending upon  the buttock problem and what other simultaneous procedures are being done. One of the most effective methods is the superior or upper buttock lift which is the back half of a circumferential body lift. Skin and fat is cut out around the waistline above the buttock area as part of the 360 degree excision of a body lift. While not as much skin can be removed in the lower back as the front part of the abdomen, the buttocks can be lifted a significant amount. Think of this procedure as ‘pulling up your pant’s’ so to speak. This buttocks lift can also be done alone, without the front half of a body lift, but it would be unusual to have a significantly sagging buttocks after weight loss without an abdominal overhang as well.

While the body lift or superior buttocks lift raises up sagging skin, it will not cause the buttocks to ‘re-inflate’ or solve its loss of volume from the weight loss. In essence, the buttock sag will be improved but it will still be fairly flat. Some plastic surgeons do an ‘auto-augmentation’ at the same time using some skin and fat that would normally be discarded with the cutout. Essentially using your tissue to serve as an implant. While this is a clever use of tissue flaps, it rarely adds significant volume and often does not  put it where the volume is really needed. (lower not higher) I remain not overly enthusiastic about this approach even though it is your own tissue.  If someone ultimately wants a buttocks that is bigger, I will usually do buttock implants at a later time.

Another type of buttock lift is from below or a lower buttock lift. This is an ‘old’ approach  that removes skin from the lower half of the buttocks that overhangs the buttocks crease. This is not usually helpful in cases of extreme weight loss as it pulls the buttock down further in cutting off skin. This  is pulling in the wrong direction for most patients. In cases of mild buttock sagging without a significant loss of volume, this type of buttock lift may be acceptable.

Dr. Barry Eppley

Indianapolis, Indiana

Upper vs Lower Lifts For Buttock Reshaping

Tuesday, January 8th, 2008

Buttock Reshaping by Lifting Techniques


The shape of the buttocks can be altered by liposuction, implants, fat injections, and lifts. Buttock lifts are reserved for those cases in which the buttocks sag, with skin overhanging the lower buttock crease. This condition is most common today after significant weight loss after bariatric surgery. In the past, buttock lifts were synonymous with the term, ‘fanny tuck’, which implied the cut out of skin along the lower buttock crease.

Today, buttock lifts are of two types, upper and lower buttock lifting. An upper buttock lift is really part of a circumferential body lift, which is now commonly performed in bariatric surgery patients who have had a lot of weight loss. In severe weight loss, the buttocks sag considerably and a circumferential body lift is like pulling up one’s pants after cutting out a lot of skin along the lower back. The back cutout is only half of the 360 degree cutout which includes a frontal tummytuck as well. This leaves a scar along the lower back and does do a tremendous job of lifting severely sagging buttocks. It will not, however, provide any volume to the buttocks which will remain quite flat. In some cases, the skin and fat from the back is rotated on a vascular pedicle to add volume to the upper buttocks as the lower buttock skin is lifted over top of it.

The lower buttock lift is done along the lower buttock crease which is at the junction of the buttocks and back of the leg. An elliptical cutout of skin and fat along this crease does remove any skin overhang and ‘hides’ the scar in this crease area. It will not, however, add any volume or add any rounder shape to the buttocks.

While lower buttocks were the only option in the past, upper buttock lifts today are done as often, if not more so, than lower buttock lifts. Either way, buttock reshaping is done more often by liposuction, fat injections, or implants than excision and lifting procedures. Buttock lifts are just one option of many in buttock sculpting options.

Dr. Barry Eppley

Indianapolis, Indiana

Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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