When planning the new infragluteal fold, surgeons should not exceed the union of the semitendinous muscle with the biceps femoris laterally since this is the natural ending of the fold . 2. 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. Plastic surgeons often reduce buttock lift with an incision under the buttocks or 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. An anatomical study demonstrated that the perineal branch of. PAP flap breast reconstruction leads to improved aesthetic proportions of the proximal thigh and buttock, ideal for patients with ptotic tissue of the inferior buttocks and medial thigh, a poorly defined infragluteal fold, and inadequate anterior-posterior buttock projection. 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. ResultsThe infragluteal fold is a connectival fibrous band. 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 gluteal sulcus is formed by the posterior horizontal skin crease of the hip joint and overlying fat and is not formed by the lower border of the gluteus maximus muscle, which crosses the fold obliquely. The infragluteal fold needs to be approached carefully, by suctioning just under the skin. Expand. Methods: Six volunteers (three males and three females) underwent an MRI scan (Siemens Aera® 1. 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. If too much fullness exists, the area that should be a diamond-shaped space is instead a straight line, which is much less appealing. These implants may be placed through bilateral supragluteal incisions, the infragluteal fold, or the intergluteal cleft incision. Short gluteal fold. Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in esthetic defects in the gluteal contour. 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. 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. Infragluteal fold. The gluteal region in patients with massive weight loss after gastric bypass is characterized by. 44 The infragluteal fold is an important indicator of gluteal. 34 Ramanadham and Rohrich 35 showed that, in the face, volume is lost and the tissues sag down toward the central line as we age, producing jowls and marionette lines, which are signs of an aging face. 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. The ischial region is the site most affected by pressure sores and has the highest recurrence and complication rates compared to other affected sites. 8 Zones in the inferior gluteal area: 1 lower internal ( light blue ), 2 lower external ( yellow ), 3 inner thigh ( purple ), 4 outer thigh ( red ). The gluteal region in patients with massive weight loss is characterized by excessive skin and exaggerated fat loss. The width of the flap and. 3). 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. Its inferior border is formed by the insertions of the semitendinous muscle and the long belly of the biceps femoris in the ischial tuberosity. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. The iatrogenic forms of banana fold and sensuous triangle deformity are produced by excessive. &NA; Use of a local flap is often needed for closure of a defect in the perineogenital area. Dr. The lower buttock is the most difficult area to address. Normally, its mean length is equal to the intergluteal fold length or 2/3 of it. Lower buttock sag is occurs when the superior skin and fat ‘fall’over the fixed infragluteal fold. 6 The infragluteal area is a support zone for the buttock, and treatment of this area with liposuction should be avoided. 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. 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. An anatomical description of the infragluteal fold (IGF) matching radiological and anatomical findings in describing specifically raise of the fibrous component at the bone. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Destruction of this. The intergluteal cleft is a surface anatomy landmark of the pelvis and lower limb. 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. The descending branches of the inferior gluteal vessels and its accompanying nerve enter the subcutaneous tissue of the gluteal thigh flap distal. 1007/s00266-004-0133-2 Abstract The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and. The retromuscolar technique is preferred by patients requesting a natural, sporty result. Therefore, it may be preferable to wait several months after implantation to determine the amount of skin resection necessary. 45 This results in a ptotic butt if it is longer. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. ResultsThe infragluteal fold is a connectival fibrous band. 1. Tissue samples (6 cm long 9 2 mm thick) were taken at three points from each fold bloc: the most medial point, the middle. What separates the lower buttocks from the other two sections is the infragluteal fold. She underwent liposculpture using the tumescent technique with infiltrated fluid, sodium chloride, epinephrine and Lidocaine in the. : situated within or introduced into the gluteal muscle. Complete 10 to 15 reps. 2. Results Our. Indianapolis, Indiana. These implants may be placed through bilateral supragluteal incisions, the infragluteal fold, or the intergluteal cleft incision. Save. Once the fat has infiltrated, any PAL device can be used to equalize (distribute) the infiltrated fat (Images 15. implant. fold [fōld] plica; a thin margin curved back on itself, or doubling. 