Is there anything that can be done to even out the uneven creasing under my butt? (Photo)

Hello Stoney Harbor,
Thank you for your question regarding the uneven creasing under your buttocks and for sharing your pictures.
Based on the photos you provided, it appears that you have excess skin and a mild amount of excess fat in the upper inner posterior thigh area, commonly known as the 'banana roll'. This area is not technically part of your buttocks, but rather the back of your thighs. To address this, an upper thigh procedure would be the most effective solution.
The optimal treatment for the skin and fat in this area involves the surgical removal of both, achieved through an incision made underneath the buttocks. A crescent or banana-shaped area of skin and fat is excised from the upper back of the thigh, and the remaining skin flap is then advanced toward the buttocks.
This procedure is typically performed under general anesthesia and lasts about 3 to 4 hours. Drains are usually placed and kept in for approximately 10 days. You can expect a recovery period of about two weeks, during which wearing a compression garment for at least six weeks will be crucial to support healing and contouring.
Please consult with a board-certified plastic surgeon to discuss this procedure in detail and to understand all aspects of the surgery, including potential risks and the expected outcomes.
I hope this information helps you in considering your options to address the uneven creases under your buttocks. Wishing you the best on your journey to a more comfortable and confident you.
Sincerely,
Dr. Katzen

Hello;

There is different options but Macroneedling Collagen Indiction Therapy (CIT) can help tremendously. You will need a few treatments.

Best of luck,

Randal Haworth

Buttock “sagging” is usually a combination of loss of volume or deflation (after weight loss or post-BBL) and/or the effect of aging and gravity. So, I personally first treat patients like you by restoring volume to the buttock with a buttock implant. This will create a more desirable smooth and rounded perky buttock profile. If not adding volume with an implant, the buttock will be shortened but may appear more flat with just a buttock lift. A lower buttock tuck is usually then performed at six months following implants. In this sequence, the implants have fully settled into final position so that any remaining loose skin can be most accurately identified and removed with the lower buttock tuck. Please note, because an extremely few number of board certified plastic surgeons specialize in buttock implants, you may have to travel away from your local area to seek consultation with this particular type of surgeon. Glad to help.

In order to correct deformity of infragluteal crease, a combination of liposuction and pplacement of deep sutures may be required. This can be combined with a true buttock lift, if needed. Good luck.

Thanks so much for reaching out. Actually, that area is very difficult to treat. Using liposuction is always dangerous for losing support. You may consider a noninvasive device like emsculpt however, I would have a limited hope that it would address your concerns. I hope this helps :-)

You really can't liposuction in this area--it can lead to disastrous results. Plastic surgeons have not performed liposuction in the banana rolls for several decades but occasionally someone will come to my office to see if they can fix a banana roll area that was liposuctioned by a non-plastic surgeon and it is so shocking to see how badly it looks and it is virtually impossible to fix.

I think there’s a bit more to the story that hasn’t been disclosed. It appears you’ve had liposuction done in these areas and including that information would be important. The banana role should not be treated with Liposuction.
Delivering consistent quality, liposuction results is more difficult than most people believe it. The number of providers who have mastered this procedure and can make accurate assessments and deliver consistent predictable results is relatively small.
Liposuction is a permanent and irreversible operation. Once done, it is virtually impossible to improve on the outcome.
Treatment options for poorly done liposuction generally come down to revision liposuction(removing more fat), fat transfer (trying add fat) or in some cases, converting the procedure into a skin tightening operation like a thigh lift.
None of these options are particularly good in your case and the potential for improvement in your case is not good.
The number of providers who can make accurate assessments and deliver predictable quality liposuction results is small. Being board-certified, and plastic surgery with an overall good reputation and years of experience is not sufficient to assure somebody has mastered Liposuction. For all these reasons, patients should be very selective when it comes to having liposuction procedures. I recommend patients carefully selected surgeons. I have a multiple in person consultations well in advance of scheduling the procedure. Personally, I recommend patient start by having a minimum of five in person consultations. During each consultation, bring pictures of your own body and use that for reference. Ask providers to open up their portfolio and show you their entire collection of before and after pictures of previous patients who had similar body characteristics showing at the same area you’re interested in having treatment. Being shown a handful of preselected images, representing the best results of the providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider. For reference an experience provider should have no difficulty showing you at least 50. set a before, and after pictures of commonly performed procedures like Liposuction of the lower extremities. They are yes you are treated are technically difficult and often do not respond as well as patient had hoped. In your case your provider was excessively aggressive, and left you with an uneven fat distribution. Improving on the outcome is going to be very difficult.
This area is difficult to treat as a primary procedure, even in the hands of someone who has mastered Liposuction. Considering that revision work as many times more difficult than primary liposuction the importance of finding a sufficiently talented provider if you want to have more surgery is going to be imperative.
most likely your best option if you feel like you want to really push forward is to try to restore the fact that should not have been removed by fat transfer. This cannot be accomplished with a single procedure, and even if done by the most talented surgeon can still never restore you to pre-procedure.
Correcting this or getting moderate improvements will most likely take multiple operations. If you do not select is officially talented procedure than any attempt at revision surgery can easily make things worse.
Most likely, your best bet is to stop where you are and spend the next year interviewing plastic surgeons until you feel very confident you found the most talented provider. In your case you need to vet plastic surgeons, not only in regards to liposuction skill, but also for fat transfer competency the problem with fat transfer is that areas previously treated aggressively with Liposuction are now devoid of host tissue, making fat, raft, survival unpredictable ..
Anytime patients want an assessment on the outcome of a plastic surgery procedure they should include their entire surgical history and include all the before and after pictures.
In reality, a substantial number of plastic surgeons who are board-certified and plastic surgery with years of experience, and good intentions are not very good at Liposuction. Most plastic surgeons think they’re better at liposuction than they actually are. That is not to say that there aren’t very talented plastic surgeons who can do liposuction well.
The banana rule should not be treated with Liposuction. The problem itself is a skinfold, and it’s not related to fat distribution.
There is no easy way to correct your outcome, and you should be very reluctant of going with providers who think this is easy to fix or that some certain technology or special device will help fix the problem.
Revision work, in the hands of anyone not the most talented providers can easily lead to making the outcome worse.
Best,
Mats Hagstrom, MD