The surgical anatomy of the subcutaneous screen on the gluteal region has. Download : Download full-size image; Figure 6. 6. Infragluteal fold revision Buttock lift The author prefers tostageexcisionalcontouring procedures in association with gluteal implants. Drains are placed via stab incisions in the infragluteal fold using a #15 blade scalpel. A disadvantage is that the lower floor of the buttocks often remains ‘emptied’, while good vascularization can be cited as an advantage. 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. For a negative upward slant (see Fig. 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. Common Butt Lift Factorslaterally, resulting in a long infragluteal fold. An angulated cannula can be used to easily enter the superficial space. Expand. 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. Therefore, in each case, the high points of the buttocks are relatively light while infragluteal fold and V-shaped crease areas are relatively dark. FIG. The flap width was designed to match the broadest width of the defect, which was assessed from the inner. Supragluteal fossettes. 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 second incision is placed at the midpoint of 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. She underwent liposculpture using the tumescent technique with infiltrated fluid, sodium chloride, epinephrine and Lidocaine in the. By adding more volume on the left and matching the right, the fold will appear as a result of this added volume. The author tried not to trespass the thigh midline with the incision along the infragluteal fold. These implants may be placed through bilateral supragluteal incisions, the infragluteal fold, or the intergluteal cleft incision. 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. 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 is like a horizontal line. The need for liposuction of the lower back or hips is considered. 3 cm, with the greatest change at the level of 10 cm below the infragluteal fold (-3. Grade III: The skin. In the present, precisely for this reason, it is believed that dissection should reach the level of the infragluteal fold. Care must be taken when completing the last portion of the. In this way, it's similar to a general lower body lift. 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 inferior border of the infragluteal fold is formed by the insertions of the semitendinous muscle and the belly of the biceps femoris. 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. The intergluteal cleft is a surface anatomy landmark of the pelvis and lower limb. Great posted photos. 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. The histologicalCreation of an infra gluteal fold is done in the same fashion as the medial thigh tuck first described by Ted Lockwood, M. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. Download scientific diagram | MRI sequence of the infragluteal fold with T1 VIBE MORPHO sequence (Thickness slice = 900. Hope this helps!Artistic rendition of relevant anatomy of the infragluteal approach. Your infragluteal fold is barely noticeable, no women has perfect exact length, position and height of the infragluteal fold. Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in esthetic defects in the gluteal contour. 9 and 10. 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. The dissection and volume this flap provides are similar to that of the SGAP flap. Red line. This maneuver is important to delineate the lateral margin on the gluteal area to adequately define the lower lateral transition area. 2, 3, 4. 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. An understanding of the anatomy of the gluteal region is essential in the evaluation and planning of surgery ( Fig. In type 1 buttock ptosis the infragluteal Read More…Background: The shape of the buttocks can take on many different forms. Background: Anatomical features that make the buttocks attractive include adequate volume, projection, and a defined infragluteal fold. Search worldwide, life-sciences literature Search. Expand. 2. fashion, is an anatomic structure in its medial part and only a Despite this reality, the ideal gluteal shape has been crease laterally. ” In contrast to the rest of the posterior thigh, this fatty roll is a rather common problem (see Fig. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. The major drawback of implant augmentation is the substantially high rate of complications associated with its techniques. 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. Additionally, I agree that a lower buttock tuck with the results scar is probably not the best of options for you. The aesthetic line of the infragluteal fold should generally be short, no longer than the. The “sensuous triangle” is found at the junction of the lateral buttocks, the lateral thigh, and the posterior thigh. Both computed tomographic (CT) and magnetic resonance (MR) venography can be used to document compression of the left renal and iliac veins, to measure ovarian vein diameters, and to. implant. It is based at the midline and extends laterally a distance dependent on the length needed to approach the infragluteal fold when transposed if limits on the width of the flap allow. Sensory fibers from a dermatome and cutaneous nerves provide innervation to the gluteal region. 