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. Lower body lift procedures remove excess skin and lift sagging buttock tissue. The “sensuous triangle” is found at the junction. Liposhifting is a technique that. Great posted photos. Liposhifting is a technique that. Incisions with ports sutured in place on the superior intergluteal crease and over the mid inferior gluteal point bilaterally. The long axis of the flap was arranged in parallel with the infragluteal fold axis. By adding more volume on the left and matching the right, the fold will appear as a result of this added volume. Answer: Double fold. 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。. On the lateral view (Fig. lateral to the mucocutaneous junction. A case of using autologous fat transplantation to correct severe post-liposuction infragluteal fold deformity in a. A. Ini-tially, a deep plane is created by the 3-mm cannula. Abstract. Expand. Conclusion: The use of a deepithelialized double dermal flap is a safe and new way to obtain excellent results in rejuvenation of the gluteal region. The way to correct this is to directly cut out that area but you will have to be wiling to accept a scar inside the new crease. It is critical to appropriately and systematically analyze the complex regional anatomy. We define unaesthetic buttock ptosis as sagging. The power of this technique is granted through the lengthened anteroposterior scar and. The Scarpa’s. This patient underwent a two-liter tumescent liposculpture procedure and is now six months post-op. 23. A new technique for correction of a buttock ptosis resulting from a degloving injury is presented. 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. Esthetic results can be individualized to patient’s wishes/expectations: by flap design (shape, width, length, thickness), by pocket dissection (shape, width, depth), and by flap fixation (sutures, infragluteal fold reconstruction). A longer infragluteal fold suggests an aged, ptotic, and deflated-looking buttock with skin and fascial excess. It arises in the median gluteal crease and follows. 10 The Mendieta and Sood classification is demonstrated in Fig. Each buttock section has its own distinct shape. It has been noted in multiple studies that patients can experience persistent PFCN. When the infragluteal fold line is horizontal (see Fig. The infragluteal fold is one of the major concerns in reshaping of the gluteal region. This supports the thigh tissue in its lifted position and enhances the infragluteal fold. 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. It is the deep furrow or groove that lies between the two gluteal regions (commonly known as the buttocks). Grade III: The skin. The posterior thigh is the area least requested for liposuction with the exception of the proximal infragluteal fold or so-called “banana fold. dermal flap will be performed for lifting the ptotic buttocks with ill-defined infragluteal fold. I hope this helps. Severe infragluteal fold. Waves and dimples can be improved down to the infragluteal fold at the junction to the thigh. These structures create the fixed, well-defined subgluteal sulcus [2]. Flap reconstruction is efficient in severe cases of infragluteal fold deformity (5), but the low patient acceptance of the subsequent scars limits its application. 3) In a lower buttock lift in my hands, it is a combination of tissue removal AND the recreation of an infragluteal fold. infragluteal fold, and small portions of the lateral anal/perineal region [1,3]. 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. 3), the buttock contour has a smooth C shape, without depression and ptosis. Thomas Fiala answered. The diamond-shaped space turns into a straight line, which is less aesthetically appealing. Tissue samples (6 cm long x 2 mm thick) were taken. To our knowledge, only two variations to the classic chevron technique have been described in an attempt to improve buttock contouring following GSCT excision. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. It is critical to appropriately and systematically analyze the complex regional anatomy. Two supragluteal fossettes (or dimples) on either side of the medial sacral crest which correspond to the posterior superior iliac spines. Therefore, in each case, the high points of the buttocks are relatively light while infragluteal fold and V-shaped crease areas are relatively dark. In this study, 84. This was sculpted for a national television program recently. The infragluteal fold is one of the major concerns in reshaping of the gluteal region. However, one of its key-component, the infragluteal fold, has not yet been clearly defined. Initially, percutaneous reduction was attempted through a small transverse incision in the infragluteal fold (figure 2). 