It can also be used to improve a double infragluteal fold, to correct infragluteal fold asymmetry, or to shorten a long buttock when combining it with an upper buttock lift. A long infragluteal fold can also be improved and a more youthful shape be obtained. Grade 3 (borderline pre-ptosis): the fold is over the M line, but still there is no ptotic tissue at the M line. 3). D. The Buttock Lift with Hyaluronic Acid and Threads. Independent of the filler chosen, the marking of the area to be filled follows some of the landmarks described above in order to achieve the desired gluteal contour. 1 43/black/F III 24 Topical and oral antibiotics Infragluteal fold, bilateral axilla, left groin 2 50/black/M III 7 Topical and oral antibiotics; surgery Buttocks, left axilla, perineumThe infragluteal fold/thigh junction (lower glu-teal cleavage) also requires definition. Patients with skin laxity and infragluteal fold ptosis may require a buttock lift or direct fold excision in order to obtain an acceptable result. Limits implant movement. Patients with buttock ptosis and medial thigh skin laxity without lateral thigh redundancy are ideal candidates. Some surgeons call this a removal of banana roll; more technically, it is an infragluteal fold incision for excision of upper posterior thigh skin and fat. Zone 3: Proximal inner thigh confluences with Zone 1 to recreate a round buttock and follow the infragluteal fold. 5 Mendieta’s ptosis evaluation utilizing skin fold angles for classification. Infragluteal fold reconstruction is achieved by reconstruction of the buttock’s sustaining apparel through deepithelialized skin flaps anchored to deep gluteal fascia. Its inferior border is formed by the insertions of the semitendinous muscle and the long belly of the biceps femoris in the ischial tuberosity. in· tra· glu· te· al -ˈglüt-ē-əl, -glü-ˈtē-əl. There is a very specialized method to form infra gluteal crease, using lipo 360 with directed fat grafting under ultrasound guided injections as required in Florida, and specialized sub dermal lipo techniques with taping to form infra gluteal crease. 2. The technical details and surgical results of a pedicled skin flap raised in the infragluteal fold, used to widen the vaginal introitus in 6 patients, to reconstruct the labia majora in 5, and to close a rectovaginal fistula in 4, survived without signs of impaired circulation. Detailed clinical assessments of infragluteal fold, degree of flaccidity, projection, gluteal shape, and skin surface irregularities are required to define the overall objectives of the procedure. The inframammary crease 5 , 13 lies over the fifth to sixth ribs. Answer: Lower butt lift. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. The Infragluteal Thigh Lift Technique. The infragluteal fold, which attaches to both the ischium and the sacrum in a continuous fashion, is an anatomic structure in its medial part and only a crease laterally. Expand. The buttock can be infiltrated through the superior gluteal mid-incision, although infiltration can also be performed through the infragluteal fold. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. The "sensuous triangle" is found at the junction of the lateral. Cárdenas The infragluteal fold is one of the major concerns in reshaping of the gluteal region. Search for termsThis area is known as a safety triangle with its apex between the sacral dimples and its base along the medial two-thirds of the infragluteal fold, on both sides. Dr. Reply: Staying Safe during Gluteal Fat Transplantation. The infragluteal area may be slightly improved after buttock augmentation resulting in less of a requirement for skin. This would go from the outer buttock fold and into the groin and possibly communicate with your prior thigh lift. PDF. Infragluteal fold revision Buttock lift The author prefers tostageexcisionalcontouring procedures in association with gluteal implants. For many years, it was thought that this area should be suctioned aggressively, and it was never taken into account that buttock support and projection depend on it. Conclusion: Focused ultrasound is a safe, effective and well tolerated procedure for remodelling areas of the body. It is used for correcting sagging lower buttock tissue that either hangs over the existing infragluteal fold or when the infragliuteal folds has dropped creating an elongated buttock shape. The iatrogenic forms of banana fold and sensuous triangle deformity are produced by excessive. One can not liposuction between the two and create a single infragluteal crease. The infragluteal area may be slightly improved after buttock augmentation resulting in less of a requirement for skin resection. D. Save. The dissection of 60 fixed surgical pieces showed the presence of a Buttocks' Sustaining Aparell formed by a trabecular conjunctival mesh termed main and secondary in a "beehive" aspect which may possibly be important in the maintenance of the buttock's characteristic contour. Note anterior abdominal wall. The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. 