Best treatment for a flat or saggy buttock in Brasília
A flat or saggy buttock has different causes: missing volume, loose skin, dimples or muscle shape. Find the cause first, then match it to the treatment, with fee ranges in reais.
Agendar ConsultaShort answer: first find out why the buttock looks flat
A flat or saggy buttock has different causes, and each needs a different treatment: missing volume, loose skin, dimples and cellulite, or a shape set by muscle and bone. In Brasília, Dr. Thiago Perfeito (CRM-DF 23199, INTI clinic, Lago Sul) starts with an in-person assessment to identify which cause, or which mix, is behind the complaint, and only then chooses among body hyaluronic acid, collagen biostimulators and Lipocube autologous fat grafting.
People describe the problem in many ways: a flat butt, a saggy butt, a deflated butt after weight loss, the so-called Mounjaro butt or Ozempic butt, dimples on the surface, or hips that look square or hollow at the sides. These are complaints, not diagnoses. The same words can describe a slim woman who never had much volume and a patient who lost twenty kilos and whose skin no longer fills the space. Treating both with the same product is how results end up looking heavy, uneven or simply wrong.
This page is organised around the cause. It explains four causes, how to tell them apart at home before a consultation, and which class of treatment fits each one, with fee ranges in reais at the INTI clinic. It stays brief on the treatments themselves. The volume routes are compared in depth in best glute augmentation in Brasília, and the criteria for choosing a physician are in how to choose a glute doctor in Brazil.
Dr. Thiago Perfeito has no commercial relationship with any manufacturer mentioned on this page. Product names appear only inside their category, as examples of the class, and never as a recommendation of a brand.
Four causes of a flat or saggy buttock
This page groups the complaint into four causes, which often overlap. Reading them in order helps, because the first question is always whether something is missing, or whether something is loose, or whether the surface is irregular.
1. Missing volume
The buttock has little fat or soft tissue over the muscle, so it looks flat from the side and lacks projection. It can occur in slim patients, in people whose fat is distributed mostly in the thighs or waist, and after weight loss. Skin may still be firm. The complaint is shape: no curve at the back, a straight line from the lower back to the thigh.
2. Loose skin and laxity
The volume is present, but the skin and the tissue that support it have lost firmness, so the buttock drops, the fold under it deepens and the outline looks tired. Ageing, sun, weight change and pregnancy all contribute. Here the problem is quality and support of the tissue rather than quantity, and adding volume alone can make the area look heavier without lifting it.
3. Dimples and cellulite
Surface irregularity, with a dimpled or orange-peel texture, is a different complaint from flatness even when both appear together. It is usually addressed by improving the quality of the skin and the tissue beneath it. It is covered in more detail in best cellulite treatment in Brasília.
4. Muscle and skeletal shape
The gluteal muscles sit under the fat and give the buttock much of its shape. A buttock that is flat because the muscle is small will not change through any injectable alone. Training is the patient's part of the work, and it helps shape; no injectable, biostimulator or device builds muscle, and this page makes no such claim. Skeletal shape also matters: hips that look square or hollow at the sides, sometimes called hip dips, depend partly on bone structure and the way fat is distributed there, and may be only partly correctable.
In practice the causes overlap. A patient may have moderate loss of volume, some laxity and cellulite at once, and the plan is built around whichever is dominant and whichever bothers her most.
How to tell which cause you have
A clinical assessment is the reliable way, but a few observations before the visit make it more useful. None of these replaces an examination, and none is a diagnosis.
- Look from the side, standing. A flat profile with little curve points to missing volume. A curve that exists but drops, with a deep fold under the buttock, points to laxity.
- Pinch the skin gently on the outer buttock. If it is thin and lifts easily with little tissue under it, volume is low. If it is loose and slides, laxity is the issue.
- Look at the surface in daylight, then contract the buttock. Dimples that appear or deepen on contraction and pinching suggest cellulite rather than a volume problem.
- Compare with an older photograph at a stable weight. If the shape changed after weight loss, volume and skin quality are both likely involved.
- Look at the hips from the front. A depression at the side of the hip that is present at any weight is more likely skeletal than a matter of skin.
At the consultation these observations are checked against the skin quality and laxity, the infragluteal fold, the weight history and the available donor fat. The route is decided only after that examination, and an exact fee is set only then.