22), consider infragluteal, as well as inner thigh liposuction, and possible resection of infragluteal fold skin excess . 1 Excerpt; Save. Great posted photos. 1). 8): Fig. Abstract. Tissue samples (6 cm long x 2 mm thick) were taken. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. The inclusion criteria was ptosis of the lower pole of buttocks. Five fixed. Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in esthetic defects in the gluteal contour. 9. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Your infragluteal fold is barely noticeable, no women has perfect exact length, position and height of the infragluteal fold. Characteristic features include short intergluteal cleft, flattened buttocks, narrow hips, distal leg atrophy, and talipes deformities. 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. In most cases, the infragluteal fold ends at the midpoint of the inferior buttock. 3) The length of the lower buttock lift excision should ideally not go beyond the. 3. 5 Mendieta’s ptosis evaluation utilizing skin fold angles for classification. The "sensuous triangle" is found at the junction of the lateral. In the anchor thighplasty technique, the medial thigh lift is extended posteriorly into the infragluteal crease. Once the shapes are more symmetric, volume enhance can be done on both sides simultaneously. 1). The infragluteal fold- thigh junction (lower gluteal cleavage) also requires definition. A, C, E, Preoperative views of a 50-year-old woman who complained of decreased gluteal projection and buttock ptosis after suction-assisted lipoplasty. The need for liposuction of the lower back or hips is considered. Background: Sagging of the buttocks is a well known body change that can occur due to natural aging, weight loss or as a sequelae from buttock implant removal. Tissue samples (6 cm long x 2 mm thick) were taken. Plan on a 2-3 week recovery. Lipoplasty aided in the accentuation of lumbar lordosis, which gives the impression of greater buttocks projection. The infragluteal fold, which is one of the main determinants for gluteal attractiveness, is located in this unit . BackgroundThe gluteal fold represents an important aspect of the gluteal region. Four fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. The hyperechoic BFL tendon might be a reliable soft tissue landmark for ultrasound localization of the infragluteal sciatic nerve. This can include excess weight that has accumulated in the waist and buttock area. It is divided into an inner, a central, and an outer zone. circular f's. 6 Innervation The sciatic nerve is the largest nerve in the human body, measuring around 2 cm in diameter in adults. 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. We recommend the lower buttock lift for patients who suffer from sagging skin beneath the lower fold of their buttocks (the infragluteal fold). A long, deflated. The final result should be to attain a waist-to-hip ratio (WHR) close to 0. What you are seeking is to have a uniform infragluteal crease on both sides. 88 and 3 cm in the circumference of the abdomen, hips and thighs, respectively. In my humble opinion you need nothing surgical. The infragluteal area may be slightly improved after buttock augmentation resulting in less of a requirement for skin. 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. This corrects the article "Vectorial Treatment of Infragluteal Fold" in volume 11, e4750. 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. Peter Fisher M. 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 infragluteal fold (IGF) is a crucial anatomic landmark representing one of the major concerns in gluteal reshaping in plastic surgery. Transversal slice passing through bony structures. 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 [3]. Autologous gluteal augmentation with circumferential body lift in the massive weight loss and aesthetic patient. 9 and 10. Fig. D. Reply: Staying Safe during Gluteal Fat Transplantation. This will produce an indentation but not make it too deep -- if the fold is too deep the buttocks collpase downward folding over the fold. (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. 