adjective. Cocke and Ricketson were the first to describe placing silicone breast implants in the subcutaneous plane with less than optimal results. Hello and thank you for your question. fold is also included in this project in comparison with the inframammary, infragluteal, and inguinal creases. For a negative upward slant (see Fig. Hello and thank you for your question. This is not a good benefits vs risk proposition. 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. One can not liposuction between the two and create a single infragluteal crease. Advanced SearchUndermining using electrocautery was performed to create two pockets in both buttocks bilaterally down to few centimeters above the infragluteal fold. Dear Anna, judging from the picture posted on the forum, you seem to have buttock ptosis with a deep infra gluteal fold. Dr. 1 Anatomy of the gluteus maximus muscle and deeper structure. 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. This horizontal crease is under the ischial tuberosity. The lower buttock is the most difficult area to address. A. lateral to the mucocutaneous junction. Patients with a long buttock may. It is critical to appropriately and systematically analyze the complex regional anatomy. 5). Case presentation: We report. Care is taken not to remove the subcutaneous tissues at the level of the infragluteal crease. 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 "sensuous triangle" is found at the junction of the lateral. No major complications or. With sagging of the muscle belly, the infragluteal fold is decreased or lost, and atrophy of the buttock is obvious with time. 3), the buttock contour has a smooth C shape, without depression and ptosis. Furthermore, the infragluteal fold should form a diamond-shaped space with the inner thigh. The FCI flap is a good choice for. The posterior knee-fold incisions can be closed or left open for. 23. BackgroundGluteal ptosis may result from sagging of redundant skin and fat. The main difference with our technique is the design. (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 infragluteal fold is where the bottom of the buttock meets the upper thigh. Methods: Six volunteers (three males and three females) underwent an MRI scan (Siemens Aera® 1. By means of MR imaging of volunteers and dissection of fresh cadavers, a here presented study revealed the infragluteal fold as a connectival fibrous band extending from the ramus of the ischium, the coccyx and the apex of sacrum, without significant. Purpose The gluteal region is a key element of beauty balance and sexual appearance. 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. 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. It is designed over the inferior portion of the buttock, with the resulting scar located just above the infragluteal fold. Destruction of this. 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. 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. What separates the lower buttocks from the other two sections is the infragluteal fold. The major drawback of implant augmentation is the substantially high rate of complications associated with its techniques. V-shaped sacral triangle . These considerations guide the technique, which includes three distinct approaches for PLLA injection based on patient input regarding the most. To our knowledge, only two variations to the classic chevron technique have been described in an attempt to improve buttock contouring following GSCT excision. ResultsThe infragluteal fold is a connectival fibrous band. Complete 10 to 15 reps. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. It has been noted in multiple. ResultsThe infragluteal fold is a connectival fibrous band. 23. Unfortunately liposuction of the banana roll can cause additional lines to form which is why I avoid liposuction in that area if possible. Search worldwide, life-sciences literature Search. A large redundant infragluteal crease probably cannot be repaired easily. 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). The author tried not to trespass the thigh midline with the incision along the infragluteal fold. Answer: Double gluteal fold. Created for people with ongoing healthcare needs but benefits everyone. 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. 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 "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. The gluteal region in patients with massive weight loss after gastric bypass is characterized by. excess skin just above the umbilicus, a redundant infragluteal fold and lack of gluteal projection. When the infragluteal fold line is horizontal (see Fig. The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. The descending branches of the inferior gluteal vessels and its accompanying nerve enter the subcutaneous tissue of the gluteal thigh flap distal. 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. The advantage is that the posterior thigh is lifted and ptosis of the caudal buttock can be corrected. fold both histologically and anatomically. 4). The infragluteal fold (IGF) is a crucial anatomic landmark representing one of the major concerns in gluteal reshaping in plastic surgery. The “sensuous triangle” is found at the junction. 