In order to consider how we can correct butt cellulite, we must consider what cellulite is. Cellulite is the undesirable appearance of your buttock skin contour that is characterized by skin dimples and indentations. The pathophysiology of cellulite dimple that you see is caused by tethering ligament at the center of the crater that attaches the skin to the underlying muscles as well as herniation of the fat along the perimeter of the crater. What allows for this herniation is at the root of the problem and this occurs due to skin redundancy. Skin redundancy is the main culprit that allows the fat to herniate along the perimeter of the circular deformity.
The reason the depth of the crater is created is that the tethering ligament, called the cutaneous retaining ligament, prevents herniation at the center. This is why releasing the tethered central ligament will not correct this deformity. This maneuver will only result in herniation of the entire cellulite contour irregularity. Understanding why skin redundancy cannot be treated by just a releasing of soft tissues is best described by considering a similar deformity that is caused in the face, coined jowling.
Jowling in the face refers to skin and soft tissue fullness that occurs along the jawline which falls over a tethered spot located along the anterior aspect of the jowl, called the prejowl. This tethered spot is similarly created by a cutaneous retaining ligament, termed the mandibular ligament. The correction of the jowling is not release of the ligament which will only result in falling of the jowl fullness to a lower location along the jawline. Instead, the definitive correction for jowling along the jawline is to lift the skin and soft tissue lateral to the prejowl up and back. In essence the redundant skin and soft tissue must be elevated and cut out to tighten the area of the jowling.
A similar maneuver must be considered in the buttock region to definitively correct butt cellulite. The definitive correction of buttock cellulite is a lateral thigh and buttock which uses a buttock excision that is strategically positioned along the upper buttock region. This excision must be positioned in a curved fashion that delineates the junction of the buttock and lower back region and makes your buttock heart shaped in appearance. Interestingly, the leverage gained from this upper buttock region is strong enough that it is able to eliminate cellulite from even the lower buttock region. A final note is that cellulite deformities cannot be filled with further fat grafting. The addition of fat is a frequent request from patients who desire correction of cellulite craters. Although filling of a dimple seems like a reasonable solution, it is not very effective since the addition of volume in the region will only lead to increased prominence of the herniation. This is actually made worse if you release the tethering ligament simultaneously.
If you are suffering from buttock cellulite, we encourage you to consider a consultation from one of our high definition buttock surgeons so that we can let you know whether you would be a good candidate for a lateral thigh and buttock tuck.