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. circular f's the permanent. fold [fōld] plica; a thin margin curved back on itself, or doubling. A: Thank you for your inquiry and sending your picture. Tissue samples (6 cm long × 2 mm thick) were taken at three. 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]. 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. 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 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. The skin perforators of the pudendal artery were marked with a Doppler probe in the medial region of the gluteal fold. It is one o…THE IGF. 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]. 39. 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. 15. The iatrogenic forms of banana fold and sensuous triangle deformity are produced by excessive. 4% of subjects reported increased muscle. All patients showed an improved definition of the infragluteal fold, with a symmetric shape of the gluteal region. Ranch & Coast founder, Dr. Plastic surgeons often reduce buttock lift with an incision under the buttocks or in the infragluteal fold. We report a case of using autologous fat transplantation to correct severe post-liposuction infragluteal fold deformity. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. The infragluteal fold is one of the major concerns in reshaping of the gluteal region. The infragluteal area may be slightly improved after buttock augmentation resulting in less of a requirement for skin resection. The muscle fascial edges should approximate with ease and a “watertight” closure is performed using eight to ten simple interrupted 0 or 2-0. 15. The infragluteal area may be slightly improved after buttock augmentation resulting in less of a requirement for skin resection. 2) The thin strips of skin and fat are worthless as grafts because of their very low volume. Aesthetically attractive buttocks required special features include adequate volume, projection, and a defined infragluteal fold. New flank tapered feminine depressed contours are limited by high and narrow pelvic rims, which help define high hipsHide glossary Glossary. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Final skin laxity classification results from the sum of each item grade multiplied. The inferiorly oriented form of the muscle may be visible in males, but in. 12. It is critical to appropriately and systematically analyze the complex regional anatomy. 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. dermal flap will be performed for lifting the ptotic buttocks with ill-defined infragluteal fold. Thus, every effort should be undertaken to preserve or reconstruct this important anatomical landmark . Abstract. This would go from the outer buttock fold and into the groin and possibly communicate with your prior thigh lift. 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. (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. Here, it continues to the midline of the thigh (halfway between the greater trochanter and the ischial tuberosity). The power of this technique is granted through the lengthened anteroposterior. 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. The anterior axillary fold is also included in this project in comparison with the inframammary, infragluteal, and inguinal creases. Zone 3: Proximal inner thigh confluences with Zone 1 to recreate a round buttock and follow the infragluteal fold. Lower body lift procedures remove excess skin and lift sagging buttock tissue. Therefore, indications for buttocks lifts range from subtle aesthetic reasons to a major recontouring following bariatric surgery. Your infragluteal fold is barely noticeable, no women has perfect exact length, position and height of the infragluteal fold. 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 FCI flap is a good choice for. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. (E) The incision is closed from distal to proximal, blending into the abdominal closure when abdominoplasty is performed. Right now you have a partial double fold, a higher medial partial crease and a lower complete crease. Figure 6. This study reevaluated the fold both histologically and anatomically. Also, evaluate the angle of the infragluteal fold. 4). Medicine. Plan on a 2-3 week recovery. 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 patient’s position is prone or lateral decubitus. The infragluteal sulcus is created right below. CárdenasThe infragluteal fold is one of the major concerns in reshaping of the gluteal region. Advanced SearchUndermining using electrocautery was performed to create two pockets in both buttocks bilaterally down to few centimeters above the infragluteal fold. Time and important weight variation. The descending branches of the inferior gluteal vessels and its accompanying nerve enter the subcutaneous tissue of the gluteal thigh flap distal. The short answer is yes. Good luck. 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. This causes movement of the infragluteal sulci in downward and lateral directions as well as lengthening of intergluteal sulcus. Fig. These structures create the fixed, well-defined subgluteal sulcus [2]. loss of the infragluteal fold [7]. S3 Over the ischial tuberosity or infragluteal fold (depending on the patient their skin can move up, down or laterally over the ischii). 