Indentations or “dents” on the buttocks are a frequent cosmetic concern. These surface irregularities manifest from changes beneath the skin, involving the structure of fat, connective tissue, or skin elasticity. The cause of the dent dictates the appropriate course of treatment. Understanding the origin of the indentation is the first step toward achieving a smoother aesthetic, with methods ranging from daily habit adjustments to advanced in-office procedures.
Identifying the Different Types of Indentations
Indentations on the buttocks fall into three categories: true cellulite, structural volume loss, and depressions caused by scarring or trauma. True cellulite presents as a dimpled or puckered texture, often described as resembling an orange peel. This appearance results from fibrous connective cords, known as septae, tethering the skin while fat cells push upward against the surface.
Structural dents arise from a deficit of volume rather than a pulling mechanism. These occur due to natural fat atrophy, which is a localized loss of fat tissue. Genetics, significant weight fluctuations, or muscle imbalances can contribute to these depressions, creating an uneven contour.
The third category includes indentations resulting from trauma, previous procedures, or localized injections. A deep dent might be caused by fat loss from a past steroid injection or scar tissue formation following liposuction. Successful correction requires correctly identifying the mechanism causing the depression.
Lifestyle and Non-Invasive Management Strategies
To address minor contour irregularities or improve skin texture, several non-invasive strategies can be implemented. Targeted exercise is important, focusing on strengthening the gluteal muscles beneath the skin. Exercises such as squats, lunges, glute bridges, and deadlifts increase muscle mass, which naturally fills out and lifts the area, reducing the visibility of minor surface irregularities.
A balanced diet and adequate hydration contribute to overall skin health and tissue firmness. A diet rich in antioxidants supports skin elasticity, making the skin appear tauter and smoother. While these adjustments do not resolve the structural cause of true cellulite, they minimize its appearance by improving muscle tone and skin quality.
Topical creams and massage techniques offer limited, temporary improvement. Products containing ingredients like retinol or caffeine can temporarily improve skin thickness and circulation. Techniques such as foam rolling or deep tissue massage may help improve lymphatic drainage and temporarily disperse fluid, slightly reducing the lumpy texture.
Professional Procedures for True Cellulite Reduction
When indentations are confirmed to be true cellulite, professional treatments focus on modifying or releasing the causative fibrous septae. Minimally invasive procedures like subcision mechanically sever the tough bands of connective tissue pulling the skin downward. Devices such as Cellfina or Aveli use a specialized needle inserted under the skin to cut these septae, allowing the skin to spring back and smooth the contour.
These septum-releasing methods provide direct and long-lasting corrections for cellulite dimpling. Since the structural cause is physically addressed, results can endure for two years or longer. The procedure is typically performed under local anesthesia and involves a short recovery period, though bruising and swelling may occur.
Other advanced techniques combine energy delivery with tissue manipulation. Radiofrequency (RF) treatments work by heating the tissue beneath the skin. This controlled heating stimulates new collagen production, tightens the skin, and weakens the tension of the fibrous septae. Non-invasive RF treatments may require a series of sessions but offer an option with no downtime for gradual texture improvement.
Addressing Indentations Caused by Volume Loss or Scarring
Indentations caused by a volume deficit or scar tissue tethering require treatments focused on filling the depression or releasing the scar. The most effective method for volume restoration is autologous fat grafting, also known as fat transfer. This procedure involves harvesting fat from another area of the body, processing it, and then injecting it into the depressed area to restore a smooth contour.
Fat grafting is useful for correcting wide, shallow depressions or irregularities resulting from localized fat atrophy, such as those caused by past injections or uneven liposuction. Since the patient’s own tissue is used, the results are natural and long-lasting, though multiple sessions may be necessary to achieve the desired correction.
For smaller, isolated dents, injectable dermal fillers provide a non-surgical alternative. Hyaluronic acid fillers offer temporary smoothing, while biostimulatory fillers, such as Sculptra, encourage the body to produce its own collagen over several months. These options are preferred for minor asymmetries or depressions where the volume requirement is small.
When a dent is caused by tight, contractile scar tissue pulling the skin inward, the first step involves a targeted release of that scar tissue. This technique, similar to subcision but focused on hardened scar bands, must be performed before or concurrently with volume replacement. Once the underlying tether is released, fat grafting or dermal fillers are used to support the lifted skin and prevent the depression from reforming.