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. Her operative photo shows a disproportionally increased amount of fat distributed along the lower third of her body, giving her a wide appearance. 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 . Also evaluate the angle of the infragluteal fold. Ini-tially, a deep plane is created by the 3-mm cannula. Read more. 1). 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. The "sensuous triangle" is found at the junction of the lateral. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. 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. A flap involving the whole gluteal area was dissected superficially to the gluteal fascia. The radiation oncologist clinically outlined the areas. In my humble opinion you need nothing surgical. Manipulation using a ball-spiked pusher under. . More superficially, the infragluteal fold is formed by the fascial insertions into the skin. 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. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Reply: Staying Safe during Gluteal Fat Transplantation. A banana fold may form for. Five fixed cadavers were used. The inframammary crease 5,13 lies o ver the fifth to sixth ribs. 15. No adverse events were recorded. Sagging of redundant skin and fat below the infragluteal fold is commonly observed in bariatric patients following massive weight loss and defines. These structures create the fixed, well-defined subgluteal sulcus [2]. Recent Surge in BBL Demand. The postoperative results depicted in the article demonstrate a successful. A longer infragluteal fold suggests an aged, ptotic, and deflated-looking buttock with skin and fascial excess. Infragluteal fold excision can be performed either before or after implantation (Fig. This study reevaluated the fold both histologically and anatomically. Which of these fibers provides. Results The mean operating time was 210 min, and the volume resected ranged from 550 to 640 g in each of the gluteal areas. Eppley, MD, DMDIn some instances, insertion of a buttock implant with a subsequent infragluteal-fold skin excision can be beneficial. This fold is the horizontal crease under the ischial tuberosity. Right now you have a partial double fold, a higher medial partial crease and a lower complete crease. Save. 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. Thus, every effort should be undertaken to preserve or reconstruct this important anatomical landmark . Tissue samples (6 cm long × 2 mm thick) were taken at three. 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 use of a deepithelialized. Conclusion: Focused ultrasound is a safe, effective and well tolerated procedure for remodelling areas of the body. 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 infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. The width of the flap and. Time and important weight variation consid- erably affect this region combined with the gravity’s effect. The upper-inner thigh holds a high stem. dermal flap will be performed for lifting the ptotic buttocks with ill-defined infragluteal fold. Short gluteal fold. 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. spiraling anteriorly to the flank and posteriorly to the infragluteal fold, thus joining the previous flank and infragluteal. These implants may be placed through bilateral supragluteal incisions, the infragluteal fold, or the intergluteal cleft incision. The fat is injected as the. ” In contrast to the rest of the posterior thigh, this fatty roll is a rather common problem (see Fig. The original buttock lift dates back many decades before BBL surgery became popular and refers to a direct excision at the lower buttocks. Background. A direct excision was performed under general anesthesia. Lower body lift procedures remove excess skin and lift sagging buttock tissue. 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 key to success for this procedure is to. infragluteal fold is composed of fascial spicules extending . We recommend the lower buttock lift for patients who suffer from sagging skin beneath the lower fold of their buttocks (the infragluteal fold). In most cases, the infragluteal fold ends at the midpoint of the inferior buttock. 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]. 4. The infragluteal fold (IGF) is a crucial anatomic landmark representing one of the major concerns in gluteal reshaping in plastic surgery. The length and definition of the infragluteal fold play important roles in aesthetically. Flap reconstruction is efficient in severe cases of infragluteal fold deformity (5), but the low patient acceptance of the subsequent scars limits its application. Four fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. 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. The inferior border of the infragluteal fold is formed by the insertions of the semitendinous muscle and the belly of the biceps femoris. Answer: Options to fix/shorten infragluteal fold after BBL? Well, after undergoing liposuction and BBL you know that more of the same is definitely not the answer. We describe an optimized and individualized approach for injecting the collagen biostimulator PLLA in the gluteal region according to the needs of each patient. 