Dents, dimples, and depressions in the buttocks almost always come down to how three layers of tissue interact beneath the skin: fat, connective tissue bands, and muscle. The most common cause is cellulite, where tough fibrous bands pull the skin inward while fat pushes outward around them, but the list of possibilities extends to old injuries, injections, muscle wasting, aging skin, and even complications from cosmetic procedures. Understanding which type of dent you are dealing with makes a real difference in whether it is purely cosmetic, treatable, or worth showing a doctor.
Fibrous Bands and Cellulite
The buttocks have a layered sandwich of tissue beneath the skin. Just under the surface sits a layer of fat, divided into compartments by vertical bands of connective tissue called septa. These bands anchor the skin to deeper structures. When the septa are tight, short, or thickened, they pull the skin downward while the surrounding fat bulges outward, creating visible dents and dimples. A biopsy study found that in people with cellulite, these bands were unevenly thick and had become stiff and fibrous, and that fat pushing into the upper skin layers was actually a secondary event caused by the ongoing tension the bands exerted.1PubMed Central. Insights Into the Pathophysiology of Cellulite: A Review
Think of it like a mattress where the buttons are sewn too tightly: the padding puffs up between the buttons, and you get that tufted look. The dents are not holes in your fat. They are spots where a band is pulling the skin inward more forcefully than the surrounding tissue can resist. This is why cellulite dimples look worse when you press or squeeze the skin, because that compression highlights the tug of the bands against the softer fat around them.
Cellulite affects somewhere around 80 to 90 percent of women after puberty. It is not a disease or a sign that something is wrong. It is a normal structural pattern of subcutaneous tissue that happens to be visible in some people more than others, depending on skin thickness, fat distribution, and the individual architecture of those connective tissue bands.
Why This Is Far More Common in Women
If you are a woman noticing dents in your buttocks and wondering why your male partner does not seem to have them, the answer is architectural. In female skin, the fibrous septa run mostly straight up and down, perpendicular to the skin surface. In male skin, those same bands criss-cross at roughly a 45-degree angle, creating a mesh-like structure that holds fat compartments more tightly in place.2PubMed Central. Cellulite: Current Understanding and Treatment Men also have more numerous, shorter, and thinner septa, which distribute tension more evenly and resist the tufting effect.
On top of that, women tend to have fewer but larger fat lobules in the superficial layer, especially around the buttocks and thighs. Larger lobules are more prone to bulging outward between the vertical bands. The result is that even men who carry significant body fat rarely develop visible cellulite dimples, while lean women can have them. This structural difference between the sexes has been confirmed through imaging and dissection studies that map the three-dimensional interplay between the skin, fat layers, and the fascia beneath them.3PubMed. Anatomic update on the 3-dimensionality of the subdermal septum and its relevance for the pathophysiology of cellulite
Dents From Injuries and Injections
Not all buttock dents are cellulite. A sharp, localized dent that appeared after a specific event points toward a different mechanism: loss of fat in one spot, known as lipoatrophy.
Blunt trauma is one trigger. Falls onto a hard surface, impacts during sports, or even a bad tumble down stairs can damage the fat layer beneath the skin. When fat cells die from the impact, the body replaces them with scar tissue rather than new fat, leaving a permanent depression. A case series of patients who fell onto the pelvic area found that all of them developed visible loss of subcutaneous fat, and MRI scans confirmed the fat had simply atrophied in the injured zone. One patient also developed a small mass of scar tissue at the site, and two experienced lasting pain in the area.4PubMed. Symptomatic fat necrosis and lipoatrophy of the posterior pelvis following trauma
Injections are the other common culprit. Corticosteroid shots intended for muscle can cause a dent if the medication is deposited too shallowly, landing in the fat layer instead. The steroid triggers local fat breakdown, leaving a visible divot at the injection site.5Modern Plastic Surgery. Treatment of Steroid Induced Lipoatrophy with Structural Fat Grafting One study examining patients with localized lipoatrophy found that corticosteroid injections, both intramuscular and intralesional, accounted for the vast majority of cases.6Journal of Pakistan Association of Dermatologists. Lipoatrophy as a manifestation of different clinical scenarios: corticosteroid injection, lupus profundus and morphea induced lipoatrophy If you have a dent that lines up with where you received an injection months or years ago, this is the likely explanation.
