The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. Infragluteal fold reconstruction is achieved by reconstruction of the buttock’s sustaining apparel through deepithelialized skin flaps anchored to deep gluteal fascia. The infragluteal fold (IGF) is a crucial anatomic landmark representing one of the major concerns in gluteal reshaping in plastic surgery. Peter Fisher M. Infragluteal fold. Download : Download full-size image; Figure 6. 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. It is designed over the inferior portion of the buttock, with the resulting scar located just above the infragluteal fold. 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 infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. 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. Four fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. In my humble opinion you need nothing surgical. The key to success for this procedure is to. A small ellipse of posterior thigh and inferior gluteal tissue approximately 3-1/2" long will allow access to place permanent sutures from the SFS to the ischial tuberosity (from the fat below the skin to the bones at the. A V-shaped proximal gluteal crease was accentuated by the. This fold’s length and shape has a pre-eminent role in gluteal aesthetics: a long fold indicates a ptotic buttock, whereas a short one suggests a young. Superiorly, it is formed by the lower border of the gluteus maximus. Autologous gluteal augmentation with circumferential body lift in the massive weight loss and aesthetic patient. Urinary and bowel. A banana fold may form for. The therapy was found comfortable with a high satisfaction rate. 2 Patient Selection. Four fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. The width of the flap and. The long axis of the flap was arranged in parallel with the infragluteal fold axis. fold [fōld] plica; a thin margin curved back on itself, or doubling. 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. Although banana fold is a common problem, unrelished by most women, few procedures are targeted specifically to fight it. The skin flap was designed along the gluteal fold. It is divided into an inner, a central, and an outer zone. The length and definition of the infragluteal fold play important roles in aesthetically pleasing buttocks. Right now you have a partial double fold, a higher medial partial crease and a lower complete crease. 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 . The infragluteal fold region is the lower edge of the buttocks. Infragluteal fold The creases on the plantar surface of the foot are not as Infragluteal sulcus complex or constant or so well marked as on the palmar Horizontal gluteal fold surface of the hand [1]. An injury specifically to the inferior gluteal nerve, which supplies the gluteus maximus muscle, results in weak extension of the hip. 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]. Peter Fisher M. 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 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. The entry point for fat injection is near the infragluteal fold and around the sacral triangle, which is the same as that for thread insertion. 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. No major complications or. 10 The Mendieta and Sood classification is demonstrated in Fig. This was sculpted for a national television program recently. Detailed Procedure Information. Sorry for your problem. Care must be taken when completing the last portion of the. Tissue. Two supragluteal fossettes (or dimples) on either side of the medial sacral crest which correspond to the posterior superior iliac spines. Great posted photos. 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. 39. Sensory fibers from a dermatome and cutaneous nerves provide innervation to the gluteal region. The surgical anatomy of the subcutaneous screen on the gluteal region has. The power of this technique is granted through the lengthened anteroposterior. The “sensuous triangle” is found at the junction of the lateral buttocks, the lateral thigh, and the posterior thigh. The original buttock lift dates back many decades before BBL surgery became popular and refers to a direct excision at the lower buttocks. ResultsThe infragluteal fold is a connectival fibrous band. In the anchor thighplasty technique, the medial thigh lift is extended posteriorly into the infragluteal crease. Expand. This is a horizontal crease under the ischial tuberosity. 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 . The upper-inner thigh holds a high stem. 6 Innervation The sciatic nerve is the largest nerve in the human body, measuring around 2 cm in diameter in adults. 44 The infragluteal fold is an important indicator of gluteal aesthetics. Oh et al 26 recently demonstrated a shortening of the infragluteal fold by performing a thread lift with an elastic silicone-polyester thread. The infragluteal fold is one of the major concerns in reshaping of the gluteal region. 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 fat graft is placed in the upper medial side for projection. The "sensuous triangle" is found at the junction of the lateral. in· tra· glu· te· al -ˈglüt-ē-əl, -glü-ˈtē-əl. S2 S1 S3 S4/5. The option with a reasonable chance for improvement with the lowest chance of problems is to do a fat transfer with some careful infragluteal liposuctioning. No adverse events were recorded. 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. The iatrogenic forms of banana fold and sensuous triangle deformity are produced by excessive. Concomitant fat transplantation to the infragluteal/posterior thigh junction region during circumferential liposuction of the thigh is effective in preventing postliposuction gluteal ptosis and improving patient satisfaction. The appropriately selected gluteal implant is folded in half. Dear Anna, judging from the picture posted on the forum, you seem to have buttock ptosis with a deep infra gluteal fold. The infragluteal folds and perineal region were treated with the patient in a prone jackknife position. This study reevaluated the fold both histologically and anatomically. Gozil R. 