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. With this technique, the deepithelialized crescent-likeThe infragluteal fold/thigh junction (lower gluteal cleavage) also requires definition. intragluteal injection. Barry Eppley. The power of this technique is granted through the lengthened anteroposterior scar and. implant. 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. Grade II: The infragluteal fold is angulated downward, flattening at the lower 1/3 of buttock. Furthermore, the infragluteal fold should form a diamond-shaped space with the inner thigh. Asymmetric lifts and reduction are to be performed on the buttock to correct for your present symmetry. You have a beautiful result after the fat grafting and the “tuck” of the infragluteal fold may be messed up forever, doing direct incision. 2 Patient Selection. Urinary and bowel. The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. A thigh lift is a procedure that involves the removal of excess skin and fat from either the inner or outer thighs. It is our preference not to use this flap much because of the scar location and occasional sciatic nerve irritation due to swelling around. 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. 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. Results Our. The gluteal region in patients with massive weight loss is characterized by excessive skin and exaggerated fat loss. 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. ResultsThe infragluteal fold is a connectival fibrous band. Ini-tially, a deep plane is created by the 3-mm cannula. Fig. 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. 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. Answer: Double gluteal fold. In contrast, a shorter infragluteal fold contributes to a full, taught, and youthful buttock. Results: After treatment, there was an average reduction of 4. Incisions with ports sutured in place on the superior intergluteal crease and over the mid inferior gluteal point bilaterally. A direct excision was performed under general anesthesia. The skin flap was designed along the gluteal fold. The flap should be fixed as low as possible to the muscle fascia. 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. Tissue samples (6 cm long x 2 mm thick) were taken. The final result should be to attain a waist-to-hip ratio (WHR) close to 0. buttock, infragluteal fold, or hips often produces sub-optimal aesthetic results. 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. 15. The Infragluteal Thigh Lift Technique. The ideal candidates for FCI flap for breast reconstruction, as for any other free flaps, are non-smokers and non-obese patients. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. 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. A banana fold may form for different reasons, among which an iatrogenic cause is recurrent. The inframammary crease 5,13 lies o ver the fifth to sixth ribs. The inclusion criteria was ptosis of the lower pole of buttocks. Does it have a downward 45° angle, run horizontally, or have an inverted. The infragluteal fold/thigh junction (lower gluteal cleavage) also requires definition. 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. Initially, percutaneous reduction was attempted through a small transverse incision in the infragluteal fold (figure 2). Additionally, I agree that a lower buttock tuck with the results scar is probably not the best of options for you. 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. Liposhifting is a technique that. 45 This results in a ptotic butt if it is longer. On the lateral view (Fig. 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. Flap reconstruction is efficient in severe cases of infragluteal fold deformity (5), but the low patient acceptance of the subsequent scars limits its application. The infragluteal fold length and definition play important roles in esthetically. 1. 4). ResultsThe infragluteal fold is a connectival fibrous band. 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 banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. The technical details and surgical results of a pedicled skin flap raised in the infragluteal fold, used to widen the. Time and important weight variation consid- erably affect this region combined with the gravity’s effect. 6. 1). 51. 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. Background: Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in aesthetic defect of gluteal contour. 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). 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. The postoperative results depicted in the article demonstrate a successful. The author has simply combined the incisions. 2, 3, 4. 3 An aged buttock region is marked. Also evaluate the angle of the infragluteal fold. 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. 7) . 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. The structure of the infragluteal fold and the degree of ptosis are the main factors that determine the aesthetic appearance. It has been noted in multiple. A banana fold may form for different reasons, among which an. Flap reconstruction is efficient in severe cases of infragluteal fold deformity (5), but the low patient acceptance of the subsequent scars limits its application. In the ideal buttock, the infragluteal fold should end. Dear Anna, judging from the picture posted on the forum, you seem to have buttock ptosis with a deep infra gluteal fold. In most cases, the infragluteal fold ends at the midpoint of the inferior buttock. 