The shape of the buttocks, hips and thighs, and the quality of the skin of these areas depends on ethnic background, obesity and age as well as past pregnancies. These factors often result in excessive development of the hips, buttocks and thighs. The treatment in the past consisted of large excisions of crescents of skin from the lower part of the buttock to the upper part of the thigh and from the iliac crest to the inner buttock area. These large excisions resulted in complete removal of the offending excesses, however, the scars from these techniques were usually extensive. The size of the buttocks and the saddlebags can be markedly reduced with liposuction and the deformities can be improved. Some cases require a combination of procedures with liposuction and excisions. Trochanteric lipectomy, liposuction and inner thigh liposuction combined with dermatocrurolipectomy are discussed in this chapter.