23. Ozmen S. spiraling anteriorly to the flank and posteriorly to the infragluteal fold, thus joining the previous flank and infragluteal. Reliable use of the gluteal thigh flap is still possible in cases where the resulting scar of a previous infragluteal transposition flap extends over the full length of the infragluteal fold (Fig. A. Five fixed cadavers were used. The authors present a simple and effective technique for reconstruction of the gluteal fold by a deepithelialized skin flap that is applicable for patients who have lost their naturalgluteal sulcus, with a resultant altered buttock shape, after trauma or other causes. A small ellipse of posterior thigh and inferior gluteal tissue approximately 3-1/2" long will allow access to place permanent sutures from the SFS to the ischial tuberosity (from the fat below the skin to the bones at the. Thus, every effort should be undertaken to preserve or reconstruct this important anatomical landmark . 51. The infragluteal fold is where the bottom of the buttock meets the upper thigh. Tissue samples (6 cm long × 2 mm thick) were taken at three. Infragluteal fold reconstruction is fracture was diagnosed, and she underwent surgery achieved by reconstruction of the buttock’s sustaining ap- for posterior instrumentation to stabilize the fracture parel through deepithelialized skin flaps anchored to deep in orthopaedic department. The region of the infragluteal fold has been generally ignored or inadequately treated. The infragluteal fold has been reconstructed, leading to an aesthetic appearance of the gluteal region soft tissue (skin and fat) will often lead to disappointing biceps femoris laterally since this is the natural ending of results, including wide scarring, recurrence of ptosis, and the fold [2]. The infragluteal fold region is the lower edge of the buttocks. No major complications or. Fig. Buttock Lifting Using Elastic Thread (Elasticum®) with a New Classification of Gluteal Ptosis. This fold or crease is formed under the ischial tuberosity by the insertions of the semitendinous muscle, biceps femoris, and lower portion of the gluteus maximus. 88 and 3 cm in the circumference of the abdomen, hips and thighs, respectively. I hope this helps. A longer infragluteal fold suggests an aged, ptotic, and deflated-looking buttock with skin and fascial excess. Abstract. This fold’s length and shape has a pre-eminent role in gluteal aesthetics: a long fold indicates a ptotic buttock, whereas a short one suggests a young. 8): Fig. The muffin bottom can be sculpted using the tumescent technique under either IV sedation or general anesthesia. It has been noted in multiple. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. 17). 3). The need for liposuction of the lower back or hips is considered. Via its numerous collateral branches, the posterior femoral cutaneous nerve innervates a very extensive territory including the posterior surface of the thigh, the infragluteal fold. A fusiform excision located in the posteromedial portion of the infragluteal fold is least likely to produce a visible scar (Figure 36-13). Patients with skin laxity and infragluteal fold ptosis may require a buttock lift or direct fold excision in order to obtain an acceptable result. The lateral border of the gluteus maximus muscle is easier to identify when the patient internally rotates the thigh. Does it have adownward 45º angle, run horizontally, or havean inverted. Cadaveric dissection reveals that the IGF is a connective fibrous band extending from the ramus of the ischium, the apex of the sacrum, and the coccyx, to the. Dear Anna, judging from the picture posted on the forum, you seem to have buttock ptosis with a deep infra gluteal fold. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. A longer infragluteal fold suggests an aged, ptotic, and deflated-looking buttock with skin and fascial excess. A. With your feet shoulder width apart, place your hands on the barbell (whether on lifting blocks or in a Smith machine), with your palms either over or under the bar. Indianapolis, Indiana. The flap width was designed to match the broadest width of the defect, which was assessed from the inner. Ranch & Coast founder, Dr. D1 has a posterior and a posteromedial surface. The author has simply combined the incisions. Supragluteal fossettes. Results The infragluteal fold is a connectival brous band extending from the ramus of the ischium (but not involving the ischial tuberosity, for a length of 21 mm ± 2 and 21 mm ± 3), the apex of the sacrum (for a length of 13 ± 2 and 11 mm ± 2), and the coccyx (for a length of 19 mm± 2 and 20 mm± 2, all measures referring to volunteers. 6+/-0. By adding more volume on the left and matching the right, the fold will appear as a result of this added volume. All patients showed an improved definition of the infragluteal fold, with a symmetric shape of the gluteal region. With sagging of the muscle belly, the infragluteal fold is decreased or lost, and atrophy of the buttock is obvious with time. The flap was composed of subcutaneous tissue, and dermis if desired, and was extended laterally to the length needed to approximately reach the infragluteal fold, and then rotated. BackgroundThe gluteal fold represents an important aspect of the gluteal region. Infragluteal fold excision can be performed either before or after implantation . This study reevaluated the fold both histologically and anatomically. Tissue samples (6 cm long 9 2 mm thick) were taken at three points from each fold bloc: the most medial point, the middle. Urinary and bowel. 