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. unsatisfactory. (E) The incision is closed from distal to proximal, blending into the abdominal closure when abdominoplasty is performed. Indeed once this area is damaged, typically by liposuction, it is tricky to fully repair and re-create the normal infragluteal fold again. Normally, its mean length is equal to the intergluteal fold length or 2/3 of it. Also evaluate the angle of the infragluteal fold. Expand. After the fat graft, thread lifting is performed considering the vector. infragluteal fold, and small portions of the lateral anal/perineal region [1,3]. This causes movement of the infragluteal sulci in downward and lateral directions as well as lengthening of intergluteal sulcus. 24 The ideal direction of the infragluteal fold from medial to lateral is downward sloping. The ideal candidates for FCI flap for breast reconstruction, as for any other free flaps, are non-smokers and non-obese patients. Surgery was performed in the jackknife position, and flaps were elevated in the suprafascial plane. 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. 2, 3, 4. 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. 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. MWL patients usually present with this negative angle and might need lifting procedures with or without skin resection at the infragluteal. TLDR. 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. The infragluteal area may be slightly improved after buttock augmentation resulting in less of a requirement for skin. Its exact dimensions, including its thickness, are determined by the volume of tissue deemed necessary to fill out the buttock contour. Tissue samples (6 cm long 9 2 mm thick) were taken at three points from each fold bloc: the most medial point, the middle. fold [fōld] plica; a thin margin curved back on itself, or doubling. The ideal infragluteal cleft is none at all, but instead a smooth transition from buttocks to thigh. Therefore, it may be preferable to wait several months after implantation to determine the amount of skin resection necessary. Plastic surgeons often reduce buttock lift with an incision under the buttocks or in the infragluteal fold. A banana fold may form for different reasons, among which an. 10 The Mendieta and Sood classification is demonstrated in Fig. 6. 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 gluteal region in patients with massive weight loss is characterized by excessive skin and exaggerated fat loss. New flank tapered feminine depressed contours are limited by high and narrow pelvic rims, which help define high hipsHide glossary Glossary. 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. A Jackson Pratt drain is then placed in each implant pocket and brought out laterally in the infragluteal fold through a separate stab incision. Its inferior border is formed by the insertions of the semitendinous muscle and the long belly of the biceps femoris in the ischial tuberosity. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. Point “C” is marked in the center of the buttock, 3 cm above the infragluteal fold. 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. the banana fold and the sensuous triangle is gained through the one incision on each side of the infragluteal fold. On the plantar surface of the foot, Gluteal fold we find the transverse lines and the longitudinal lines [1]. 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. Lower buttock sag is occurs when the superior skin and fat ‘fall’over the fixed infragluteal fold. In contrast, a shorter infragluteal fold contributes to a full, taught, and youthful buttock. The main goal of a butt tuck procedure is to repair lost or obstructed infragluteal. In my opinion, adding volume with an autologous fat transfer would be the best option in your case. 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. Some surgeons call this a removal of banana roll; more technically, it is an infragluteal fold incision for excision of upper posterior thigh. Limits implant movement. This is a difficult area to fix. From this point of view, in our opinion, there are four salient morphologic features to be considered in the preoperative planning: anterior and posterior views, the profile, and the infragluteal fold. If too much fullness exists, the area that should be a diamond-shaped space is instead a straight line, which is much less appealing. This can include excess weight that has accumulated in the waist and buttock area. Figure 6. Background: Anatomical features that make the buttocks attractive include adequate volume, projection, and a defined infragluteal fold. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. 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. It has been noted in multiple studies that patients can experience persistent PFCN. Saddlebags at the infragluteal fold level are replaced by tight flat skin. The inframammary crease 5,13 lies o ver the fifth to sixth ribs. 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 . Tissue samples (6 cm long x 2 mm thick) were taken. This 5 cm gap between the caudal edge of the flap and the infragluteal fold can appear empty. 