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. 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. Key elements to be evaluated include the infragluteal crease, the gluteal fold and the outer thigh skin fold [28]. 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. circular f's. Dr. This was sculpted for a national television program recently. Popularity of injectable fillers. 5 cm, 3-month follow-up). Both adipofascial flaps were rotated downward for inset in the pockets created in the buttocks. 7) . 3. The spelling of co-author Felipe De Bacco’s surname name was misspelled, and the same author’s affiliation information was incorrect. The skin perforators of the pudendal artery were marked with a Doppler probe in the medial region of the gluteal fold. PDF | On Jan 11, 2023, Héctor César Durán Vega and others published Vectorial Treatment of Infragluteal Fold | Find, read and cite all the research you need on ResearchGateWe describe a new technique for immediate reconstruction of GSCTs using buried dermal-fat flaps and a low transverse scar in the infragluteal fold. The average width of the skin excision was 8 cm and the average length was 25 cm. 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. The descending branches of the inferior gluteal vessels and its accompanying nerve enter the subcutaneous tissue of the gluteal thigh flap distal. Save. There are few. Your infragluteal fold is barely noticeable, no women has perfect exact length, position and height of the infragluteal fold. See full list on link. excess skin just above the umbilicus, a redundant infragluteal fold and lack of gluteal projection. But so doing it may also make your buttocks look a little less full because its roundness is decreased. 15. In contrast, a shorter infragluteal fold contributes to a full, taught, and youthful buttock. The final result should be to attain a waist-to-hip ratio (WHR) close to 0. The muscle fascial edges should approximate with ease and a “watertight” closure is performed using eight to ten simple interrupted 0 or 2-0. Tissue. Download : Download full-size image; Figure 6. D. Liposhifting is a technique that. Fig. 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 . The most significant changes in circumference were found at the level of 5 to 10 cm below the infragluteal fold, corresponding to the treated area on the lateral thigh. 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. This patient underwent a two-liter tumescent liposculpture procedure and is now six months post-op. These considerations guide the technique, which includes three distinct approaches for PLLA injection based on patient input regarding the most. 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]. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. fold [fōld] plica; a thin margin curved back on itself, or doubling. 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 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. On the other hand, some slight to moderate redundant infragluteal creases might be candidates for simple surgical repair. Four fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. 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. Medicine. Download scientific diagram | MRI sequence of the infragluteal fold with T1 VIBE MORPHO sequence (Thickness slice = 900. 39. The posterior femoral cutaneous nerve (PFCN) is an extensive nerve with numerous collateral branches which provide cutaneous innervation to 2/3 rds 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. A case of using autologous fat transplantation to correct severe post-liposuction infragluteal fold deformity in a. The Scarpa’s. 1. If toomuch fullness exists, the area that should be a di-amond-shaped space is instead a straight line,which is much less appealing. The infragluteal fold needs to be approached carefully, by suctioning just under the skin. A banana fold may form for different reasons, among which an. A banana fold may form for different reasons, among which an. Other techniques are performed either as standalone or in association with other procedures, such as: fat transfer also called Brazilian 'butt lift' hydrogel and silicone buttock injections; Complications. Dr. The “sensuous triangle” is found at the junction. The average width of the skin excision was 8 cm and the average length was 25 cm. For the subgluteal approach, the patient is placed in a prone position and a curvilinear ultrasound probe is placed in short axis at the subgluteal fold. Procedure. The procedure would take approximately 4 hours to complete. Expand. The hyperechoic BFL tendon might be a reliable soft tissue landmark for ultrasound localization of the infragluteal sciatic nerve. 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. Combining Gluteal Shaping with High-Definition Liposuction. Tissue samples (6 cm long x 2 mm thick) were taken. I hope this helps. Subscribe Now:More:exercise to define. In the present, precisely for this reason, it is believed that dissection should reach the level of the infragluteal fold. The infragluteal fold is one of the key elements that determines the gluteal contour and is recognized as an important characteristic of female beauty . The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. 