3). The inferiorly oriented form of the muscle may be visible in males, but in. But so doing it may also make your buttocks look a little less full because its roundness is decreased. The major drawback of implant augmentation is the substantially high rate of complications associated with its techniques. The cannula should have one orifice and be thick (4 or 5 mm), long (32 cm), and directed to the IGF and beyond. The region of the infragluteal fold has been generally ignored or inadequately treated. An outer thigh lift removes skin and fat from the outside of the thigh. [1] The Vertical Technique This approach is performed vertically from above the IGF. The infragluteal area may be slightly improved after buttock augmentation resulting in less of a requirement for skin resection. In my humble opinion you need nothing surgical. The intergluteal cleft or just gluteal cleft, also known by a number of synonyms, including natal cleft, butt crack, and cluneal cleft, is the groove between the buttocks that runs from just below the sacrum to the perineum, [1] so named because it forms the visible border between the external rounded protrusions of the. Skin creases of the trunk 1 (Fig 1) include the inframammary crease, the suprapubic crease, the oblique skin crease of the groin, and the infragluteal crease. Key elements to be evaluated include the infragluteal crease, the gluteal fold and the outer thigh skin fold [28]. 15. A. Procedure. The inframammary crease 5 , 13 lies over the fifth to sixth ribs. Most patients had a deep infragluteal fold. 3) In a lower buttock lift in my hands, it is a combination of tissue removal AND the recreation of an infragluteal fold. 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. Most patients had a deep infragluteal fold. The inferior border of the infragluteal fold is formed by the insertions of the semitendinous muscle and the belly of the biceps femoris. Before the Implantation. Retrospectively, however, it is clear that a better lifting effect and gluteal shortening could have been achieved if a longer scar had been used along the infragluteal fold for the patients in Figs. This would go from the outer buttock fold and into the groin and possibly communicate with your prior thigh lift. amniotic fold the folded edge of the amnion where it rises over and finally encloses the embryo. 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 (Figure 4). Procedure. Tissue samples (6 cm long x 2 mm thick) were taken. All patients judged the outcome as very good. (E) The incision is closed from distal to proximal, blending into the abdominal closure when abdominoplasty is performed. The superior tip of the intergluteal cleft. Results: After treatment, there was an average reduction of 4. Patients with buttock ptosis and medial thigh skin laxity without lateral thigh redundancy are ideal candidates. A: Thank you for your inquiry and sending your picture. thigh, IGD (infragluteal diamond), G (Gluteus) 123 246 Aesth Plast Surg (2023) 47:245–259. The mid-buttock is also divided into a central and an outer zone which usually has a depression. 11 The safest place to inject HA in the gluteal region is the subcu-Infragluteal fold created by the ischial tuberosity, the insertions of the semiten-dinous muscle and long belly of the biceps femoris, and the lower border of the gluteus maximus. 5 and 6. The infragluteal fold is one of the major concerns in reshaping of the gluteal region. Five fixed cadavers were used. The anatomical study. Her operative photo shows a disproportionally increased amount of fat distributed along the lower third of her body, giving her a wide appearance. We report a case of using autologous. The infragluteal sulcus is created right below. 4). 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. infragluteal fold [2–4]. ResultsThe infragluteal fold is a connectival fibrous band. 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 postoperative results depicted in the article demonstrate a successful. The infragluteal folds and perineal region were treated with the patient in a prone jackknife position. Unit D has six subunits (D1–D6). This crease does not reflect the lower margin of the gluteus major muscle, but. Patients with skin laxity and infragluteal fold ptosis may require a buttock lift or direct fold excision in order to obtain an acceptable result. Here, it continues to the midline of the thigh (halfway between the greater trochanter and the ischial tuberosity). The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. Then other planes are created using the same cannula in different trajectories, always from the deeper aspect to the more superficial plane. The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. com The infragluteal fold (IGF) is a crucial anatomic landmark representing one of the major concerns in gluteal reshaping in plastic surgery. The author tried not to trespass the thigh midline with the incision along the infragluteal fold. On the upper area, markings are shown for the gluteus. The buttocks have three different sections, the upper buttock, the mid buttock, and the lower buttock. If too much fullness exists, the area that should be a diamond-shaped space is a straight line, which is much less appealing. The flap length, determined from the distance between the perforator and the distal flap margin, was designed to be slightly longer than the defect itself. 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. The ischial region is the site most affected by pressure sores and has the highest recurrence and complication rates compared to other affected sites. Results were maintained at 6 months. 