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 []. The "sensuous triangle" is found at the junction of the lateral. intragluteal injection. 4). . Good luck. . PDF | On Jan 11, 2023, Héctor César Durán Vega and others published Vectorial Treatment of Infragluteal Fold | Find, read and cite all the research you need on ResearchGateWe describe a new technique for immediate reconstruction of GSCTs using buried dermal-fat flaps and a low transverse scar in the infragluteal fold. Expand. If too much fullness exists, the area that should be a diamond-shaped space is instead a straight line, which is much less appealing. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. Plastic Surgery 35 years experience. In the ideal buttock, the infragluteal fold should end. Surgery was performed in the jackknife position, and flaps were elevated in the suprafascial plane. [1] The Vertical Technique This approach is performed vertically from above 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 []. 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. Patients with buttock ptosis and medial thigh skin laxity without lateral thigh redundancy are ideal candidates. Five fixed cadavers. the market share of other surgical as well as non-surgical body contouring approaches. Reply: Staying Safe during Gluteal Fat Transplantation. On the other hand, some slight to moderate redundant infragluteal creases might be candidates for simple surgical repair. Tissue samples (6 cm long x 2 mm thick) were taken. The retromuscolar technique is preferred by patients requesting a natural, sporty result. Download scientific diagram | MRI sequence of the infragluteal fold with T1 VIBE MORPHO sequence (Thickness slice = 900. 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. 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. Hello and thank you for your question. A new technique for correction of a buttock ptosis resulting from a degloving injury is presented. The descending branches of the inferior gluteal vessels and its accompanying nerve enter the subcutaneous tissue of the gluteal thigh flap distal. 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. Both adipofascial flaps were rotated downward for inset in the pockets created in the buttocks. ResultsThe infragluteal fold is a connectival fibrous band. 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 inclusion criteria was ptosis of the lower pole of buttocks. The "sensuous triangle" is found at the junction of the lateral. 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 infragluteal fold is one of the key elements that determines the gluteal contour and is recognized as an important characteristic of female beauty . Conclusion: Focused ultrasound is a safe, effective and well tolerated procedure for remodelling areas of the body. Fig. It has been noted in multiple. The short answer is yes. lateral to the mucocutaneous junction. It has been noted in multiple. amniotic fold the folded edge of the amnion where it rises over and finally encloses the embryo. 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. Answer: Double gluteal fold. The cannula should have one orifice and be thick (4 or 5 mm), long (32 cm), and directed to the IGF and beyond. loss of the infragluteal fold [7]. 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). circular f's the permanent. The inclusion criteria was ptosis of the lower pole of buttocks. Infragluteal fold. The patient’s position is prone or lateral decubitus. A, C, E, Preoperative views of a 50-year-old woman who complained of decreased gluteal projection and buttock ptosis after suction-assisted lipoplasty. All patients showed an improved definition of the infragluteal fold, with a symmetric shape of the gluteal region. 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. She underwent liposculpture using the tumescent technique with infiltrated fluid, sodium chloride, epinephrine and Lidocaine in the. C2 – At least one cm lateral to the occipital protuberance at. It has been noted in multiple. What you are seeking is to have a uniform infragluteal crease on both sides. Besides the excessive fat accumulation, insufficient muscle tone may also contribute to the formation of saddlebags. We recommend the lower buttock lift for patients who suffer from sagging skin beneath the lower fold of their buttocks (the infragluteal fold). The treatment should not focus on the central and lower. The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. 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. Transversal slice passing through bony structures. L3 provides innervation to the medial femoral condyle . A new surgical treatment method using a gluteal-fold flap (GFF) for anal stricture after total ISR is developed and it is believed that GFF transfer is an excellent option for treating anorectal strictures after totalISR. The 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. Time and important weight variation consid- erably affect this region combined with the gravity’s effect. 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. Lipoplasty aided in the accentuation of lumbar lordosis, which gives the impression of greater buttocks projection. By adding more volume on the left and matching the right, the fold will appear as a result of this added volume. This study reevaluated the fold both histologically and anatomically. The inframammary crease 5,13 lies o ver the fifth to sixth ribs. This study focuses on the histological comparison of creases of the trunk and participation of the elastic fibers in their formation. The buttocks have three different sections, the upper buttock, the mid buttock, and the lower buttock. 