Dimples on the buttocks almost always come down to one of three entirely different things, depending on where exactly they sit and when they appeared. The most common explanation is cellulite, where fibrous bands beneath the skin pull inward and create visible depressions across the cheeks. But “butt dimples” can also refer to the paired indentations on the lower back just above the buttocks, known as the dimples of Venus, or to a small pit near the tailbone present from birth called a sacral dimple. Each has a distinct cause, and only one occasionally warrants medical attention.
Cellulite Dimples and Why They Form
When most people notice dimpling across their buttocks, especially dimples that seem to come and go with posture or that become more noticeable over time, they are looking at cellulite. The buttocks are actually the single most common location for it, and the reason has everything to do with the architecture just beneath the skin.
The tissue under buttock skin is layered: there is a superficial fat layer, a deeper fat layer, and sheets of connective tissue called fascia running between them. Connecting these layers to the skin’s underside are fibrous strands called septa. In the gluteal region, there are two types: short, thin septa that link the superficial fascia to the dermis, and tall, thick septa that run from the deep fascia all the way up to the skin’s surface. When fat cells in the superficial layer expand or the shorter septa weaken, the taller septa stay firmly anchored. They pull the skin inward at their attachment points while the surrounding tissue pushes outward, and that tug-of-war creates the characteristic dimpled look.
1Oxford University Press / Aesthetic Surgery Journal Open Forum. Cellulite: Current Understanding and Treatment – Section: ETIOPATHOGENESISThink of it like a mattress with buttons. The buttons (septa) hold the surface down at fixed points while the stuffing (fat) pushes up between them. The deeper the stuffing or the tighter the buttons, the more pronounced the tufting. That is essentially what is happening in the skin over your glutes.
Why Cellulite Dimples Are Far More Common in Women
If you are a woman noticing these dimples, you are in overwhelming company. Estimates suggest cellulite affects somewhere around 80 to 90 percent of post-pubertal women. The reason is structural, not just about body fat percentage. In women, the fibrous septa in the subcutaneous fat tend to run perpendicular to the skin surface, standing upright like columns. Fat gets stored in large globular pockets between those columns. When the fat cells expand or the septa shorten due to connective tissue changes, the columns retract at the points where they attach to the skin, pulling the surface inward and producing dimples.
2Dermatologic Surgery. Validated Assessment Scales for Cellulite Dimples on the Buttocks and Thighs in Female PatientsIn men, these septa tend to run at an angle or in a crisscross pattern, which distributes force more evenly and makes visible dimpling much less likely. Hormones play a role too: estrogen influences how and where fat is deposited, and it affects the connective tissue itself. This is why cellulite often first appears or worsens around puberty, pregnancy, or hormonal shifts, not necessarily because of weight gain.
One persistent myth is that cellulite is a sign of being overweight. It is not. Lean, athletic women get cellulite. The dimples reflect how the connective tissue is structured and how it interacts with the fat layer underneath, and that structure is largely inherited. Losing weight can sometimes reduce the appearance of cellulite, but it can also make it more visible if the skin loses volume while the septa stay anchored in the same spots.
Does Cellulite Get Worse With Age?
Many people assume cellulite worsens as the skin thins with age, and it often does become more visible over the years. But the relationship is not as straightforward as “thinner skin equals more dimpling.” Research has shown that dermal thickness decreases with age in both men and women, yet cellulite overwhelmingly affects women and commonly appears in young adults, suggesting that age-related skin thinning is not the primary driver.
3PubMed Central. Insights Into the Pathophysiology of Cellulite: A Review – Section: Discussion and ConclusionsWhat probably matters more over time is the gradual loss of elasticity in both the skin and the septa, changes in fat distribution driven by shifting hormone levels, and reduced collagen production. These factors can make existing dimples look deeper or more numerous even if your weight stays stable. The underlying architecture was already set up for dimpling; aging just removes some of the counterbalancing forces that kept the surface smoother when you were younger.
Dimples of Venus Are Something Else Entirely
If the dimples you are noticing are a symmetrical pair of indentations on your lower back, right where the back meets the top of the buttocks, you are looking at something completely unrelated to cellulite. These are called the dimples of Venus (or, in anatomical terms, fossae lumbales laterales). They sit directly over the posterior superior iliac spine, which is a bony landmark on each side of the pelvis. A short ligament connects the skin to this bony point, and where the skin gets pulled down toward the bone, you see a small depression.