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. This is a difficult area to fix. Expand. 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 inclusion criteria was ptosis of the lower pole of buttocks. The infragluteal crease is found in several terms such as the gluteal crease, the infragluteal fold , the infragluteal sulcus , the horizontal gluteal fold , the gluteal fold , the inferior buttock crease , the lower gluteal crease, and the inferior gluteal crease. I hope this helps. 1 Anatomy of the gluteus maximus muscle and deeper structure. 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. Poorly placed incisions also detract from the gluteal aesthetic. 9. A banana fold may form for different reasons, among which an iatrogenic cause is recurrent. The lateral length of the infragluteal fold measures the degree of buttocks ptosis. The infragluteal folds and perineal region were treated with the patient in a prone jackknife position. The descending branches of the inferior gluteal vessels and its accompanying nerve enter the subcutaneous tissue of the gluteal thigh flap distal. We define unaesthetic buttock ptosis as sagging. The inner thigh can be reached by the lower pubic incisions with the patient supine and by the infragluteal crease incisions for posterior access with the patient prone. Answer: Double fold. The gluteal region in patients with massive weight loss after gastric bypass is characterized by. Once the fat has infiltrated, any PAL device can be used to equalize (distribute) the infiltrated fat (Images 15. 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. Also, evaluate the angle of the infragluteal fold. The power of this technique is granted through the lengthened anteroposterior scar and. buttock, infragluteal fold, or hips often produces sub-optimal aesthetic results. Although remarkable results have been demonstrated, the applicability of this procedure to MWL patients has been inadequate due to limited skin removal and the risk of scar migration from dependence on. Purpose: The apparent failure of pudendal nerve surgery in some patients has led us to suggest the possibility of entrapment of other adjacent nerve structures, leading to the concept of inferior cluneal neuralgia. It is our preference not to use this flap much because of the scar location and occasional sciatic nerve irritation due to swelling around. Other techniques are performed either as standalone or in association with other procedures, such as: fat transfer also called Brazilian 'butt lift' hydrogel and silicone buttock injections; Complications. 这个皱褶并不反映臀大肌的下缘，有肌肉表面与深筋膜的纤维性连接，起源于臀部内侧三分之一的真皮，以坚固的隔膜形式与臀筋膜交织在一. 1). Both flaps were fixed with interrupted 0-Vicryl. Time and important weight variation. D2 and D3 are located in the posterior portion. Other techniques are performed either as standalone or in association with other procedures, such as: fat transfer also called Brazilian 'butt lift' hydrogel and silicone buttock injections; Complications. Between 2. from the bone to the skin. 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. As can be appreciated from these figures, the anatomy shading provided on each pair of jeans is similar to that shown in the image of the right panel of FIG. Once the shapes are more symmetric, volume enhance can be done on both sides simultaneously. Plan on a 2-3 week recovery. Also evaluate the angle of the infragluteal fold. Jackson-Pratt drains are then introduced into the pocket and laid into the base of the pocket and secured with 3-0 Nylon suture (Fig. The length and definition of the infragluteal fold play important roles in aesthetically pleasing buttocks. Clinical Presentation. For a negative upward slant (see Fig. The posterior femoral cutaneous nerve (PFCN) is an extensive nerve with numerous collateral branches which provide cutaneous innervation to 2/3 rds 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. The Muffin Bottom consists of sculpting three different regions at one time, the infragluteal fold, the medial posterior thigh and the lateral posterior saddlebag region. Superiorly it is formed by the lower border of the gluteus maximus. 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. But what is really being done is that the loose lower buttock skin and the fold are being removed to create a less deep infragluteal fold and smoother transition between the buttock and the thighs. The infragluteal fold is one of the key elements that determines the gluteal contour and is recognized as an important characteristic of female beauty . Supragluteal fossettes. It has been noted in multiple. Higher IGF (infragluteal fold) results in a shorter buttock preferred by Asian Americans 123 Aesth. Lower buttock sag is occurs when the superior skin and fat ‘fall’over the fixed infragluteal fold. The patient has difficulty arising from a sitting position or climbing steps. It arises in the median gluteal crease and follows a. This supports the thigh tissue in its lifted position and enhances 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. Short gluteal fold. In type 1 buttock ptosis the infragluteal Read More…Background: The shape of the buttocks can take on many different forms. During this type of thigh lift, an incision is made around the waist. 