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. 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. thigh, IGD (infragluteal diamond), G (Gluteus) 123 246 Aesth Plast Surg (2023) 47:245–259. 3) The length of the lower buttock lift excision should ideally not go beyond the. A. 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. Results Our. This fold is the horizontal crease under the ischial tuberosity. . 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. buttock, infragluteal fold, or hips often produces sub-optimal aesthetic results. Between 2. 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. Common Butt Lift Factorslaterally, resulting in a long infragluteal fold. 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 posterior femoral cutaneous nerve (PFCN) is an extensive nerve with numerous collateral branches which provide cutaneous innervation to 2/3 rds of the posterior thigh, the infragluteal fold, as well as the lateral anal region, scrotum, and labia majora through its inferior cluneal and pudendal nerve branches. The skin perforators of the pudendal artery were marked with a Doppler probe in the medial region of the gluteal fold. implant. unsatisfactory. 3). There is a very specialized method to form infra gluteal crease, using lipo 360 with directed fat grafting under ultrasound guided injections as required in Florida, and specialized sub dermal lipo techniques with taping to form infra gluteal crease. Does it have adownward 45º angle, run horizontally, or havean inverted. 6. 3 cm, with the greatest change at the level of 10 cm below the infragluteal fold (-3. This is a difficult area to fix. 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. Our technique allows for the. The inframammary crease 5 , 13 lies over the fifth to sixth ribs. 15. 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 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. A direct excision was performed under general anesthesia. loss of the infragluteal fold [7]. 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. gluteal fold: [ fōld ] plica; a thin margin curved back on itself, or doubling. The infragluteal fold is one of the major concerns in reshaping of the gluteal region. We developed a practical and safe pedicled flap for reconstruction of ischial pressure sores based on the rich available perforators from the internal pudendal artery and the surplus of skin at the. A banana fold may form for different reasons, among which an. Therefore, in each case, the high points of the buttocks are relatively light while infragluteal fold and V-shaped crease areas are relatively dark. The procedure would take approximately 4 hours to complete. In contrast, a shorter infragluteal fold contributes to a full, taught, and youthful buttock [Babuccu O. 51. Time and important weight variation. I hope this helps. The infragluteal fold, which is one of the main determinants for gluteal attractiveness, is located in this unit . The muffin bottom can be sculpted using the tumescent technique under either IV sedation or general anesthesia. Unit D has six subunits (D1–D6). 6. BackgroundThe gluteal fold represents an important aspect of the gluteal region. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. As can be appreciated from these figures, the anatomy shading provided on each pair of jeans is similar to that shown in the image of the right panel of FIG. The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. On the left gluteal region, markings are shown for the muscle-fiber orientation for the gluteus maximus muscle. The flap should be fixed as low as possible to the muscle fascia. 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. The fat is injected as the. Grade II: The infragluteal fold is angulated downward, flattening at the lower 1/3 of buttock. 5). Infragluteal fold. The gluteal region in patients with massive weight loss after. PMID: 15940397 DOI: 10. 0+/-1. Hope this helps!Artistic rendition of relevant anatomy of the infragluteal approach. Ini-tially, a deep plane is created by the 3-mm cannula. The Buttock Lift with Hyaluronic Acid and Threads. Its inferior border is formed by the insertions of the semitendinous muscle and the long belly of the biceps femoris in the ischial tuberosity. 2. Considering its widespread innervation and many collateral branches, PFCN neuropathy has been commonly reported, primarily due to iatrogenic etiology. A direct excision was performed under general anesthesia. Four fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. The infragluteal fold became less evident, the but- buttock lift and augmentation with the dermal fat flap tock mass was elevated, and augmentation was achieved described was performed, resulting in correction of the with the maximum projection at midlevel of the gluteus. The gluteal sulcus (also known as the gluteal fold, tuck, fold of the buttock, or horizontal gluteal crease) is an area of the body of humans and anthropoid apes, described by a horizontal crease formed by the inferior aspect of the buttocks and the posterior upper thigh. The muscle fascial edges should approximate with ease and a “watertight” closure is performed using eight to ten simple interrupted 0 or 2-0. fold is also included in this project in comparison with the inframammary, infragluteal, and inguinal creases. The histologicalCreation of an infra gluteal fold is done in the same fashion as the medial thigh tuck first described by Ted Lockwood, M. 20 The inferior gluteal artery, supplying 2/3 of the muscle, enters from the inferior bor-The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. 