5 cm distal to the subgluteal fold, the sciatic nerve was consistently identified directly at the ventral end of the hyperechoic structure in all volunteers. It has been noted in multiple. ResultsThe infragluteal fold is a connectival fibrous band. The final result should be to attain a waist-to-hip ratio (WHR) close to 0. S3 provides innervation to the infragluteal fold . 6 Those patients with some buttock volume and skin falling slightly below the infragluteal fold are described as having Grade I ptosis. Augmentation of the fold with fat would help you achieve a smoother transition between the butt. 8 Zones in the inferior gluteal area: 1 lower internal ( light blue ), 2 lower external ( yellow ), 3 inner thigh ( purple ), 4 outer thigh ( red ). 2) Excision of the infragluteal overhang is the definitive and assorted treatment of lower buttock ptosis. A more objective, faster and shorter version of this scale, to be evaluated. Infragluteal fold excision can be performed either before or after implantation (Fig. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Two supragluteal fossettes (or dimples) on either side of the medial sacral crest which correspond to the posterior superior iliac spines. Advanced SearchUndermining using electrocautery was performed to create two pockets in both buttocks bilaterally down to few centimeters above the infragluteal fold. 23. Procedure. It arises in the median gluteal crease and follows. 3 Excerpts; Save. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. PDF. The medial part of the infragluteal fold is formed by a fat pad that covers the inferior medial border of the gluteus maximus muscle. Answer: Double gluteal fold. For example, a cir-cumferential body lift (CBL) incision that runs straight across the back will make the buttock appear too long and rectangular or too square, depending on whetherAnswer: Surgery for left buttock ptosis. Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in esthetic defects in the gluteal contour ( 5 ). Care is taken not to remove the subcutaneous tissues at the level of the infragluteal crease. I think this would give a far better yield than the infragluteal fold excision or the buttock fold excision. Sorry for your problem. On the lateral view (Fig. infragluteal fold, and small portions of the lateral anal/perineal region [1,3]. Save. The power of this technique is granted through the lengthened anteroposterior scar and. In the article “Vectorial Treatment of Infragluteal Fold,” published as e4750 on January 11, 2023, in Plastic and Surgery Global Open, corrections have been made to the author list and affiliations. The "sensuous triangle" is found at the junction of the lateral. 3. Those patients with severe skin laxity, along with a laterally extending infragluteal fold with an angle of greater than 30° are classified as having Grade III ptosis ( Fig. Combining Gluteal Shaping with High-Definition Liposuction. Gluteal fat injection mortality is approximately 1/3000 patients. Superiorly it is formed by the lower border of the gluteus maximus. It is our preference not to use this flap much because of the scar location and occasional sciatic nerve irritation due to swelling around. On the left gluteal region, markings are shown for the muscle-fiber orientation for the gluteus maximus muscle. FIG. 4% of subjects reported increased muscle. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. A flap involving the whole gluteal area was dissected superficially to the gluteal fascia. The infragluteal fold has been reconstructed, leading to an aesthetic appearance of the gluteal region soft tissue (skin and fat) will often lead to disappointing biceps femoris laterally since this is the natural ending of results, including wide scarring, recurrence of ptosis, and the fold [2]. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. D2 and D3 are located in the posterior portion. The infragluteal fold, which attaches to both the ischium and the sacrum in a continuous fashion, is an anatomic structure in its medial part and only a crease laterally. Undermining will not go beyond the infragluteal fold, so it is important to place the template 2 cm above the fold . The superior tip of the intergluteal cleft. fold [fōld] plica; a thin margin curved back on itself, or doubling. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. We report a case of using autologous fat transplantation to correct severe post-liposuction infragluteal fold deformity. The inframammary crease 5,13 lies o ver the fifth to sixth ribs. Profunda perforator characteristics that were examined included the distance from the pubic tubercle to the infragluteal fold (IGF), the distance of the perforators from the IGF, distance posterior to the gracilis, the diameter of the perforator at fascial exit, and total number of perforators present. ResultsThe infragluteal fold is a connectival fibrous band. A direct excision was performed under general anesthesia. A new surgical treatment method using a gluteal-fold flap (GFF) for anal stricture after total ISR is developed and it is believed that GFF transfer is an excellent option for treating anorectal strictures after totalISR. Recent Surge in BBL Demand. 2) The thin strips of skin and fat are worthless as grafts because of their very low volume. The gluteal region in patients with massive weight loss is characterized by excessive skin and exaggerated fat loss. The infragluteal fold is a connectival fibrous band extending from the ramus of the ischium (but not involving the ischial tuberosity, for a length of 21 mm ± 2 and 21 mm ± 3), the. Oh et al 26 recently demonstrated a shortening of the infragluteal fold by performing a thread lift with an elastic silicone-polyester thread. The original buttock lift dates back many decades before BBL surgery became popular and refers to a direct excision at the lower buttocks. These implants may be placed through bilateral supragluteal incisions, the infragluteal fold, or the intergluteal cleft incision. 3. The infragluteal fold is one of the major concerns in reshaping of the gluteal region. implant. 20. aryepiglottic fold a fold of mucous membrane extending on each side between the lateral border of the epiglottis and the summit of the arytenoid cartilage. Does it have a downward 45° angle, run horizontally, or have an inverted. 22), liposuction of the inner thigh and infragluteal area may be indicated. After 1 year, she under- gluteal fascia. This technique creates a new, more aesthetically pleasing fold in order to resolve dropping skin and the presence of a double skin fold (the “banana roll”) beneath the buttocks. Buttock ptosis or sag can also occur when the infragluteal fold attachments are lost or disrupted. This study reevaluated the fold both histologically and anatomically. 臀下皱襞（The infragluteal fold，IGF） [1，2]是臀区与股后区之间形成的皮肤皱褶。. The surgical anatomy of the subcutaneous screen on the gluteal region has aroused the interest of plastic surgeons because of the increasing. Answer: Double gluteal fold. The infragluteal fold should stop in the midbuttock or slightly lateral, in which a short fold has a youthful appearance. Right now you have a partial double fold, a higher medial partial crease and a lower complete crease. A direct excision was performed under general anesthesia. Clinical Presentation. If toomuch fullness exists, the area that should be a di-amond-shaped space is instead a straight line,which is much less appealing. It has been noted in multiple studies that patients can experience persistent PFCN. Le Louarn and Pascal’s incision was made horizontally along the inguinal fold without descending into the gluteal crease; they also treated the excess fat with liposuction and the skin laxity with serial resections. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. ” In contrast to the rest of the posterior thigh, this fatty roll is a rather common problem (see Fig. V-shaped sacral triangle . And placing such a graft always runs the risk of causing an infection. What you are seeking is to have a uniform infragluteal crease on both sides. The spelling of co-author Felipe De Bacco’s surname name was misspelled, and the same author’s affiliation information was incorrect. Great posted photos. Study record managers: refer to the Data Element Definitions if submitting registration or results information. Your options are to carefully suction the fold and to either do a surgical buttock crease lift or fat injections to to butt just above the crease, or a combination thereof. Background: Anatomical features that make the buttocks attractive include adequate volume, projection, and a defined infragluteal fold. Indianapolis, Indiana. 6. Poorly placed incisions also detract from the gluteal aesthetic. infragluteal fold [2–4]. For this we have applied. The lower buttock is the most difficult area to address. Expand. In my humble opinion you need nothing surgical. This procedure recreates the fold on the bottom part of the butt, known as the infragluteal fold, creating a more defined separation between the butt and the thigh. This fold or crease is formed under the ischial tuberosity by the insertions of the semitendinous muscle, biceps femoris, and lower portion of the gluteus maximus. The only way to create a sharper erase/line at the underside of the buttocks is an excisional tuck, making the existing infragluteal fold deeper. Fee $6,000+ Best to virtual consult with. Closure of the implant pocket should be tension-free. The implant was inserted through an infragluteal fold incision. It is divided into an inner, a central, and an outer zone. Intergluteal cleft. 