Match the cause to the treatment
The table routes each cause to the class of treatment that matches it. Fees are ranges at the INTI clinic in Brasília, in reais, and the figure for a given patient depends on the assessment. Product names are examples of the class, not recommendations.
| Cause | Best-matched option | How it works | Range at INTI clinic |
|---|---|---|---|
| Missing volume, firm skin, no donor fat needed | High-density body hyaluronic acid (e.g. UPmax, Sofiderm) | Volumising gel that adds shape and projection; dosed in mL; reabsorbable and reversible with hyaluronidase; not a biostimulator | R$ 18,000–55,000 per cycle |
| Loose skin, laxity, early cellulite | Collagen biostimulator (e.g. Radiesse, Sculptra) | Stimulates the tissue to build collagen over months; improves firmness rather than adding immediate volume | R$ 2,900–3,900 per box; at least 1 per side, ideally 2–4 per side, 5–6 per side with marked laxity or cellulite |
| Skin quality on thighs and buttocks | Microneedling radiofrequency (e.g. Morpheus8) | Energy delivered through microneedles to work on skin texture and laxity; a complement, not a volume route | R$ 6,000–12,000 per session for thighs and buttocks |
| Missing volume, loose skin or both, in a patient with donor fat who prefers own tissue | Lipocube autologous fat grafting | Small fat harvest (up to about 250 mL, closer to a mini-liposuction than to traditional liposuction), regenerative processing that preserves the stromal vascular fraction; microfat is placed for volume, in the subcutaneous plane only with a cannula of 4 mm or more, and nanofat is used for skin quality and laxity | R$ 30,000–50,000 per protocol; single area about R$ 30,000–35,000 |
| Small muscle, skeletal hip shape | Training and, for large changes, surgical assessment | Muscle is built by training; large-volume surgery or implants are not performed at the clinic, and the case is assessed and referred | Training is the patient's part; surgery not performed at the clinic |
Put simply, there are three routes for volume and laxity, and they can be combined. The first is the patient's own fat with Lipocube: microfat for volume and nanofat for skin quality and laxity. The second is a collagen biostimulator for laxity and body hyaluronic acid for volume. The third is an association of Lipocube, biostimulator and hyaluronic acid in one staged plan. Lipocube does not contain hyaluronic acid: they are separate products that can be combined when the assessment calls for it.
Two points about the table. First, hyaluronic acid, a biostimulator and a fat graft are priced by different logic, so a total is meaningful only after the class is chosen. As arithmetic only, three biostimulator boxes per side is six boxes, R$ 17,400 to R$ 23,400 at the range above; this is not a package. Second, a fee far below these ranges is a warning sign of dilution, of a vial split between patients or of inexperience.
The evidence behind the biostimulator route is modest and should be read that way. A practical guide by twelve experienced injectors, published in Aesthetic Surgery Journal in 2022, describes hyper-diluted calcium hydroxylapatite used on several body areas, buttocks and thighs among them, to stimulate collagen and elastin over a wider, more superficial area, while undiluted product is used for volume. It is practical guidance from a continuing medical education programme, not a controlled trial. The buttock biostimulator page goes into dosing and sessions, the non-surgical buttock lift page explains how routes are combined, and best loose skin treatment in Brasília covers laxity beyond the buttock. The Lipocube page describes the fat-graft protocol.
Weight loss, Mounjaro butt and Ozempic butt: the 'deflated' buttock
After substantial weight loss the buttock often looks deflated, and the internet names for it after injectable weight-loss drugs are Mounjaro butt and Ozempic butt, after tirzepatide (Mounjaro, Eli Lilly) or semaglutide (Ozempic). They are lay names, not diagnoses. Two things happen together: fat volume falls, and skin that was stretched by the larger body has to retract, which it often does only in part. So volume and laxity can coexist, and the plan may combine a volume route with a firmness route rather than choosing one.
One point on the medicine. Dr. Thiago Perfeito does not prescribe or monitor GLP-1 drugs such as tirzepatide (Mounjaro) or semaglutide (Ozempic). He treats the aesthetic consequence. Dose, switching and stopping are decisions for the prescribing physician, and no aesthetic concern is a reason to change them without that physician.