44 The infragluteal fold is an important indicator of gluteal aesthetics. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. 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. 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. Good luck. We define unaesthetic buttock ptosis as sagging. 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. This fold makes a usually Read More…Important dermatome & anatomical landmarks. The "sensuous triangle" is found at the junction of the lateral. . It has been noted in multiple studies that patients can experience persistent PFCN. This 5 cm gap between the caudal edge of the flap and the infragluteal fold can appear empty. It extends from sacral level S3 or S4 and ends just inferior to the apex of the sacrum, at the level of the anus. An injury specifically to the inferior gluteal nerve, which supplies the gluteus maximus muscle, results in weak extension of the hip. A. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. The procedure would take approximately 4 hours to complete. I think this would give a far better yield than the infragluteal fold excision or the buttock fold excision. 4. Reply: Staying Safe during Gluteal Fat Transplantation. lateral to the mucocutaneous junction. Results: Our technique allows wide exposure for tumour resection and functional restoration of the pelvic floor while placing the scars in anatomical locations and restoring buttock. Cosmetic surgery of the buttocks contemplates not only changes in volumes but also (and above all) a redefinition of the contours. 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. D. This is a difficult area to fix. Its inferior border is formed by the insertions of the semitendinous muscle and the long belly of the biceps femoris in the ischial tuberosity. This is not a good benefits vs risk proposition. In conclusion, using a deepithelialized double dermal flap is a safe and new way to obtain excellent results in rejuvenating the gluteal region. 9. Fee $6,000+ Best to virtual consult with. The buttock skin and subcutaneous tissue were advanced superiorly and rotated medially to tighten the buttocks, lateral thigh, and posterior thigh. Supra-gluteal fossettes (one on either side), over the poste-rior superior iliac spine, created by the multifidusThe 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. The superior border is formed by the lower border of the gluteus maximus. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. Save. Peter Fisher M. Undermining will not go beyond the infragluteal fold, so it is important to place the template 2 cm above the fold (Figure 6). Severe 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. 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. Results The mean operating time was 210 min, and the volume resected ranged from 550 to 640 g in each of the gluteal areas. 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 . S3 provides innervation to the infragluteal fold . Her operative photo shows a disproportionally increased amount of fat distributed along the lower third of her body, giving her a wide appearance. Between 2. 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. The hyperechoic BFL tendon might be a reliable soft tissue landmark for ultrasound localization of the infragluteal sciatic nerve. Most patients had a deep infragluteal fold. The inferior gluteal area is divided into four zones by tracing a vertical line from the center of the gluteus and a horizontal line that crosses through the infragluteal fold (Fig. If too much fullness exists, the area that should be a diamond-shaped space is a straight line, which is much less appealing. Influence of the Recipient Site on the Outcomes of Fat Grafting in Facial Reconstructive Surgery. On the left gluteal region, markings are shown for the muscle-fiber orientation for the gluteus maximus muscle. 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. D. 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. We describe an optimized and individualized approach for injecting the collagen biostimulator PLLA in the gluteal region according to the needs of each patient. 5, irrespective of the magnitude. Unfortunately liposuction of the banana roll can cause additional lines to form which is why I avoid liposuction in that area if possible. It arises in the median gluteal crease and follows. Infragluteal fold. Dr. Liposhifting is a technique that. Selective fat reduction centrally and laterally. 88 and 3 cm in the circumference of the abdomen, hips and thighs, respectively. 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 infragluteal fold (IGF) is a crucial anatomic landmark representing one of the major concerns in gluteal reshaping in plastic surgery. The dissection for the pocket where the flap will be inserted has to stop 5 cm above the infragluteal fold to avoid injury of the medial cluneal and the cutaneous femoris posterior sensory nerve . 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. This supports the thigh tissue in its lifted position and enhances the infragluteal fold. The advantage is that the posterior thigh is lifted and ptosis of the caudal buttock can be corrected. Surgery was performed in the jackknife position, and flaps were elevated in the suprafascial plane. 