5 Mendieta’s ptosis evaluation utilizing skin fold angles for classification. Supragluteal fossettes (one on either side), over the posterior superior iliac spine, created by the multifidus muscle, the lumbodorsal aponeurosis and the insertion. Most patients in the study had a deep infragluteal fold (the fold at the bottom of the buttocks), which is the exact issue this procedure will address. The thigh circumference measured at 3 predefined levels decreased on average by 2. from the bone to the skin. The "sensuous triangle" is found at the junction of the lateral. Created for people with ongoing healthcare needs but benefits everyone. Liposhifting is a technique that. Fig. Plan on a 2-3 week recovery. Each buttock section has its own distinct shape. Abstract. In cases when full leg definition is wanted, two additional incisions can be placed in the posterior fold of the knee area: one medial and one lateral (Fig. The APEX thighlift takes advantage of the hidden scar described in earlier techniques, using an incision along the medial thigh inguinal crease (or inside that if thinning of a widened pubis is desired) that extends posteriorly into the infragluteal fold . While buttock sagging is a general term it has different types as defined by the level of the infragluteal fold. The infragluteal fold was marked as the lower limit to ensure preservation of the structure and thus avoid ptosis of the gluteal mass and implant displacement. PMID: 15940397 DOI: 10. 3 An aged buttock region is marked. It was not until 1973 that gluteal augmentation was performed for cosmetic purposes. 2, 3, 4. The area between the iliac crest and the infragluteal fold was divided into 3 equal parts, with the upper third left undisturbed, the middle third marked for placement of the implant. We recommend the lower buttock lift for patients who suffer from sagging skin beneath the lower fold of their buttocks (the infragluteal fold). 2) Loose skin from loss of buttock volume creates skin folds that obscures the infragluteal fold. Download : Download full-size image; Figure 6. The gluteal sulcus (also known as the gluteal fold, tuck, fold of the buttock, or horizontal gluteal crease) is an area of the body of humans and anthropoid apes, described by a horizontal crease formed by the inferior aspect of the buttocks and the posterior upper thigh. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. On the plantar surface of the foot, Gluteal fold we find the transverse lines and the longitudinal lines [1]. 44 The infragluteal fold is an important indicator of gluteal. Concomitant fat transplantation to the infragluteal/posterior thigh junction region during circumferential liposuction of the thigh is effective in preventing postliposuction gluteal ptosis and improving patient satisfaction. Grade 4 (mild ptosis): the gluteal tissue passes over the infragluteal fold at the M line; on the lateral view, we evaluate the angle of the skin fold at the infragluteal fold; in Grade 4, the angle is less than 10°. A case of using autologous fat transplantation to correct severe post-liposuction infragluteal fold deformity in a patient who experienced fat graft overabsorption, fat graft translocation, and gluteal ptosis aggravation. Higher IGF (infragluteal fold) results in a shorter buttock preferred by Asian Americans 123 Aesth. Annotations in Figures 4 to to6 6 highlight improvements in skin condition and localized depression, improvement of gluteal shape, and shorter infragluteal fold, thus representing successful treatment. Care is taken not to remove the subcutaneous tissues at the level of the infragluteal crease. The patient has difficulty arising from a sitting position or climbing steps. Cosmetic surgery of the buttocks contemplates not only changes in volumes but also (and above all) a redefinition of the contours. Waves and dimples can be improved down to the infragluteal fold at the junction to the thigh. 39. Surgery was performed in the jackknife position, and flaps were elevated in the suprafascial plane. Expand 6 A gluteal ptosis classification scheme has also been devised by Mendieta, which is similar in design to that of breast ptosis described by Regnault. fold both histologically and anatomically. An injury specifically to the inferior gluteal nerve, which supplies the gluteus maximus muscle, results in weak extension of the hip. 24 The ideal direction of the infragluteal fold from medial to lateral is downward sloping. Although banana fold is a common problem, unrelished by most women, few procedures are targeted specifically to fight it. Incisions with ports sutured in place on the superior intergluteal crease and over the mid inferior gluteal point bilaterally. The infragluteal fold is one of the key elements that determines the gluteal contour and is recognized as an important characteristic of female beauty . Hope this helps!Artistic rendition of relevant anatomy of the infragluteal approach. Undermining will not go beyond the infragluteal fold, so it is important to place the template 2 cm above the fold (Figure 6). Final skin laxity classification results from the sum of each item grade multiplied. Patient with skin laxity of the gluteal area must be carefully advised that little change