1 Anatomy of the gluteus maximus muscle and deeper structure. Lower body lift procedures remove excess skin and lift sagging buttock tissue. Its exact dimensions, including its thickness, are determined by the volume of tissue deemed necessary to fill out the buttock contour. fold both histologically and anatomically. On the upper area, markings are shown for the gluteus medius muscle. It extends from sacral level S3 or S4 and ends just inferior to the apex of the sacrum, at the level of the anus. Asymmetric lifts and reduction are to be performed on the buttock to correct for your present symmetry. The length and definition of the infragluteal fold play important roles in aesthetically. 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. Advanced SearchUndermining using electrocautery was performed to create two pockets in both buttocks bilaterally down to few centimeters above the infragluteal fold. Also, evaluate the angle of the infragluteal fold. This causes movement of the infragluteal sulci in downward and lateral directions as well as lengthening of intergluteal sulcus. 3) In a lower buttock lift in my hands, it is a combination of tissue removal AND the recreation of an infragluteal fold. Most patients had a deep infragluteal fold. T3 provides innervation to the midclavicular line . 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. Open in new tab Download slide. A banana fold may form for different reasons, among which an iatrogenic cause is recurrent. The infragluteal fold is one of the key elements that determines the gluteal contour and is recognized as an important characteristic of female beauty . Characteristic features include short intergluteal cleft, flattened buttocks, narrow hips, distal leg atrophy, and talipes deformities. This procedure recreates the fold on the bottom part of the butt, known as the infragluteal fold, creating a more defined separation between the butt and the thigh. Fig. The thigh circumference measured at 3 predefined levels decreased on average by 2. Patients with skin laxity and infragluteal fold ptosis may require a buttock lift or direct fold excision in order to obtain an acceptable result. Most patients had a deep infragluteal fold. The superior tip of the intergluteal cleft. 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 is one of the major concerns in reshaping of the gluteal region. A longer infragluteal fold suggests an aged, ptotic, and deflated-looking buttock with skin and fascial excess. This can include excess weight that has accumulated in the waist and buttock area. Both flaps were fixed with interrupted 0-Vicryl. The ideal infragluteal cleft is none at all, but instead a smooth transition from buttocks to thigh. The infragluteal fold/thigh junction (lower gluteal cleavage) also requires definition. Undermining will not go beyond the infragluteal fold, so it is important to place the template 2 cm above the fold . A. This study reevaluated the fold both histologically and anatomically. 2). 4% of subjects reported increased muscle. 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. C3 provides innervation to the supraclavicular fossa . This procedure recreates the fold on the bottom part of the butt, known as the infragluteal fold, creating a more defined separation between the butt and the thigh. 9. But so doing it may also make your buttocks look a little less full because its roundness is decreased. Infragluteal fold revision Buttock lift The author prefers tostageexcisionalcontouring procedures in association with gluteal implants. The recovery time is at least two weeks but may be longer depending on your specific surgery. Point “C” is marked in the center of the buttock, 3 cm above the infragluteal fold. Although banana fold is a common problem, unrelished by most women, few procedures are targeted specifically to fight it. 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. In conclusion, using a deepithelialized double dermal flap is a safe and new way to obtain excellent results in rejuvenating the gluteal region. Popularity of injectable fillers. 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. PDF. With sagging of the muscle belly, the infragluteal fold is decreased or lost, and atrophy of the buttock is obvious with time. 3. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. With this technique, the deepithelialized crescent-likeThe infragluteal fold/thigh junction (lower gluteal cleavage) also requires definition. The power of this technique is granted through the lengthened anteroposterior scar and. ResultsThe infragluteal fold is a connectival fibrous band. S3 provides innervation to the infragluteal fold . Closure of the implant pocket should be tension-free. We report a case of using autologous fat transplantation to correct severe post-liposuction infragluteal fold deformity. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. 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. 9. Additionally, I agree that a lower buttock tuck with the results scar is probably not the best of options for you. This 5 cm gap between the caudal edge of the flap and the infragluteal fold can appear empty. Care is taken not to remove the subcutaneous tissues at the level of the infragluteal crease. Time and important weight variation consid-erably affect this region combined with the gravity’s effect. Each buttock section has its own distinct shape. (D) The patient is turned to the supine position, and the legs remain spread on extender bars that are well padded. 2010. The main difference with our technique is the design. 6+/-0. In contrast, a shorter infragluteal fold contributes to a full, taught, and youthful buttock. The final result should be to attain a waist-to-hip ratio (WHR) close to 0. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. Ranch & Coast founder, Dr. Background: Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in aesthetic defect of gluteal contour. 