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 cannula should have one orifice and be thick (4 or 5 mm), long (32 cm), and directed to the IGF and beyond. Infragluteal fold created by the ischial tuberosity, the insertions of the semitendinous muscle and long belly of the biceps femoris, and the lower border of the gluteus maximus. 8): Fig. 15. In this way, it's similar to a general lower body lift. 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. Liposhifting is a technique that. The long axis of the flap was arranged in parallel with the infragluteal fold axis. The final result should be to attain a waist-to-hip ratio (WHR) close to 0. The power of this technique is granted through the lengthened anteroposterior. The ischial region is the site most affected by pressure sores and has the highest recurrence and complication rates compared to other affected sites. Infragluteal fold reconstruction is achieved by reconstruction of the buttock’s sustaining apparel through deepithelialized skin flaps anchored to deep gluteal fascia. Besides the excessive fat accumulation, insufficient muscle tone may also contribute to the formation of saddlebags. Profunda perforator characteristics that were examined included the distance from the pubic tubercle to the infragluteal fold (IGF), the distance of the perforators from the IGF, distance posterior to the gracilis, the diameter of the perforator at fascial exit, and total number of perforators present. The average width of the skin excision was 8 cm and the average length was 25 cm. Five fixed cadavers were used. 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. Does it have a downward 45º angle, run horizontally, or have an inverted upward. fashion, is an anatomic structure in its medial part and only a Despite this reality, the ideal gluteal shape has been crease laterally. Thomas Fiala answered. 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. 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 patient has difficulty arising from a sitting position or climbing steps. It has been noted in multiple. Also, evaluate the angle of the infragluteal fold. 7) . You have a beautiful result after the fat grafting and the “tuck” of the infragluteal fold may be messed up forever, doing direct incision. : situated within or introduced into the gluteal muscle. But so doing it may also make your buttocks look a little less full because its roundness is decreased. For this we have applied a pedicled skin flap raised in the infragluteal fold, the technical details and surgical results of which are presented in this paper. Considering its widespread innervation and many collateral branches, PFCN neuropathy has been commonly reported, primarily due to iatrogenic etiology. The infragluteal fold region is the lower edge of the buttocks. 5 Mendieta’s ptosis evaluation utilizing skin fold angles for classification. The implant was inserted through an infragluteal fold incision. 5 ). 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. The second incision is placed at the midpoint of the infragluteal fold. Grade 4 (mild ptosis): the gluteal tissue passes over the infragluteal fold at the M line; on the lateral view, we evaluate the angle of the skin fold at the infragluteal fold; in Grade 4, the angle is less than 10°. Dr. Liposhifting is a technique that. The inclusion criteria was ptosis of the lower pole of buttocks. 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. The region of the infragluteal fold has been generally ignored or inadequately treated. Tissue samples (6 cm long x 2 mm thick) were taken. Lipoplasty aided in the accentuation of lumbar lordosis, which gives the impression of greater buttocks projection. 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. A banana fold may form for different reasons, among which an. The treatment should not focus on the central and lower. com The infragluteal fold (IGF) is a crucial anatomic landmark representing one of the major concerns in gluteal reshaping in plastic surgery. 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. Five fixed. If ou still has residual excess skin and fat on the lower buttock and. Download scientific diagram | MRI sequence of the infragluteal fold with T1 VIBE MORPHO sequence (Thickness slice = 900. PDF. In this study, 84. However, there is no clear anatomical description of the infragluteal fold,. 3) The length of the lower buttock lift excision should ideally not go beyond the. Fee $6,000+ Best to virtual consult with. Barry Eppley. The “sensuous triangle” is found at the junction of the lateral buttocks, the lateral thigh, and the posterior thigh. Download scientific diagram | Definitions of the lines drawn between reference points from publication: Gluteal Region Morphology: The Effect of the Weight Gain and Aging | The gluteal region is. Many of the early proponents of the procedure were not open to discussing complications. Undermining will not go beyond the infragluteal fold, so it is important to place the template 2 cm above the fold . It arises in the median gluteal crease and follows. All patients showed an improved definition of the infragluteal fold, with a symmetric shape of the gluteal region. 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 []. 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). 