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. Five fixed cadavers were used. Grade III ptosis has the most skin and volume below the fold, with significant skin laxity and a more angular infragluteal fold. 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. Also evaluate theangle of the infragluteal fold. Does it have a downward 45° angle, run horizontally, or have an inverted. 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. A banana fold may form for different reasons, among which an. Its inferior border is formed by the insertions of the semitendinous muscle and the long belly of the biceps femoris in the ischial tuberosity. Asymmetric lifts and reduction are to be performed on the buttock to correct for your present symmetry. 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 . Red line. This would go from the outer buttock fold and into the groin and possibly communicate with your prior thigh lift. 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. Infragluteal fold reconstruction is achieved by reconstruction of the buttock’s sustaining apparel through deepithelialized skin flaps anchored to deep gluteal fascia. The structure of the infragluteal fold and the degree of ptosis are the main factors that determine the aesthetic appearance. These considerations guide the technique, which includes three distinct approaches for PLLA injection based on patient input regarding the most. The main goal of a butt tuck procedure is to repair lost or obstructed infragluteal. 39. 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. A thigh lift is a procedure that involves the removal of excess skin and fat from either the inner or outer thighs. Care is taken not to remove the subcutaneous tissues at the level of the infragluteal crease. Figure 6. 6). The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. A direct excision was performed under general anesthesia. Care is taken not to remove the subcutaneous tissues at the level of the infragluteal crease. In contrast, a shorter infragluteal fold contributes to a full, taught, and youthful buttock [Babuccu O. 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. Results The mean operating time was 210 min, and the volume resected ranged from 550 to 640 g in each of the gluteal areas. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. The ideal candidates for FCI flap for breast reconstruction, as for any other free flaps, are non-smokers and non-obese patients. 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. A more objective, faster and shorter version of this scale, to be evaluated. Open in a separate window. ” In contrast to the rest of the posterior thigh, this fatty roll is a rather common problem (see Fig. 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. 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. By adding more volume on the left and matching the right, the fold will appear as a result of this added volume. The muscle fascial edges should approximate with ease and a “watertight” closure is performed using eight to ten simple interrupted 0 or 2-0. the market share of other surgical as well as non-surgical body contouring approaches. Considering its widespread innervation and many collateral branches, PFCN neuropathy has been commonly reported, primarily due to iatrogenic etiology. Five fixed. Shorter, less dimpled, and tight skinned buttocks are smoothly wider and better projecting at the mid-level. With sagging of the muscle belly, the infragluteal fold is decreased or lost, and atrophy of the buttock is obvious with time. Save. Infragluteal fold excision can be performed either before or after implantation . Buttock ptosis is acceptable and fairly common when located at the inner part of the thigh close to the pubis, but is considered unaesthetic when located at the posterior and lateral parts of the buttock. Gozil R. The patient has difficulty arising from a sitting position or climbing steps. 1. In my opinion, adding volume with an autologous fat transfer would be the best option in your case. The purpose of this study was to perform an anatomical description of the infragluteal fold (IGF) matching radiological and anatomical findings in describing specifically raise of the fibrous component at the bone level. Buttock Lifting Using Elastic Thread (Elasticum®) with a New Classification of Gluteal Ptosis. Fig. Augmentation of the fold with fat would help you achieve a smoother transition between the butt. The infragluteal fold, which The concept of the ideal shape for the gluteal region has attaches to both the ischium and the sacrum in a continuous changed over time and over cultures and still is evolving. This study reevaluated the fold both histologically and anatomically. 