Buttock Tuck

What a Buttock Tuck Changes

A buttock tuck is the excision used when the buttock has dropped and the skin will not tighten on its own. Skin redundancy shows up as contour irregularities and dimples, which this operation treats as cellulite. The sag itself shows up as fullness low on the cheek, which this operation calls a diaper butt. Standing or sitting straight, the buttock should taper into the posterior thigh. Bulges, lumps, and a fold of extra skin are the findings that call for the excision.

The lift is made by taking skin and soft tissue from the upper buttock and the lower back. The skin of the lower buttock is brought up, and the redundant skin is cut away at the top. That is the opposite direction from a tummy tuck, which pulls loose abdominal skin down and trims it. Tightening from the top of the cheek reduces the lower buttock crease and makes a smoother line from the lower buttock into the upper posterior thigh.

In rare cases the cheek is also too large, and buttock liposuction is added to the excision so the overall cheek gets smaller. That combination is the exception. The usual problem is loose, low skin, not a cheek that only needs fat removed. Liposuction without the excision, in a patient whose skin is already loose, leaves the sag in place.

The excision is not an implant, and it is not a filler. It does not make a cheek larger by itself. The cheek gets tighter, and the graft is what puts volume back. A patient who wants only a bigger cheek, with skin that still fits, is not describing this excision. A patient who wants the low fold gone, the dimples from extra skin reduced, and the height of the cheek reset against the back is describing it.

The posterior thigh is the landmark for the taper. When the cheek hangs on that thigh, the gull wing is what lifts the cheek off it. The line from the lower cheek into the thigh should read as one smooth pass once the redundant skin is gone. Lumps left along that pass mean the excision did not take the fold that was hanging there. Weight that is still changing is a reason to wait, because skin cut away in the middle of a loss can loosen again after the weight settles.

The Gull Wing Excision

A buttock tuck uses an excision over the upper buttock and the lower back that is shaped like a gull wing. The line is planned so it can sit in the G-string line and stay covered by a bikini bottom. The cut has four jobs. It takes away the sag in the soft tissue, reduces buttock dimples, sets the back-to-buttock height, and leaves a line that clothing can hide.

Cellulite, on this operation, is those dimples from redundant skin. Cutting out the redundant skin is how the dimples are reduced. The same lift takes the low fullness of a diaper butt off the posterior thigh. A smooth taper from the cheek into the thigh is the contour the excision is aimed at. The dimples are not treated here as a surface problem separate from the extra skin.

Buttock height is set with where the gull wing sits. A survey of female back, buttock, and leg heights in models found a preferred ratio of 45:25:30. If the buttock height is too short, the upper excision is placed higher, which lengthens the buttock. If the buttock height is long, the upper incision is placed lower, which shortens it. The ratio is a guide for that placement. It is not a promise that every patient lands on those exact percentages. The gull wing is one line, so the two cheeks are lifted together. A plan that lifts only one side would leave the back-to-buttock height uneven. The same line has to hide in the G-string line on both sides. If the sag is much worse on one side, the amount of skin taken can differ, but the final line is still one gull wing.

Why the Lift Needs Fat Grafting

A buttock tuck tightens the cheek, and the tightening flattens it. Fat transfer is added so the volume and the projection of the cheek can be put back. The graft is fat grafting placed over the glute, in the subcutaneous tissue, not inside the muscle. The graft is planned at the same time as the excision, because a tight, flat cheek is not the end point.

The fat is harvested from the lower back, the flanks, and the upper buttock skin that is about to be excised. Removing flank fat also narrows the waist. The harvest from skin that is coming out anyway is done with ex-vivo liposuction, rather than traditional liposuction of tissue that is about to be discarded. Ex-vivo liposuction is used because it can take a larger fat volume, shorten the operative time, spare the patient extra trauma, limit blood loss, and improve the quality of the fat that is kept for grafting.

The upper pole is where the gull wing tightens the cheek. The projection that the tightening removes is what the graft is there to restore. The hip is not the target of this graft. A thigh lift can be added when the thigh sags along with the buttock, as part of a larger contouring plan. The graft on the cheek and the excision on the back stay the two maneuvers that define the operation.

Who a Buttock Tuck Is For

Aging, sun, gravity, and inherited skin laxity are the usual reasons the cheek drops. Weight loss, weight that has gone up and down, and multiple pregnancies are the other histories this excision is used for. A person who has tried diet and exercise and still carries a heavy buttock with loose skin is in that group. Liposuction alone would remove fat and leave the loose skin. The skin has to be cut away after that fat is removed.

A steady weight for 6 to 12 months comes before the surgery. A large loss after the operation can change the result. The consultation reviews goals, medical history, medicines, earlier surgery, and diet, and it includes an exam of the buttock and the skin. Aspirin, other painkillers, anti-inflammatories, and herbal supplements that can increase bleeding are stopped beforehand. Someone else should drive the patient home and stay for the early recovery.

Risks, benefits, alternatives, and limits are part of that visit. The rare problems named for this operation are unusual bleeding, infection, blood clots, and fat emboli. Patient safety protocols are how those risks are kept down, and the office is available right after surgery. The American Society of Plastic Surgeons describes buttock augmentation with a patient's own fat as a change in size and shape. On this operation that fat transfer is the second step, added because the excision flattens, and it is not a substitute for removing the loose skin.

Recovery After a Buttock Tuck

Recovery time following a buttock tuck is approximately 3 to 4 weeks. Sitting upright is avoided for two weeks so the incision is not pulled. Physical activity is increased only by four weeks. Lower body exercises wait until six weeks after the surgery. The incision lines begin to fade six months later.

Bruising, swelling, and discomfort are expected and usually settle over a few days to a few weeks. Liposuction, fat transfer, and the excision done together are performed under general anesthesia. The two-week limit on sitting upright is there to protect the incision. It is a limit on tension across the gull wing, and it is the timing this operation uses.

The result to look for is a cheek that is tighter, with less of a lower crease, a smoother pass into the posterior thigh, and projection restored by the graft rather than left flat. The hidden line, the 45:25:30 height guide, and the ex-vivo harvest are the planning details that go with that result. A patient whose only goal is a larger cheek, with skin that is not redundant, is looking at fat transfer without this excision.