It is also called purse-string suspension surgery. It improves buttock sagging due to inadequate support from loose skin in patients who present an abundant volume of the buttock. If such patients do not need to undergo buttock augmentation, they can consider this surgery to correct buttock ptosis.

This surgery is conducted by making a 0.5-cm incision at the central gluteal groove and both lateral sides of the buttock. Via such small incisions, Dr. Chuang embeds a buttock lift thread along the subcutaneous passage with a special tractor and pulls and hauls the suture to the center. Such an endocentric embedding suspension method tightens and lifts the droopy gluteal tissues superomedially to the center of the buttock (purse-string suturing). Finally, the thread is fixated deep in the periosteum at the incision of the center of the gluteal groove. The larger the number of buttock lift threads embedded, the tighter and more persistent the results would be. On an average, at least two threads should be embedded at each side of the buttock to attain distinct results. Such a surgery is merely aimed at buttock skin lift rather than filling or plumping up the buttocks, so the size of the buttock is not changed after the surgery. It is suitable for female patients with hypertrophic but droopy buttocks or early buttock sagging. Nevertheless, the strength and durability of using a buttock lift thread to support whole tissues vary along with individuals, and patients should avoid strenuous or continuous lower body activities after the operation in case of premature loosening of the buttock lift thread. Surgical results last for 2–3 years on average, and the surgery can be repeated in the future.