These dimples are purely anatomical. They are visible on some people and not others, largely depending on body composition and the shape of the pelvis. They are more noticeable in people with lower body fat in that region and have long been considered an aesthetic feature rather than a medical concern. Research has found that people with the dimple of Venus tend to have a higher pelvic incidence angle, which is a measurement of how tilted the pelvis is, and more sagittally oriented facet joints in the lower spine.
4Karger Publishers. Dimple of Venus Is Associated with the Increased Pelvic Incidence Angle and More Sagittally Oriented Facet Joint – Section: ResultsIn practical terms, this means the dimples of Venus may be a visible marker of a particular pelvic shape, but they do not predict back problems or signal any underlying condition. They are present from birth in many people and simply become more or less visible depending on how much subcutaneous fat sits over the area. If yours have appeared suddenly, it is almost certainly a change in body composition making a pre-existing anatomical feature more visible, not something new developing.
Sacral Dimples in Babies and Adults
A sacral dimple is a small pit or indentation in the skin near the base of the tailbone, right at the top of the crease between the buttocks. Unlike cellulite or Venus dimples, sacral dimples are congenital, meaning they are present from birth. They are fairly common in newborns, with prevalence estimates ranging from roughly 2 to 7 percent.
5PubMed Central. Sacral dimple: clinical perspectives of lesions hidden beneath the skin – Section: IntroductionMost sacral dimples are completely harmless. A simple sacral dimple is typically defined as a single, midline depression less than 5 mm across, located within about 2.5 cm of the anus, with no other unusual skin features around it. These simple dimples are not associated with spinal problems and do not require imaging or treatment.
6PubMed Central. Sacral dimple: clinical perspectives of lesions hidden beneath the skin – Section: DiagnosisWhere sacral dimples warrant closer attention is when they are unusually large, deep, located far from the anus, or accompanied by other skin findings like a tuft of hair, a skin tag, unusual pigmentation, or a hemangioma. These features can sometimes signal a condition called occult spinal dysraphism, where the lower spinal cord did not close completely during development. One potential complication is tethered cord syndrome, where the spinal cord is anchored in a way that restricts its movement and can cause neurological problems over time. When concerning skin features are present in the lumbosacral region, clinicians typically recommend spinal ultrasound to check for underlying abnormalities.
7PubMed Central. Risk of occult spinal dysraphism based on lumbosacral cutaneous manifestations – Section: CONCLUSIONIf you are an adult who has always had a small dimple near the tailbone that has never caused symptoms, it is almost certainly a simple sacral dimple that never needed evaluation. Adults who develop new pitting or drainage in this area should see a doctor, but that would more likely point to a pilonidal cyst than a sacral dimple.
Rare Congenital Dimples at Other Sites
Occasionally, dimples appear in less typical locations, including the buttocks, shoulders, or elbows, and are present from birth. These congenital skin dimples have sometimes been described as a benign trait that can run in families. However, case reports have documented symmetric congenital dimples appearing alongside various other conditions, including certain congenital syndromes, metabolic disorders, and mechanical trauma during development.
8Karger Publishers. Multiple congenital symmetric skin dimplesThese cases are unusual enough that most people will never encounter them. If a baby is born with dimples in unusual locations, pediatricians will typically evaluate whether the dimples are isolated or part of a broader pattern. For adults noticing a dimple on the buttock that has been there as long as they can remember and has never changed, the odds strongly favor a benign anatomical quirk.
Treatment Options for Cellulite Dimples
Because cellulite dimples are by far the most common reason someone notices buttock dimpling, treatment research has focused heavily on addressing the fibrous septa that cause the depressions. The approaches that have the most evidence behind them work by physically releasing or dissolving those tethering bands.
Subcision
Subcision involves inserting a small device beneath the skin to physically cut the fibrous bands responsible for individual dimples. In one targeted approach, a small hook is deployed beneath the depression to pull each septal band, confirming it contributes to that specific dimple, before cleaving it.
