Postbariatric, cosmetic, and circumferential body lift patients seek to avoid a flattened buttock contour. Gluteal implants have been described with various rates of complications and difficulties. Lipografting moderately increases buttock volume; neither procedure directly addresses ptosis. The procedure described in this article addresses the volume deficit and ptosis. Most adipocutaneous flaps originate within the superior gluteal region and maintain volume in the top half of the buttocks, lacking the ability to reach the midportion of the buttocks. The ideal flap should be versatile, result in a superior gluteal concavity, and give the maximum projection at the midlevel of the buttocks.