of this problem will be achieved, especially at the level of infragluteal fold. The infragluteal fold is a fixed and well-defined structure that serves as the inferior border of the buttock proper and is formed by subcutaneous fat and thick fascial insertions from the femur and pelvis through the intermuscular fascia to the skin . The infragluteal fold became less evident, the but- buttock lift and augmentation with the dermal fat flap tock mass was elevated, and augmentation was achieved described was performed, resulting in correction of the with the maximum projection at midlevel of the gluteus. There is a very specialized method to form infra gluteal crease, using lipo 360 with directed fat grafting under ultrasound guided injections as required in Florida, and specialized sub dermal lipo techniques with taping to form infra gluteal crease. Infragluteal fold. excess skin just above the umbilicus, a redundant infragluteal fold and lack of gluteal projection. We developed a practical and safe pedicled flap for reconstruction of ischial pressure sores based on the rich available perforators from the internal pudendal artery and the surplus of skin at the. The infragluteal fold- thigh junction (lower gluteal cleavage) also requires definition. Via its numerous collateral branches, the posterior femoral cutaneous nerve innervates a very extensive territory including the posterior. The posterior thigh is the area least requested for liposuction with the exception of the proximal infragluteal fold or so-called “banana fold. Case presentation: We report. Patients with an apparent and angular infragluteal fold with. This is not a good benefits vs risk proposition. Good luck. Results: After treatment, there was an average reduction of 4. Superiorly, it is formed by the lower border of the gluteus maximus. This fold is the horizontal crease under the ischial tuberosity. From here we can easily access the lower gluteal area and the internal and external posterior thigh (Fig. Superiorly it is formed by the lower border of the gluteus maximus. The posterior femoral cutaneous nerve (PFCN) is an extensive nerve with numerous collateral branches which provide cutaneous innervation to 2/3rds of the posterior thigh, the infragluteal fold, as well as the lateral anal region, scrotum, and labia majora through its inferior cluneal and pudendal nerve branches. It has been widely accepted that one of the features of aesthetically pleasing buttocks is a short infragluteal fold that does not extend past the union of the semitendinous muscle with the biceps femoris, which is medial to the midaxial line of the thigh [4]. ExpandThese implants may be placed through bilateral supragluteal incisions, the infragluteal fold, or the intergluteal cleft incision. These considerations guide the technique, which includes three distinct approaches for PLLA injection based on patient input regarding the most. Plastic Surgery 35 years experience. The posterior femoral cutaneous nerve (PFCN) is an extensive nerve with numerous collateral branches which provide cutaneous innervation to 2/3rds of the posterior thigh, the infragluteal fold, as well as the lateral anal region, scrotum, and labia majora through its inferior cluneal and pudendal nerve branches. Once the fat has infiltrated, any PAL device can be used to equalize (distribute) the infiltrated fat (Images 15. In the pre-op photo, the patient presents with significant lipodystrophy of the iliac crest roll hips, periumbilical lower abdomen, anteromedial and posterolateral saddlebags, and the infragluteal fold banana rolls. The skin perforators of the pudendal artery were marked with a Doppler probe in the medial region of the gluteal fold. Five fixed. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Does it have a downward 45° angle, run horizontally, or have an inverted. The “sensuous triangle” is found at the junction. Both volume and projection of the buttocks may be improved. Besides the excessive fat accumulation, insufficient muscle tone may also contribute to the formation of saddlebags. 39. The postoperative resultsMethods: We describe a new technique for immediate reconstruction of GSCTs using buried dermal-fat flaps and a low transverse scar in the infragluteal fold. The gluteal sulcus (also known as the gluteal fold, tuck, fold of the buttock, or horizontal gluteal crease) is an area of the body of humans and anthropoid apes, described by a horizontal crease formed by the inferior aspect of the buttocks and the posterior upper thigh. The aesthetic line of the infragluteal fold should generally be short, no longer than the. The lateral part of the gluteus maximus muscle tapers between the long head of the biceps femoris and the vastus lateralis muscles. Although banana fold is a common problem, unrelished by most women, few procedures are targeted specifically to fight it. The infragluteal fold consists of the inferior border of the gluteal region and is formed by thick fascial insertions from the femur and pelvis through the intermuscular fascia to the skin []. 39. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. A photograph or two of the area would be extremely helpful in determining what the problem may be and thus the solution, if any. Butt tuck surgery help people attain rounder, smoother and natural-looking buttocks. When the infragluteal fold line is horizontal (see Fig. &NA; Use of a local flap is often needed for closure of a defect in the. The main difference with our technique is the design. From this point of view, in our opinion, there are four salient morphologic features to be considered in the preoperative planning: anterior and posterior views, the profile, and the infragluteal fold. The structure of the infragluteal fold and the degree of ptosis are the main factors that determine the aesthetic appearance. The infragluteal fold is one of the key elements that determines the gluteal contour and is recognized as an important characteristic of female beauty . Unfortunately liposuction of the banana roll can cause additional lines to form which is why I avoid liposuction in that area if possible. This is often tried but never. The authors’ experience using autologous fat transplantation to treat tissue defects led them to use this technique for correcting iatrogenic forms of banana fold and sensuous triangle deformity. This deepithelialized dermal flap allows for the creation of a well-defined stable infragluteal fold through an incision of the infragluteal fold and exposure of ischial tuberosity and anchor it to the ischial tuberosity. An outer thigh lift removes skin and fat from the outside of the thigh. Perception of ideal buttocks varies across cultures. Thomas Fiala answered. the market share of other surgical as well as non-surgical body contouring approaches. unsatisfactory. Also evaluate theangle of the infragluteal fold. Between 2. Results Our. ” It can also be used to improve a double infragluteal fold, to correct infragluteal fold asymmetry, or to shorten a long buttock when combining it with an upper buttock lift. The planned implication of the Sustaining Aparell may determine, through an observation of its structure, a flattening or a ptosis of the gluteal region, allowing a better understanding of the aesthetic of this region. 3) In a lower buttock lift in my hands, it is a combination of tissue removal AND the recreation of an infragluteal fold. Most patients had a deep infragluteal fold. Since you already have a belt lipectomy or a 360 circumferential lower body lift, the skin and fat of the buttocks have already been raised. Open in a separate window. The power of this technique is granted through the lengthened anteroposterior scar and. A banana fold may form for different reasons, among which an. Hello and thank you for your question. the gluteal tissue passes over the infragluteal fold at the M line; the angle of the skin fold at the infragluteal fold is between 10 and 30 . A banana fold may form for. 20 The inferior gluteal artery, supplying 2/3 of the muscle, enters from the inferior bor-The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. Grade II ptosis includes moderate skin and volume below the fold, with a more angular infragluteal fold moving inferomedially from the lateral thigh. The infragluteal fold needs to be approached carefully, by suctioning just under the skin. Thus, you may want to consider restoring volume to your buttock and. 1. By means of MR imaging of volunteers and dissection of fresh cadavers, a here presented study revealed the infragluteal fold as a connectival fibrous band extending from the ramus of the ischium, the coccyx and the apex of sacrum, without significant. Many of the early proponents of the procedure were not open to discussing complications. Care must be taken when completing the last portion of the. The infragluteal fold, which serves as the inferior border of the buttock proper, is formed by thick fascial insertions from the femur and pelvis through the intermuscular fascia to the skin. 45 This results in a ptotic butt if it is longer. 5). T3 provides innervation to the midclavicular line . Notice in the center photograph that a fuller. lateral to the mucocutaneous junction. It is one o…THE IGF. The infragluteal fold, which attaches to both the ischium and the sacrum in a continuous fashion, is an anatomic structure in its medial part and only a crease laterally. 4. In the anchor thighplasty technique, the medial thigh lift is extended posteriorly into the infragluteal crease. implant. The skin flap was designed along the gluteal fold. Keep your arms straight as you lift the weight with your hips and glutes. Tissue samples (6 cm long x 2 mm thick) were taken. Helpful Barry L. The infragluteal fold (red lines) may have a downward slope (ideal with a well-defined diamond zone), be horizontal, or have an upward slope. The average width of the skin excision was 8 cm and the average length was 25 cm. My recommendation would be getting better contour on the left before addressing the right. The infragluteal fold is one of the key elements that determines the gluteal contour and is recognized as an important characteristic of female beauty ( 4 ).