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. The aesthetic line of the infragluteal fold should generally be short, no longer than the. Answer: Double fold. Severe infragluteal fold. You have a beautiful result after the fat grafting and the “tuck” of the infragluteal fold may be messed up forever, doing direct incision. The surgical anatomy of the subcutaneous screen on the gluteal region has. 2 Patient Selection. Additionally, I agree that a lower buttock tuck with the results scar is probably not the best of options for you. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. Four fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. This study reevaluated the fold both histologically and anatomically. Answer: Options to fix/shorten infragluteal fold after BBL? Well, after undergoing liposuction and BBL you know that more of the same is definitely not the answer. The infragluteal fold is one of the key elements that determines the gluteal contour and is recognized as an important characteristic of female beauty . An anatomical description of the infragluteal fold (IGF) matching radiological and anatomical findings in describing specifically raise of the fibrous component at the bone. Grade II ptosis includes moderate skin and volume below the fold, with a more angular infragluteal fold moving inferomedially from the lateral thigh. 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. 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. 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 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. The buttock skin and subcutaneous tissue were advanced superiorly and rotated medially to tighten the buttocks, lateral thigh, and posterior thigh. ” It can also be used to improve a double infragluteal fold, to correct infragluteal fold asymmetry, or to shorten a long buttock when combining it with an upper buttock lift. The flaps are undermined by only one cm. circular f's the permanent. 23. Undermining will not go beyond the infragluteal fold, so it is important to place the template 2 cm above the fold (Figure 6). springer. Care must be taken when completing the last portion of the. 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. 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. The dissection and volume this flap provides are similar to that of the SGAP flap. A banana fold may form for different reasons, among which an. I think this would give a far better yield than the infragluteal fold excision or the buttock fold excision. This would go from the outer buttock fold and into the groin and possibly communicate with your prior thigh lift. Expand. 1. BackgroundThe gluteal fold represents an important aspect of the gluteal region. PDF. The infragluteal fold length and definition play important roles in esthetically pleasing buttocks. Paraspinous muscles cannot be forgotten in the lower abdomen. 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. 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. If done by an experienced surgeon, you should see improvement but it is not easy to create a single crisp infragluteal fold. 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. 6). The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. Thus, you may want to consider restoring volume to your buttock and. 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. Peter Fisher M. Five fixed cadavers were used. 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. I hope this helps. 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 procedure is indicated in patients with mild buttock ptosis with excess skin and subcutaneous tissue in the inferior gluteal fold or “banana fold. 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. Characteristic features include short intergluteal cleft, flattened buttocks, narrow hips, distal leg atrophy, and talipes deformities. Buttock ptosis or sag can also occur when the infragluteal fold attachments are lost or disrupted. 44 The infragluteal fold is an important indicator of gluteal aesthetics. 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. On the upper area, markings are shown for the gluteus. (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. 5 cm, 3-month follow-up). Superiorly it is formed by the lower border of the gluteus maximus. 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. By utilizing an FCI flap for the reconstruction of a contour deformity in the region, the gluteal sulcus can be sufficiently reconstructed, and a pleasing buttock. Tissue. A banana fold may form for different reasons, among which an iatrogenic cause is recurrent. 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. The iatrogenic forms of banana fold and sensuous triangle deformity are produced by excessive. The posterior thigh is the area least requested for liposuction with the exception of the proximal infragluteal fold or so-called “banana fold. Other procedures commonly done include lifts and changing the infragluteal fold length. 12. Intergluteal cleft. Most patients had a deep infragluteal fold. Volume in this area is restored with careful fat. The “sensuous triangle” is found at the junction of the lateral buttocks, the lateral thigh, and the posterior thigh. The hyperechoic BFL tendon might be a reliable soft tissue landmark for ultrasound localization of the infragluteal sciatic nerve. Results Our.