When Muscle Changes Create Visible Dents
The shape of your buttocks depends heavily on the gluteal muscles underneath the fat. When those muscles waste away or develop unevenly, the surface contour changes. The most noticeable version of this is what people casually call “hip dips,” the inward curve between the hip bone and the upper thigh. While hip dips are partly just skeletal anatomy, muscle atrophy can make them dramatically deeper.
Prolonged sitting, nerve injuries, hip problems, and disuse can all cause the gluteus medius to shrink. Research on patients with hip abnormalities found significant reductions in both the size and length of the gluteus medius on the affected side, with the muscle losing roughly 8 to 11 percent of its length compared to the healthy side.7PubMed Central. Changes of gluteus medius muscle in the adult patients with unilateral developmental dysplasia of the hip That is enough to change the visible contour of the buttock. If you notice one side looking flatter or more hollowed than the other, muscle atrophy on that side is a genuine possibility, especially if you also have pain, weakness, or a history of favoring one leg.
Even without an underlying condition, years of sedentary work can gradually flatten the gluteal muscles. The fat layer is still there, but without the muscular volume beneath it to provide shape, the buttock loses its rounded contour and can develop visible hollows or dents where the bones and tendons sit closer to the surface.
Aging, Weight Fluctuations, and Skin Laxity
As skin ages, it loses collagen, its elastic fibers degrade, and it holds less water. The result is thinner, looser skin that drapes over the underlying fat and muscle less tightly than it used to. Research developing assessment scales for skin laxity found a strong correlation between worsening laxity on the buttocks and thighs and increasing age and body mass index. Sun exposure and significant weight gain also contributed.8Dermatologic Surgery. Validated Assessment Scales for Skin Laxity on the Posterior Thighs, Buttocks, Anterior Thighs, and Knees in Female Patients
This matters because lax skin makes everything underneath more visible. The same fibrous bands and fat distribution that were invisible at 25 start showing through at 45, not because the bands changed but because the skin covering them got thinner and less elastic. Weight loss compounds the effect. Losing a significant amount of fat from the buttocks without a corresponding tightening of skin leaves excess tissue that sags and puckers. The dents left behind are a combination of the fibrous bands now being more prominent and the reduced fat volume failing to fill the space the skin still covers.
Yo-yo dieting is especially harsh on buttock contour. Repeated cycles of gaining and losing weight stretch the skin and weaken its elastic recovery over time. After several cycles, the skin may never fully retighten, even if you return to a lower weight. The buttocks are one of the areas where this shows up most clearly because the combination of gravity, sitting pressure, and relatively thin skin makes any loss of structural integrity immediately visible.
Rare Medical Causes Worth Knowing About
A small number of people develop buttock dents from autoimmune or inflammatory conditions. Lupus profundus, a form of lupus that targets the fat layer under the skin, can destroy fat in specific areas and leave deep depressions. Morphea, a localized form of scleroderma, can do something similar by replacing fat and normal tissue with dense scar. These are uncommon and were found in a study to account for only a small fraction of lipoatrophy cases compared to injection-related causes.6Journal of Pakistan Association of Dermatologists. Lipoatrophy as a manifestation of different clinical scenarios: corticosteroid injection, lupus profundus and morphea induced lipoatrophy
The distinguishing feature of these conditions is that the dent keeps getting deeper or is accompanied by skin changes like discoloration, hardening, or tenderness. Cellulite dimples stay roughly the same over time. A dent that progressively worsens, or one that appeared without any trauma or injection history, warrants a visit to a dermatologist. These conditions are treatable when caught, but the fat loss they cause is usually permanent if left alone.
Dents After Cosmetic Procedures
Ironically, procedures intended to improve buttock shape can sometimes leave visible dents. Liposuction that removes fat unevenly can create contour irregularities, especially if too much fat is taken from one area and not enough from the adjacent zone. Buttock implants can produce visible rippling or palpable edges that look like dents through the skin, particularly in patients with thin overlying fat. Secondary procedures using liposuction and fat grafting are sometimes performed specifically to smooth out these irregularities left behind by a previous implant.9PubMed Central. Enhancing Buttock Contours: A Safer Approach to Gluteal Augmentation with Ultrasonic Liposuction, Submuscular Implants, and Ultrasound-Guided Fat Grafting
If you have dents that appeared after a cosmetic procedure, the cause is typically either uneven fat removal, scar tissue formation at the surgical site, or the implant itself not sitting flush with the surrounding tissue. These are correctable in most cases, but the correction usually requires another procedure rather than time alone.
What Can Actually Be Done About Buttock Dents
Treatment depends entirely on what is causing the dent. There is no single approach that works for all types.