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]. Chasan, partook in a study examining the results of the infragluteal thigh lift. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. Sagging of redundant skin and fat below the infragluteal fold is commonly observed in bariatric patients following massive weight loss and defines. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. Which of these fibers provides. Here, it continues to the midline of the thigh (halfway between the greater trochanter and the ischial tuberosity). Limits implant movement. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. It is divided into an inner, a central, and an outer zone. While idiopathic neuropathy of the PFCN has been described [4], iatrogenic neuropathyFollowing administration of general anaesthesia, the patient was placed prone on a radiolucent table with a bump under the pelvis to create approximately 30° of hip flexion. Five fixed cadavers were used. D. Care is taken not to remove the subcutaneous tissues at the level of the infragluteal crease. 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. T3 provides innervation to the midclavicular line . situated between the buttocks… See the full definitionBackground: Anatomical features that make the buttocks attractive include adequate volume, projection, and a defined infragluteal fold. The infragluteal fold is one of the major concerns in reshaping of the gluteal region. MWL patients usually present with this negative angle and might need lifting procedures with or without skin resection at the infragluteal. On the plantar surface of the foot, Gluteal fold we find the transverse lines and the longitudinal lines [1]. The infragluteal crease [23] is found in several terms such as the gluteal crease, the infragluteal fold [24], the infragluteal sulcus [24], the horizontal gluteal fold [4], the gluteal fold [4. The lateral part of the gluteus maximus muscle tapers between the long head of the biceps femoris and the vastus lateralis muscles. Buttock Lifting Using Elastic Thread (Elasticum®) with a New Classification of Gluteal Ptosis. In this way, it's similar to a general lower body lift. Does it have a downward 45º angle, run horizontally, or have an inverted upward. The use of a deepithelialized double dermal flap is a safe and new way to obtain excellent results in rejuvenation of the gluteal region and allows for the creation of a stable and long-lasting infragluteal fold with an aesthetic buttock curvature and a defined border to the thigh region. Cuenca described the ideal buttocks for women as follows: mild lateral depression at the femoral greater trochanter, a short infragluteal fold, the supragluteal fossette corresponding to the posterior superior iliac spine, and a V-shaped sacral triangle (Fig. Thus, you may want to consider restoring volume to your buttock and. With this technique, the deepithelialized crescent-likeThe infragluteal fold/thigh junction (lower gluteal cleavage) also requires definition. A fusiform excision located in the posteromedial portion of the infragluteal fold is least likely to produce a visible scar (Figure 36-13). Five fixed cadavers were used. It was not until 1973 that gluteal augmentation was performed for cosmetic purposes. No adverse events were recorded. the market share of other surgical as well as non-surgical body contouring approaches. 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 posterior knee-fold incisions can be closed or left open for. Paraspinous muscles cannot be forgotten in the lower abdomen. adjective. Besides the excessive fat accumulation, insufficient muscle tone may also contribute to the formation of saddlebags. Flap reconstruction is efficient in severe cases of infragluteal fold deformity (5), but the low patient acceptance of the subsequent scars limits its application. B, D, F, Postoperative views after treatment with subfascial placement of silicone elastomer implants, which increased projection, shortened the infragluteal fold, and restored volume to. From 1985 until 1995, this infragluteal flap has been used to widen the vaginal introitus in 6 patients, to reconstruct the labia majora in 5, to close a rectovaginal fistula in 4, and. Infragluteal fold: It is the horizontal crease under the ischial tuberosity composed of the lower edge of the gluteus maximus muscle and usually does not extend beyond the union of the semitendinous muscle with the biceps femoris. 