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. ” 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. Its inferior border is formed by the insertions of the semitendinous muscle and the long belly of the biceps femoris in the ischial tuberosity. This study reevaluated the fold both histologically and anatomically. 1. No adverse events were recorded. What you are seeking is to have a uniform infragluteal crease on both sides. Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in esthetic defects in the gluteal contour. Procedure. Five fixed. 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. The treatment should not focus on the central and lower. 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. Fig. Indeed once this area is damaged, typically by liposuction, it is tricky to fully repair and re-create the normal infragluteal fold again. The structure of the infragluteal fold and the degree of ptosis are the main factors that determine the aesthetic appearance. Methods: Six volunteers (three males and. Sagging of redundant skin and fat below the infragluteal fold is commonly observed in bariatric patients following massive weight loss and defines. The infragluteal fold is where the bottom of the buttock meets the 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. Barry Eppley. If too much fullness exists, the area that should be a diamond-shaped space is instead a straight line, which is much less appealing. Excess tissue was removed, and wound closure was performed in multiple layers. 44 The infragluteal fold is an important indicator of gluteal aesthetics. D. 2). 5 cm, 3-month follow-up). Two supragluteal fossettes (or dimples) on either side of the medial sacral crest which correspond to the posterior superior iliac spines. All patients judged the outcome as very good. 1 Anatomy of the gluteus maximus muscle and deeper structure. springer. 3 Excerpts; Save. V-shaped sacral triangle . It is important to recall that the inner thigh is divided in thirds; the middle is an adhesion zone, which contains only superficial fat, so over resection should be avoided in this area. 3. However, one of its key-component, the infragluteal fold, has not yet been clearly defined. 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 key to success for this procedure is to. The ideal infragluteal cleft is none at all, but instead a smooth transition from buttocks to thigh. PMID: 15940397 DOI: 10. It has been noted in multiple. The abdomen, hips, thighs, dorsum and infragluteal fold were the treated areas. The infragluteal fold needs to be approached carefully, by suctioning just under the skin. Preoperatively, the patient is examined and the buttock’s size and shape are evaluated. . Other procedures commonly done include lifts and changing the infragluteal fold length. The infragluteal fold is where the bottom of the buttock meets the upper thigh. Does it have a downward 45º angle, run horizontally, or have an inverted upward. This is typically done under local anesthesia. The main difference with our technique is the design. The procedure can be performed as a single procedure or as in cases of massive weight loss in the context of a lower body lift (circumferential abdominoplasty, belt. Usually, the access is a midline incision located above the IGF, or it is performed above the buttock. 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 width of the flap and. These implants may be placed through bilateral supragluteal incisions, the infragluteal fold, or the intergluteal cleft incision. This fold is the horizontal crease under the ischial tuberosity. The diamond-shaped space turns into a straight line, which is less aesthetically appealing. 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 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. The infragluteal fold became less evident, the buttock mass was elevated, and augmentation was achieved with the maximum projection at midlevel of the gluteus. 5 Mendieta’s ptosis evaluation utilizing skin fold angles for classification. The length and definition of the infragluteal fold play important roles in aesthetically. In this study, 84. adjective. Butt tuck surgery help people attain rounder, smoother and natural-looking buttocks. 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. ResultsThe infragluteal fold is a connectival fibrous band. Saddlebags at the infragluteal fold level are replaced by tight flat skin. 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. Thomas Fiala answered. Weight gain following thighplasty may negatively affect your surgery results. Five fixed. excess skin just above the umbilicus, a redundant infragluteal fold and lack of gluteal projection. 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. An anatomical study demonstrated that the perineal branch of. 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]. 39. 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. Grade 3 (borderline pre-ptosis): the fold is over the M line, but still there is no ptotic tissue at the M line. Hello and thank you for your question. Buttock Lifting Using Elastic Thread (Elasticum®) with a New Classification of Gluteal Ptosis. 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.