Technical Aspects of Addressing Lower Buttock Ptosis and Contouring: The Thong Lift Technique

Abstract Background Recent advancements in buttock aesthetics have largely focused on fat transfer, implants, and belt line lifts, all of which overlook the specific needs of the lower pole of the buttock, especially the inferomedial region. These areas are characterized by ptosis, exaggerated infragluteal creasing, and an L-shaped/boxy appearance, requiring targeted intervention. Objectives The authors of this study aim to investigate the utilization of an infragluteal thigh lift, termed the thong lift (TL), to correct isolated lower buttock ptosis and L-shaped/boxy buttock deformity. Methods A retrospective chart review and patient survey was conducted for consecutive patients who underwent the TL procedure at a single surgical center between January 2017 and April 2024. Clinical data collected included patient demographics, indications, surgical history, and postoperative outcomes. Patients were also administered a standardized satisfaction survey following the procedure to rate outcomes. Results In total, 26 consecutive female patients (mean age: 48.5 years, range, 27-69 years) underwent the TL procedure during the study period. The average follow-up was 48.7 months. Patient satisfaction was high, with contour and scar quality rated as “good” to “excellent,” on average. All patients (100%) reported improved aesthetic appearance and satisfaction with their outcomes. Only minor complications were recorded (15.4%), all of which were resolved. Conclusions Based on the results of this study, the TL is a promising technique that can be utilized to correct lower buttock ptosis and contour irregularities overlooked by traditional techniques, offering a targeted solution with minimal complications and high patient satisfaction. Level of Evidence: 4 (Therapeutic)