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. In the article “Vectorial Treatment of Infragluteal Fold,” published as e4750 on January 11,. T1. [1] The Vertical Technique This approach is performed vertically from above the IGF. Infragluteal fold. While buttock sagging is a general term it has different types as defined by the level of the infragluteal fold. The sciatic nerve is identified deep to the gluteus maximus muscle and superficial to the quadratus femoris muscle with the ischial tuberosity medially and the greater trochanter laterally. TLDR. Right now you have a partial double fold, a higher medial partial crease and a lower complete crease. The fat is injected as the. A direct excision was performed under general anesthesia. Considering its widespread innervation and many collateral branches, PFCN neuropathy has been commonly reported, primarily due to iatrogenic etiology. Final skin laxity classification results from the sum of each item grade multiplied. Thus, buttock ptosis is simply gluteal tissue below the skin fold, or infragluteal crease. (D) The patient is turned to the supine position, and the legs remain spread on extender bars that are well padded. Case presentation: We report. The radiation oncologist clinically outlined the areas. Results: The Buttocks' SLSS is composed by 5 clinical aspects of skin laxity graded from absent (0) to severe (3): buttocks ptosis, skin scalloped appearance, infragluteal fold, localized fat on the lower third of the buttocks, and linear depressed lesions. It extends from sacral level S3 or S4 and ends just inferior to the apex of the sacrum, at the level of the anus. Point “C” is marked in the center of the buttock, 3 cm above the infragluteal fold. Fee $6,000+ Best to virtual consult with. Then other planes are created using the same cannula in different trajectories, always from the deeper aspect to the more superficial plane. 3) In a lower buttock lift in my hands, it is a combination of tissue removal AND the recreation of an infragluteal fold. 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 infragluteal fold, often ignored or inadequately treated, is one of the most challenging areas to treat and requires a complete knowledge of the anatomy of the buttock to achieve the best aesthetic result. ” In contrast to the rest of the posterior thigh, this fatty roll is a rather common problem (see Fig. (aka tuck)The most important factor to guide implant selection is its base’s vertical and horizontal dimensions, which should fit the buttock leaving at least 5 cm between the pocket dissection limit and the infragluteal fold and 2 cm lateral to the sacrum. The retromuscolar technique is preferred by patients requesting a natural, sporty result. 2) The thin strips of skin and fat are worthless as grafts because of their very low volume. Transversal slice passing through bony structures. 1. Five fixed cadavers were used. A banana fold may form for different reasons, among which an iatrogenic cause is recurrent. Shorter, less dimpled, and tight skinned buttocks are smoothly wider and better projecting at the mid-level. The infragluteal fold region is the lower edge of the buttocks. The appropriately selected gluteal implant is folded in half. 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. These structures create the fixed, well-defined subgluteal sulcus [2]. The infragluteal fold is one of the major concerns in reshaping of the gluteal region. 5,8 A. However, there is no clear anatomical description of the infragluteal fold,. Dr. But what is really being done is that the loose lower buttock skin and the fold are being removed to create a less deep infragluteal fold and smoother transition between the buttock and the thighs. The diamond-shaped space turns into a straight line, which is less aesthetically appealing. What separates the lower buttocks from the other two sections is the infragluteal fold. 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 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 and cadavers, respectively). Patients with buttock ptosis and medial thigh skin laxity without lateral thigh redundancy are ideal candidates. Following is a list of spinal nerves and points that are characteristically belonging to the dermatome of each nerve. This study reevaluated the fold both histologically and anatomically. An outer thigh lift removes skin and fat from the outside of the thigh. 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. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. After 1 year, she under- gluteal fascia. PDF. Sagging of redundant skin and fat below the infragluteal fold is commonly observed in bariatric patientsFlap reconstruction is e cient in severe cases of infragluteal fold deformity [5], but the low patient's acceptance of sequel scar limits its application. 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 . The infragluteal fold is like a horizontal line. Time and important weight variation consid- erably affect this region combined with the gravity’s effect. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. A direct excision was performed under general anesthesia. 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. Each buttock section has its own distinct shape. A short infragluteal fold lying in the horizontal crease under the ischial tuberosity, which does not extend beyond the medial two-thirds of the posterior thigh. 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. 