Introduction The appearance of the buttocks has become more and more important for people in recent years. The standards of beauty have seen some recent changes as well. We got from “Is my butt too big?” to “Is my butt too small?” Nowadays we are fascinated with the big booty, its roundness, and appeal. If up until a few years ago women were trying to make their buttocks look smaller, now things are exactly the opposite. Now we have push-up panties, push-up jeans, push-up everything that could potentially help make the buttocks bigger. However, when it comes to the sagginess of the buttocks, there is little that push-up panties or anything else can do. In this article, we will discuss why butt sagginess occurs and what the surgical options to correct it. Causes of butt sagginess Most of us are used to the idea of breast sagginess as a sign of aging. Saggy breasts are representative of older women; however, few people know that saggy breasts can also occur in rather young women who have overly large breasts and also in women who have lost a considerable amount of weight in a short period of time. Things are not very different when it comes to butt sagginess either. The loss of skin elasticity is associated with old age, so this is one of the causes of butt sagginess. However, when butt sagginess occurs as a result of aging, the sagginess is not severe, at least not as when it occurs as a result of considerable weight fluctuations. When people gain a considerable amount of weight and then lose this weight suddenly, chances are there will be skin sagginess in different areas of the body. Most commonly, saggy skin will be on the abdominal area or the arms or the thighs, but it all depends on the patient’s anatomy and the tendency to accumulate fat in one area of the body over the other. What happens when we gain weight is that the tissues stretch. The skin stretches to accommodate the excess weight. But when weight loss occurs, the skin can’t shrink back to the new contours of the body. So, the weight might disappear, but the excess skin will be left behind to create a saggy effect. This can happen to any area of the body, including the buttocks. Butt sagginess as a result of weight loss can be really unpleasant and unaesthetic. The butt can look flat and small, and the sagginess could make it even worse. This is the reason why many patients resort to plastic surgery to enhance their body after losing weight. Surgical options for butt sagginess As is the case with skin sagginess in any area of the body, there are no other efficient solutions to correct it aside from undergoing plastic surgery. Plastic surgery offers different solutions for butt sagginess, depending on the anatomical characteristics of the patient and her aesthetic expectations from the procedure. Here are some procedures that can be performed to correct the sagginess of the buttocks: – Butt augmentation with implants If you want breast implants but you are suffering from breast sagginess, the plastic surgeon will tell you that it is not recommended to increase the volume of the breasts without correcting the sagginess with a breast lift. When it comes to butt sagginess, getting implants might correct the imperfection if the sagginess is not extreme. Of course, this is a surgical solution recommended for patients who also want to increase the size of their buttocks, aside from correcting the sagginess. Butt implant surgery is performed using implants that are inserted in a pocket inside the gluteal muscles. The procedure can be performed in about two hours and can also be performed with other plastic surgery procedures such as fat transfer, liposuction and even a traditional butt lift. When the butt lift is combined with butt implant surgery, the plastic surgeon will perform the techniques required for the lift and introduce the implants in the same operation. The incisions required to insert the implants are performed on the intragluteal fold, so they are not visible when the patient is wearing underwear. Keep in mind that with the incisions so close to the anus, this procedure has a high risk of developing an infection during the recovery stage. This is why it is important for the patient to ensure proper hygiene at the incision site at all times during the first two weeks post-op or until the incisions are fully closed and healed. The recovery period after butt implant surgery is about two weeks. After this, the patient can resume work and most daily responsibilities. – Butt lift The butt lift is the recommended surgical option for patients who are happy with the volume of their buttocks and just need the sagginess corrected. The butt lift entails the excision of the surplus of skin that is present in the buttocks. The procedure is performed in about two hours, but it can be longer if combined with other body lifting methods. The butt lift is usually performed on patients who have lost a considerable amount of weight. The procedure is very delicate and should only be performed by an experienced and talented, board-certified plastic surgeon if you want to get the best results possible and avoid unwanted complications. The recovery period after the butt lift is also about two weeks, and during this time patients are advised to avoid any type of pressure applied on the buttocks that might cause the incisions to open. – Brazilian butt lift While this procedure also has the word ”lift” in the name, it is very different from the butt lift. The traditional butt lift entails excision of the surplus skin. The Brazilian butt lift is a procedure just as complex as the traditional butt lift, but much less invasive. When the Brazilian butt lift is performed, there are no significant incisions that are made. The procedure is actually a combination of two procedures: liposuction and fat transfer. This means that the plastic surgeon will start by addressing the donor areas with liposuction. Generally, the donor areas for the Brazilian butt lift are the abdominal wall and the flanks, but also the thighs and even the back if the patient is confronted with unwanted adipose deposits in the area. Liposuction is performed in one or multiple areas of the body as the plastic surgeon needs to get enough fat for transfer to the buttocks. After being extracted from the donor areas, the fat is purified through a complex centrifugation process. A certain amount of the fat extracted will be eliminated after the purification process as the blood and other impurities are removed from the mix that will be used for the transfer. The last step of the procedure is fat transfer to the buttocks. The fat transfer is performed with the use of a special syringe that will inject the purified fat into the buttocks at different depths and in different areas. The plastic surgeon will try to achieve a symmetric result and address the buttocks as a whole, compared to using implants which are inserted only into the upper part of the buttocks. The Brazilian butt lift also requires general anesthesia and can take two hours or more to be performed. The recovery period is the same as in the case of other butt enhancement procedures, and the patient is not allowed to sit on the buttocks or lie on the back for about three weeks post-op. The Brazilian butt lift can be a suitable surgical option if the sagginess of the buttocks is minor or moderate. Conclusion Butt sagginess is an aesthetic imperfection that can affect many patients, both men and women. The only efficient method that can be used to correct this imperfection is plastic surgery. An experienced, talented, board-certified plastic surgeon will know which procedure is suitable for each patient, depending on her anatomy and the goals she has in mind. Generally speaking, to correct butt sagginess we can use either a butt augmentation with implants, a butt lift, or a Brazilian butt lift. Each procedure is performed differently and addresses certain conditions. For example, butt implant surgery is the optimal option when the patient has moderate sagginess and a desire to get a bigger butt. The butt lift is perfect for when the patient is happy with the volume of the butt but has excessive sagginess, while the Brazilian butt lift is recommended for patients who have minor sagginess and want to see an improvement in the buttocks as a whole.