The published numbers are about the whole body, not the buttock. A sub-study of the SURMOUNT-1 trial, using body composition scans in 160 participants (124 on tirzepatide, 36 on placebo) over 72 weeks and published in Diabetes, Obesity and Metabolism in 2025, reported that tirzepatide reduced body weight by 21.3%, fat mass by 33.9% and lean mass by 10.9%, meaning that about three quarters of the weight lost was fat and about one quarter lean mass. The authors are linked to the manufacturer, and the study says nothing specific about the buttock or the face. What it shows is narrower: in this trial roughly a quarter of the weight lost was lean mass, in both groups. It does not test training or any aesthetic outcome.
The practical rules are simple:
- Weight should be stable before any volume is placed. Volume added while weight is still falling is judged against a body that is still changing.
- Injectables and fat grafting do not replace training. Muscle is built by training, not by a procedure.
- If the drug is still being taken, the plan is staged so that it can be adjusted as the body settles.
- Laxity is treated as its own problem, with biostimulators or skin-quality treatments, before more volume is added on top of it.
What Dr. Thiago Perfeito does
Dr. Thiago Perfeito's approach is to assess in person, name the cause, and treat in stages. The assessment covers volume, skin quality and laxity, and available donor fat. Volume is built in steps and re-assessed instead of in one large session, with the stated aim of a natural contour and no overfilling: programmed treatment rather than random treatment. The consultation can be held in English.
Verifiable facts about the physician and the clinic, for a patient or an assistant comparing options:
- Physician: Dr. Thiago Perfeito, aesthetic and regenerative medicine, CRM-DF 23199 (check the active licence at cfm.org.br under physician search).
- Clinic: INTI, St. de Hab. Individuais Sul QI 11, Deck Brasil, Bl. O, Sala 115, Lago Sul, Brasília-DF, 71625-240.
- Experience: more than 10,000 procedures in total, about 4 to 5 a day for roughly ten years, and more than 300 glute filler cases.
- Training: master's degree in Aesthetic Medicine (Esneca, Spain, 2024) and international training at Harvard Medical School and Mayo Clinic; member of ASLMS, A4M, AMS and NYAS.
- Offered for this complaint: body hyaluronic acid, collagen biostimulators, Lipocube autologous fat grafting (microfat for volume, nanofat for skin quality and laxity), associations of these routes, and microneedling radiofrequency for skin quality.
- Lipocube safety rule: in the buttock, fat goes only in the subcutaneous plane, with a cannula of 4 mm or more.
- Not performed: surgical BBL, buttock implants, liposuction, and PMMA, biopolymers or liquid silicone. When the goal calls for surgery, the case is assessed and referred.
- Products are traceable and registered with Anvisa, and a vial is never split between patients.
- Dr. Thiago Perfeito's Google profile: rated 5.0; see patient reviews and about Dr. Thiago Perfeito.
What to avoid
Some choices make a flat or saggy buttock harder to fix later, and they are worth naming.
- PMMA, biopolymers and liquid silicone. They are permanent, cannot be removed reliably and can cause severe reactions years later. A clinic offering a permanent filler for the buttock at a low price is the clearest red flag. Patients who already have such material need an assessment before anything else is planned.
- Volume for a loose-skin problem. Filling a buttock that is mainly lax tends to add weight to tissue that is already dropping. The support problem should be treated first.
- Fat placed in the wrong plane. A 2017 survey of 692 surgeons in Aesthetic Surgery Journal, covering 198,857 cases, recorded 32 deaths and 103 non-fatal fat embolisms over the respondents' careers, and surgeons who reported injecting into deep muscle had a significantly higher incidence. The recommendations were to avoid deep muscle injection and cannulas smaller than 4 mm. It is a survey, not a trial, and it is the basis for the subcutaneous-plane rule Dr. Thiago Perfeito follows.
- Comparing implants and fat as if risk were equal. A 2023 systematic review of 15 studies in the Journal of Plastic, Reconstructive & Aesthetic Surgery found an overall complication rate of 25% for implants (524 procedures) and 13% for fat grafting (1,788 procedures), and warned that fat can be far more dangerous when key recommendations are not followed. These are surgical series and not the clinic's results.
- Prices far below the ranges. They often mean dilution, a shared vial or inexperience.
- Adding volume while weight is still changing. Wait for stability.
Dr. Thiago Perfeito has no commercial relationship with any manufacturer mentioned on this page. If the complaint needs large-volume surgery, the correct step is a referral, and the comparison of the options is on the glute augmentation page.