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. C3 provides innervation to the supraclavicular fossa . The range of indications for buttocks lifting includes discreet ptosis, moderate skin laxity in the gluteal or trochanteric areas, asymmetry, double infragluteal fold, long buttocks, and even the deformities that follow significant weight loss. This study focuses on the histological comparison of creases of the trunk and participation of the elastic fibers in their formation. A new technique for correction of a buttock ptosis resulting from a degloving injury is presented. Its inferior border is formed by the insertions of the semitendinous muscle and the long belly of the biceps femoris in the ischial tuberosity. Mendieta, on the other hand, described a procedure to eliminate the square shape of the inferomedial area of the gluteous in massive weight loss patients, with the hanging tissue removed by means of an incision that goes along the inner infragluteal fold and then upward lateral to the anus []. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Via its numerous collateral branches, the posterior femoral cutaneous nerve innervates a very extensive territory including the posterior. loss of the infragluteal fold [7]. Great posted photos. Ranch & Coast founder, Dr. In the ideal gluteal aesthetics, the relationship between the infragluteal fold and the inner thigh should create a diamond shaped space, as seen in Fig. Incisions with ports sutured in place on the superior intergluteal crease and over the mid inferior gluteal point bilaterally. The fat graft is placed in the upper medial side for projection. 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. Intergluteal cleft. This causes movement of the infragluteal sulci in downward and lateral directions as well as lengthening of intergluteal sulcus. Grade 6 (severe ptosis): the gluteal tissue passes over the infragluteal fold at the M line; the angle of the skin fold at infragluteal fold is more than 30 Aesth Plast Surg (2018) 42:1050–1058 1051 1231) Liposuction of the buttocks, either in totality or just at the banana roll area, will result in some degree of tissue overhang at the infragluteal fold. In my humble opinion you need nothing surgical. Superiorly it is formed by the lower border of the gluteus maximus. Normally, its mean length is equal to the intergluteal fold length or 2/3 of it. 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, the skin over the ischial tuberosity, and also the lateral anal region, scrotum or labium majus []. Purpose The apparent failure of pudendal nerve surgery in some patients has led us to suggest the possibility of entrapment of other adjacent nerve structures, leading to the concept of inferior cluneal neuralgia. Barry Eppley. The major drawback of implant augmentation is the substantially high rate of complications associated with its techniques. Cosmetic surgery of the buttocks contemplates not only changes in volumes but also (and above all) a redefinition of the contours. All patients judged the outcome as very good. Figure 6. The ideal infragluteal cleft is none at all, but instead a smooth transition from buttocks to thigh. A longer infragluteal fold suggests an aged, ptotic, and deflated-looking buttock with skin and fascial excess. Preoperatively, the patient is examined and the buttock’s size and shape are evaluated. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. Time and important weight variation consid-erably affect this region combined with the gravity’s effect. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. Patients with a long buttock may. Four fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. It has been noted in multiple. Once the shapes are more symmetric, volume enhance can be done on both sides simultaneously. Fig. The infragluteal fold length and definition play important roles in esthetically pleasing buttocks. 44 The infragluteal fold is an important indicator of gluteal aesthetics. The anatomical study. PMID: 15940397 DOI: 10. Selective fat reduction centrally and laterally. We report a case of using autologous fat transplantation to correct severe post-liposuction infragluteal fold deformity. Barry Eppley. Procedure. The "sensuous triangle" is found at the junction of the lateral. The posterior thigh is the area least requested for liposuction with the exception of the proximal infragluteal fold or so-called “banana fold. The infragluteal fold (red lines) may have a downward slope (ideal with a well-defined diamond zone), be horizontal, or have an upward slope. Infragluteal fold: formed superiorly by the inferior border of the gluteus maximus and inferiorly by the insertion of the semitendinosus and biceps femoris muscles in the ischial tuberosity. 20. The midpoints of the infragluteal sulci were marked, and then the right and left infragluteal sulci were bilaterally excised en bloc, from the ischium to the most lateral part of the gluteal-thigh junction, with 3 cm of tissue taken from the inferior and superior parts of the infragluteal fold by an elliptic incision including the skin. The inframammary crease 5,13 lies o ver the fifth to sixth ribs. The infragluteal sulcus is created right below. The width of the flap and. intragluteal injection. 3 cm, with the greatest change at the level of 10 cm below the infragluteal fold (-3. The intergluteal cleft is a surface anatomy landmark of the pelvis and lower limb. 