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. Thus, buttock ptosis is simply gluteal tissue below the skin fold, or infragluteal crease. Infragluteal fold revision Buttock lift The author prefers tostageexcisionalcontouring procedures in association with gluteal implants. While buttock sagging is a general term it has different types as defined by the level of the infragluteal fold. We report a case of using autologous fat transplantation to correct severe post-liposuction infragluteal fold deformity. 12. Although the gluteal shape is open to the effects of demographic factors such as ethnicity, feeding habits, and lifestyle, according to these findings, it might be advised that in the assessment of the gluteal region. In the process of r. 44 The infragluteal fold is an important indicator of gluteal aesthetics. Superiorly it is formed by the lower border of the gluteus maximus. S3 – Over the tuberosity of the ischium or infragluteal fold S4 and S5 – In the perianal area, less than one cm lateral to the mucocutaneous zone Don’t Forget to Solve all the previous Year Question asked on Important dermatomes and anatomical landmarksThe orientation of IGF fibers offers a hammock-like support system. An injury specifically to the inferior gluteal nerve, which supplies the gluteus maximus muscle, results in weak extension of the hip. This study reevaluated the fold both histologically and anatomically. The thigh circumference measured at 3 predefined levels decreased on average by 2. amniotic fold the folded edge of the amnion where it rises over and finally encloses the embryo. Superiorly, it is formed by the lower border of the gluteus maximus. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. It is the lower boundary of the breast and is an important element of the natural ptotic appearance of the breast. 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. Both adipofascial flaps were rotated downward for inset in the pockets created in the buttocks. 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. 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. The power of this technique is granted through the lengthened anteroposterior. The current trend is towards more fat grafting and less implant use, as fat grafting, when carefully applied, is seen as less likely to have complications. The average width of the skin excision was 8 cm and the average length was 25 cm. The average width of the skin excision was 8 cm and the average length was 25 cm. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. 20. My recommendation would be getting better contour on the left before addressing the right. These considerations guide the technique, which includes three distinct approaches for PLLA injection based on patient input regarding the most. &NA; The ideal skin‐flap reconstruction provides functional preservation and a good cosmetic outcome in both the. Notice in the center photograph that a fuller. Note anterior abdominal wall. The dissection and volume this flap provides are similar to that of the SGAP flap. Volume in this area is restored with careful fat. You have a beautiful result after the fat grafting and the “tuck” of the infragluteal fold may be messed up forever, doing direct incision. Hope this helps!Artistic rendition of relevant anatomy of the infragluteal approach. 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 []. With this technique, the deepithelialized crescent-likeThe infragluteal fold/thigh junction (lower gluteal cleavage) also requires definition. Supragluteal fossettes (one on either side), over the posterior superior iliac spine, created by the multifidus muscle, the lumbodorsal aponeurosis and the insertion. 3 Excerpts; Save. Many of the early proponents of the procedure were not open to discussing complications. Dr. My recommendation would be getting better contour on the left before addressing the right. This study reevaluated the fold both histologically and anatomically. Once the shapes are more symmetric, volume enhance can be done on both sides simultaneously. The “sensuous triangle” is found at the junction of the lateral buttocks, the lateral thigh, and the posterior thigh. The structure of the infragluteal fold and the degree of ptosis are the main factors that determine the aesthetic appearance. A banana fold may form for different reasons, among which an iatrogenic cause is recurrent. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. 1 Anatomy of the gluteus maximus muscle and deeper structure. Right now you have a partial double fold, a higher medial partial crease and a lower complete crease. Preoperatively, the patient is examined and the buttock’s size and shape are evaluated. Medicine. Recent Surge in BBL Demand. Gluteal Deadlifts. An anatomical description of the infragluteal fold (IGF) matching radiological and anatomical findings in describing specifically raise of the fibrous component at the bone level is performed. Surgery was performed in the jackknife position, and flaps were elevated in the suprafascial plane. Higher IGF (infragluteal fold) results in a shorter buttock preferred by Asian Americans 123 Aesth.