9Aesthetic Surgery Journal Open Forum. Cellulite and the Aesthetic Management of the Buttocks and Thighs: 6 Cases Illustrating Targeted Verifiable Subcision as Part of a Multimodal Approach to Lower Body Rejuvenation – Section: METHODSAcoustic subcision uses rapid sound-wave pulses to disrupt the septa without a blade. In one study comparing two different pulse rates, the majority of blinded reviewers correctly identified all before-and-after treatment photos, and 80 percent of participants agreed that their cellulite looked improved at the 12-week follow-up. Pain was low and no serious side effects occurred.
10PubMed. Comparing safety and efficacy of acoustic subcision at two different rapid acoustic pulse rates to improve the appearance of cellulite – Section: RESULTSEnzyme Injection
An injectable enzyme treatment using collagenase clostridium histolyticum was developed specifically for cellulite dimples on the buttocks. The enzyme dissolves the collagen in the septa, releasing the tether and allowing the skin to smooth out.
11PubMed Central. Collagenase Clostridium Histolyticum-aaes for Treatment of Cellulite: A Pooled Analysis of Two Phase-3 Trials This treatment was FDA-approved and marketed under the brand name QWO, though its manufacturer later discontinued it for commercial reasons unrelated to safety or efficacy. The approach demonstrated that enzymatic disruption of septa could produce visible smoothing, and the concept has influenced ongoing research into similar injectable treatments.12PubMed Central. Collagenase Clostridium histolyticum for the Treatment of Cellulite in the Buttocks and Thigh: Early Insights From Clinical Practice
Acoustic Wave Therapy
Acoustic wave therapy uses focused sound waves applied externally to the skin. In a placebo-controlled, randomized, double-blinded study, the treated group showed statistically significant improvements in the number and depth of dimples, skin firmness, and texture, while the placebo group did not.
13PubMed. Placebo controlled, prospectively randomized, double-blinded study for the investigation of the effectiveness and safety of the acoustic wave therapy (AWT®) for cellulite treatment Low-energy extracorporeal shock wave therapy has also shown promise by remodeling collagen within the skin.
14PubMed Central. Can cellulite be treated with low-energy extracorporeal shock wave therapy? – Section: ResultsWhat Does Not Work as Well as Advertised
The cellulite treatment market is enormous, and the gap between what is marketed and what is supported by good evidence is wide. Topical creams containing caffeine, retinol, or herbal extracts are among the most widely sold products for cellulite, yet their effects are limited to temporary skin tightening through mild dehydration or irritation of the surface layer. They cannot reach the septa or the fat lobules that actually cause the dimpling.
Massage-based devices, including rollers and suction tools, can temporarily improve the appearance of cellulite by increasing blood flow and shifting fluid in the tissue. The effects typically fade within hours to days. Dry brushing falls into the same category: it feels like you are doing something, and the temporary plumping of irritated skin can briefly reduce dimple visibility, but nothing structural has changed.
Exercise builds muscle and can alter the contour of the buttocks in ways that reduce the appearance of dimpling, but it cannot change the orientation of the septa or dissolve the fibrous bands pulling the skin inward. The same goes for weight loss. Both are beneficial for overall health and can sometimes improve the look of cellulite, but neither addresses the root cause. The research consistently points in one direction: treatments that physically or enzymatically release the septa are the only ones that produce lasting structural change in cellulite dimples.
How to Tell Which Kind of Dimple You Have
Location and pattern are your best clues. Cellulite dimples are usually scattered, multiple, and most visible when you squeeze the skin or when light hits at an angle. They tend to appear on the cheeks and outer thighs, and they can shift or flatten depending on your position. Venus dimples are exactly two, perfectly symmetrical, and sit right where the lower back meets the top of the buttock crease, over a bony prominence you can feel if you press. A sacral dimple is a single small pit right at or just above the top of the gluteal cleft, near the tailbone.
If you have widespread dimpling across the buttock cheeks, you are almost certainly looking at cellulite. If you have two symmetrical dimples on the lower back, those are Venus dimples and purely cosmetic. If you have a single small pit at the base of the spine that has been there your whole life and never caused trouble, that is likely a simple sacral dimple. Any dimple that is new, growing, draining fluid, or associated with pain or neurological symptoms like numbness or weakness in the legs deserves a visit to a doctor, not because buttock dimples are dangerous in general, but because those specific features fall outside the normal range.