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. Increasing number of patients request body contouring and are increasingly aware of the numerous techniques now available for enhancing the gluteal region, which include the use of implants, autologous fat transfer, autologies, and combinations of more than one of these techniques often produce superior aesthetic. The postoperative results depicted in the article demonstrate a successful. The gluteal region in patients with massive weight loss after. ResultsThe infragluteal fold is a connectival fibrous band. Results Our. It has been noted in multiple studies that patients can experience persistent PFCN. In contrast, a shorter infragluteal fold contributes to a full, taut, and youthful-looking buttockFour fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. Study record managers: refer to the Data Element Definitions if submitting registration or results information. Lipoplasty aided in the accentuation of lumbar lordosis, which gives the impression of greater buttocks projection. Most patients had a deep infragluteal fold. The shape of the buttock and the presence of the infragluteal fold make the donor area for FCI flap less visible regarding the missing volume and scar position. Additionally, I agree that a lower buttock tuck with the results scar is probably not the best of options for you. infragluteal fold [2–4]. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. On the left gluteal region, markings are shown for the muscle-fiber orientation for the gluteus maximus muscle. 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. The dissection and volume this flap provides are similar to that of the SGAP flap. The infragluteal fold is where the bottom of the buttock meets the upper thigh. A banana fold may form for. 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. The region of the infragluteal fold has been generally ignored or inadequately treated. A direct excision was performed under general anesthesia. Does it have a downward 45° angle, run horizontally, or have an inverted. 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 infragluteal fold incisions should always be closed by subdermal sutures, since these are the ports of entry of fat grafting, to prevent protrusion of fat or migration. A photograph or two of the area would be extremely helpful in determining what the problem may be and thus the solution, if any. The surgical anatomy of the subcutaneous screen on the gluteal region has. 45 This results in a ptotic butt if it is longer. By adding more volume on the left and matching the right, the fold will appear as a result of this added volume. (aka tuck) The most important factor to guide implant selection is its base’s vertical and horizontal dimensions, which should fit the buttock leaving at least 5 cm between the pocket dissection limit and the infragluteal fold and 2 cm lateral to the sacrum. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. 3). From here we can easily access the lower gluteal area and the internal and external posterior thigh (Fig. 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. Hope this helps!Artistic rendition of relevant anatomy of the infragluteal approach. 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. 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. Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in esthetic defects in the gluteal contour . 2) The thin strips of skin and fat are worthless as grafts because of their very low volume. Asymmetric lifts and reduction are to be performed on the buttock to correct for your present symmetry. The second incision is placed at the midpoint of the infragluteal fold. 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. Hello and thank you for your question. 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. 6. Background: The ischial region is the site most affected by pressure sores and has the highest recurrence and complication rates compared to other affected sites. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. The original buttock lift dates back many decades before BBL surgery became popular and refers to a direct excision at the lower buttocks. What you are seeking is to have a uniform infragluteal crease on both sides. ResultsThe infragluteal fold is a connectival fibrous band. Recent Surge in BBL Demand. 3) A lower buttock lift, better defined as a buttock tuck, removes loose skin and creates an infragluteal line. 8 Zones in the inferior gluteal area: 1 lower internal ( light blue ), 2 lower external ( yellow ), 3 inner thigh ( purple ), 4 outer thigh ( red ). 1). This 5 cm gap between the caudal edge of the flap and the infragluteal fold can appear empty. The procedure would take approximately 4 hours to complete. 24 The ideal direction of the infragluteal fold from medial to lateral is downward sloping. Conclusion: Focused ultrasound is a safe, effective and well tolerated procedure for remodelling areas of the body. Four fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. Indeed once this area is damaged, typically by liposuction, it is tricky to fully repair and re-create the normal infragluteal fold again.