For cellulite dimples caused by fibrous bands, the most direct treatment is mechanical release of the bands themselves. A procedure called subcision uses a small blade or needle inserted under the skin to cut the pulling band. One review of the technique described how severing the band eliminates the traction on the skin, redistributes tension in the surrounding fat, and triggers formation of new connective tissue from the resulting bleeding beneath the skin.10PubMed Central. Treatment of Dimpling from Cellulite More recent targeted versions of this procedure allow the practitioner to verify which specific band is responsible for a dimple before cutting it, improving precision.11PubMed Central. Targeted Verifiable Subcision for Management of Cellulite on the Buttock and Thigh: Incorporation Into Real-World Lower Body Rejuvenation Approaches
For dents caused by volume loss, whether from lipoatrophy, aging, or weight changes, the approach is different. Fat grafting can fill the depression by transplanting fat from another area of the body. Injectable fillers are another option. A large observational study of injectable poly-L-lactic acid, a substance that stimulates the body’s own collagen production, found that the buttock region was the most commonly treated nonfacial area, accounting for about 60 percent of treatment sessions. Side effects were mostly mild, like bruising at the injection site, and the rate of lumps forming was very low.12PubMed Central. Nonfacial Use of Injectable Poly-L-lactic Acid: Safety Data From a Multicenter Observational Study in the United States
Radiofrequency devices that heat the tissue beneath the skin have shown some ability to contract the fat layer. One study found that roughly two-thirds of patients treated with controlled radiofrequency heating experienced a contraction of the subcutaneous tissue volume of about 20 percent.13Europe PMC. Effect of controlled volumetric tissue heating with radiofrequency on cellulite and the subcutaneous tissue of the buttocks and thighs These devices do not cut bands or add volume; they work by tightening the existing tissue, which may smooth out mild dimpling but is unlikely to fix deep, localized dents.
Exercise, Lifestyle, and the Limits of Both
Building the gluteal muscles through targeted exercise, squats, lunges, hip thrusts, and lateral band walks, can improve the overall shape of the buttocks by adding muscular volume beneath the fat layer. This can reduce the appearance of dents caused by muscle wasting and can make cellulite dimples less conspicuous by creating a firmer foundation for the skin to rest on. If your dents are related to prolonged sitting or general deconditioning, a consistent glute-strengthening program is genuinely the best first step.
What exercise cannot do is cut a fibrous band, replace lost fat from an old injection site, or reverse skin laxity from aging. The fitness industry sells the idea that you can “fix cellulite” with the right workout program, and while muscle growth can improve the look, the structural cause of the dimpling is in the connective tissue, not the muscle. A person with very strong glutes can still have visible cellulite. A person with weak glutes can have perfectly smooth skin. The two issues overlap but are not the same.
Maintaining a stable weight helps more than most people realize. Every cycle of significant weight gain and loss stresses the skin and the connective tissue architecture beneath it. Staying within a relatively narrow weight range gives the tissue the best chance of maintaining its structure over time, even as collagen slowly declines with age.
When to Actually See a Doctor
Most buttock dents are cosmetic and harmless, but a few patterns are worth getting checked. A single dent that appeared suddenly, keeps getting deeper, or is accompanied by pain could be fat necrosis from an unrecognized injury or, rarely, a deeper mass. The case series described earlier found that post-traumatic fat necrosis can sometimes mimic a tumor on imaging, which is why the patients in that study were initially referred to an oncology service before the benign diagnosis was confirmed.4PubMed. Symptomatic fat necrosis and lipoatrophy of the posterior pelvis following trauma
Dents with overlying skin changes, such as hardening, color changes, or tenderness, should prompt a dermatology evaluation to rule out inflammatory causes like lupus profundus or morphea. And asymmetric denting where one side is noticeably more hollowed than the other, particularly if it is accompanied by weakness or a limp, is worth mentioning to a doctor because of the possibility of nerve involvement or muscle atrophy from an underlying hip or spinal issue.
For everything else, the standard cellulite dimples that most people are asking about when they search this question, the honest reality is that they are a normal feature of human anatomy, disproportionately visible in women because of the way female connective tissue is structured, and present in some form in the vast majority of post-pubertal women regardless of fitness level or body weight. They are not a sign that something is wrong with you. If they bother you enough to seek treatment, the options described above exist, but understanding that the underlying cause is architectural rather than a deficiency in your diet or workout routine is the most useful thing to take away.