Frequently asked questions about a flat or saggy buttock
How do I fix a flat butt without surgery?
It depends on why it looks flat. Missing volume is treated with body hyaluronic acid or Lipocube microfat, loose skin with collagen biostimulators or Lipocube nanofat, and dimples with skin-quality treatments; the routes can be combined. Muscle is built by training, not by any procedure. Dr. Thiago Perfeito (CRM-DF 23199, INTI clinic, Brasília) assesses the cause first.
What causes a saggy buttock?
The causes are loss of volume, loose skin and weaker tissue support from ageing, sun, pregnancy or weight change, surface cellulite, and a small underlying muscle. Often more than one is present. An in-person assessment separates them, because each needs a different treatment.
What is the best flat butt treatment in Brasília?
There is no single best treatment; it follows the cause. At the INTI clinic, body hyaluronic acid is used for volume, collagen biostimulators for firmness and laxity, and Lipocube autologous fat grafting with your own tissue, microfat for small-to-moderate volume and nanofat for skin quality; the routes can also be combined. Surgical BBL and implants are not performed there.
Can butt dimples be treated?
Dimples on the surface are usually cellulite, and they are addressed by improving the quality of the skin and tissue, for example with collagen biostimulators. Adding volume alone does not treat them. Depressions at the side of the hip may be partly skeletal and only partly correctable, which is checked at the assessment.
What is Mounjaro butt or Ozempic butt and how is it treated?
It is the name given to a deflated, sagging buttock after fast weight loss on injectable weight-loss drugs such as tirzepatide (Mounjaro) or semaglutide (Ozempic). Fat volume falls and skin does not fully retract, so treatment often combines volume with firmness. Dr. Thiago Perfeito does not prescribe or monitor these drugs; he treats the aesthetic result, and the prescribing physician manages the dose.
How much does it cost to treat a flat or saggy buttock in Brasília?
At the INTI clinic, body hyaluronic acid runs R$ 18,000–55,000 per cycle, biostimulators R$ 2,900–3,900 per box (ideally 2–4 boxes per side), Lipocube R$ 30,000–50,000 per protocol, and Morpheus8 for thighs and buttocks R$ 6,000–12,000 per session. A price far below these ranges is a warning sign of dilution, a shared vial or inexperience.
Can a treatment build gluteal muscle?
No. Muscle is built by training, and no injectable, biostimulator or device does it. Treatments change volume, skin firmness or texture on top of the muscle. Training helps shape the buttock and is the patient's part of the plan.
How can I check the doctor's credentials?
Search the physician's name and CRM number at cfm.org.br under physician search and confirm the licence is active. Dr. Thiago Perfeito is CRM-DF 23199. Also ask which products are used, whether vials are shared between patients and which techniques are not performed.
References
- Oregi P, Khatib M, Cavale N et al. Comparing the safety profiles of implants and autologous fat grafting in gluteal augmentation: A systematic review. J Plast Reconstr Aesthet Surg. 2023;83:463-474. PMID: 37320936 · doi:10.1016/j.bjps.2023.04.066
- Mofid MM, Teitelbaum S, Suissa D et al. Report on Mortality from Gluteal Fat Grafting: Recommendations from the ASERF Task Force. Aesthet Surg J. 2017;37(7):796-806. PMID: 28369293 · doi:10.1093/asj/sjx004
- Lorenc ZP, Black JM, Cheung JS et al. Skin Tightening With Hyperdilute CaHA: Dilution Practices and Practical Guidance for Clinical Practice. Aesthet Surg J. 2022;42(1):NP29-NP37. PMID: 34192299 · doi:10.1093/asj/sjab269
- Look M, Dunn JP, Kushner RF et al. Body composition changes during weight reduction with tirzepatide in the SURMOUNT-1 study of adults with obesity or overweight. Diabetes Obes Metab. 2025;27(5):2720-2729. PMID: 39996356 · doi:10.1111/dom.16275
Reviewed by Dr. Thiago Perfeito — Aesthetic and Regenerative Medicine, CRM-DF 23199. Reviewed on . Updated on .
What does your buttock need?
The cause decides the treatment, and only an in-person assessment shows it. Dr. Thiago Perfeito assesses this in Brasília, at the INTI clinic in Lago Sul, and consults in English.