Gluteal deformities encountered in patients who have lost a massive amount of weight are
unprecedented in body-contouring surgery and plastic surgeons need uncommon techniques when
contouring and augmenting the gluteal region in these patients. Following massive weight loss, a lot of
patients show atrophy in their buttocks. In addition to the skin laxity and the volume loss relaxation of
the superficial fascial apron contributes to gluteal ptosis as well. To restore a youthful gluteal contour,
part of the tissue normally resected in circumferential lower body lift can be used enhancing gluteal
contour with autologous tissue augmentation. Gluteal aesthetics in massive weight loss patients can be
achieved also with large volume autologous fat transfer or alloplastic implants. Adjunctive techniques
such as resection and tightening of the gluteal superficial fascia system (gluteal SMAS), posterior thigh
lift and infragluteal diamond lift can refine the results.
Keywords: Gluteal contouring, buttock ptosis, lower body lift, belt lipectomy.