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°. It arises in the median gluteal crease and follows. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. The lateral part of the gluteus maximus muscle tapers between the long head of the biceps femoris and the vastus lateralis muscles. It is one o…THE IGF. 5 and 6. Thus, you may want to consider restoring volume to your buttock and. Liposhifting is a technique which free. You have a beautiful result after the fat grafting and the “tuck” of the infragluteal fold may be messed up forever, doing direct incision. Incisions with ports sutured in place on the superior intergluteal crease and over the mid inferior gluteal point bilaterally. 3 Excerpts; Save. ” In contrast to the rest of the posterior thigh, this fatty roll is a rather common problem (see Fig. The infragluteal fold needs to be approached carefully, by suctioning just under the skin. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. 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. A case of using autologous fat transplantation to correct severe post-liposuction infragluteal fold deformity in a. Expand. The iatrogenic forms of banana fold and sensuous triangle deformity are produced by excessive liposuction. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. 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. The buttock skin and subcutaneous tissue were advanced superiorly and rotated medially to tighten the buttocks, lateral thigh, and posterior thigh. The posterior knee-fold incisions can be closed or left open for. 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. The structure of the infragluteal fold and the degree of ptosis are the main factors that determine the aesthetic appearance. Weight gain following thighplasty may negatively affect your surgery results. 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. This horizontal crease is under the ischial tuberosity. I think this would give a far better yield than the infragluteal fold excision or the buttock fold excision. 6). In cases when full leg definition is wanted, two additional incisions can be placed in the posterior fold of the knee area: one medial and one lateral (Fig. The authors present a simple and effective technique for reconstruction of the gluteal fold by a deepithelialized skin flap that is applicable for patients who have lost their naturalgluteal sulcus, with a resultant altered buttock shape, after trauma or other causes. The aesthetic line of the infragluteal fold should generally be short, no longer than the. Grade 3 (borderline pre-ptosis): the fold is over the M line, but still there is no ptotic tissue at the M line. Notice in the center photograph that a fuller. 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 ischial region is the site most affected by pressure sores and has the highest recurrence and complication rates compared to other affected sites. 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. 17). Results were maintained at 6 months. Expand. Some surgeons call this a removal of banana roll; more technically, it is an infragluteal fold incision for excision of upper posterior thigh. In short, one that enhance a patient’s figure and has a V-shaped crease of the sacral triangle, a short infragluteal fold, supragluteal fossettes, and lateral depressions. 6. 23. Thus, buttock ptosis is simply gluteal tissue below the skin fold, or infragluteal crease. A photograph or two of the area would be extremely helpful in determining what the problem may be and thus the solution, if any. The 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]. 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. Background. The structure of the infragluteal fold and the degree of ptosis are the main factors that determine the aesthetic appearance. Cocke and Ricketson were the first to describe placing silicone breast implants in the subcutaneous plane with less than optimal results. Superiorly it is formed by the lower border of the gluteus maximus. 45 This results in a ptotic butt if it is longer. Chasan, partook in a study examining the results of the infragluteal thigh lift. Patients with an apparent and angular infragluteal fold with. The surgical anatomy of the subcutaneous screen on the gluteal region has aroused the interest of plastic surgeons because of the increasing. 4. The key to success for this procedure is to. Usually, the access is a midline incision located above the IGF, or it is performed above the buttock. 8 Zones in the inferior gluteal area: 1 lower internal ( light blue ), 2 lower external ( yellow ), 3 inner thigh ( purple ), 4 outer thigh ( red ). Flap reconstruction is efficient in severe cases of infragluteal fold deformity (5), but the low patient acceptance of the subsequent scars limits its application. This technique creates a new, more aesthetically pleasing fold in order to resolve dropping skin and the presence of a double skin fold (the “banana roll”) beneath the buttocks. 23. 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 . Subscribe Now:More:exercise to define. If ou still has residual excess skin and fat on the lower buttock and. Tissue samples (6 cm long x 2 mm thick) were taken. Normally, its mean length is equal to the intergluteal fold length or 2/3 of 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. 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. Normally, its mean length is equal to the intergluteal fold length or 2/3 of 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. Fig. 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. A more objective, faster and shorter version of this scale, to be evaluated. The need for liposuction of the lower back or hips is considered. 2. A. The buttock can be infiltrated through the superior gluteal mid-incision, although infiltration can also be performed through the infragluteal fold. Five fixed.