fold is also included in this project in comparison with the inframammary, infragluteal, and inguinal creases. 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]. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Tissue samples (6 cm long × 2 mm thick) were taken at three. 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. 9 and 10. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. gluteal fold: [ fōld ] plica; a thin margin curved back on itself, or doubling. The gluteal region in patients with massive weight loss after gastric bypass is characterized by. Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in esthetic defects in the gluteal contour. Some surgeons call this a removal of banana roll; more technically, it is an infragluteal fold incision for excision of upper posterior thigh. 15. 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. If too much fullness exists, the area that should be a diamond-shaped space is a straight line, which is much less appealing. Many of the early proponents of the procedure were not open to discussing complications. Results: After treatment, there was an average reduction of 4. The descending branches of the inferior gluteal vessels and its accompanying nerve enter the subcutaneous tissue of the gluteal thigh flap distal. lateral to the mucocutaneous junction. Tissue samples (6 cm long x 2 mm thick) were taken. Limited inferiorly by infragluteal fold. A minor surgery: These are usually treated with a minor surgery, where the cyst, and it's entire lining, is removed. Common Butt Lift Factorslaterally, resulting in a long infragluteal fold. Fee $6,000+ Best to virtual consult with. amniotic fold the folded edge of the amnion where it rises over and finally encloses the embryo. Does it have adownward 45º angle, run horizontally, or havean inverted. 6 The infragluteal area is a support zone for the buttock, and treatment of this area with liposuction should be avoided. It is critical to appropriately and systematically analyze the complex regional anatomy. Since you already have a belt lipectomy or a 360 circumferential lower body lift, the skin and fat of the buttocks have already been raised. And placing such a graft always runs the risk of causing an infection. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. The inclusion criteria was ptosis of the lower pole of buttocks. Expand. thigh, IGD (infragluteal diamond), G (Gluteus) 123 246 Aesth Plast Surg (2023) 47:245–259. Asymmetric lifts and reduction are to be performed on the buttock to correct for your present symmetry. Procedure. This causes movement of the infragluteal sulci in downward and lateral directions as well as lengthening of intergluteal sulcus. Gluteal fat injection mortality is approximately 1/3000 patients. fashion, is an anatomic structure in its medial part and only a Despite this reality, the ideal gluteal shape has been crease laterally. It has been noted in multiple. 15. Other procedures commonly done include lifts and changing the infragluteal fold length. Its inferior border is formed by the insertions of the semitendinous muscle and the long belly of the biceps femoris in the ischial tuberosity. The ischial region is the site most affected by pressure sores and has the highest recurrence and complication rates compared to other affected sites. In the process of r. Download : Download full-size image; Figure 6. The infragluteal fold is one of the major concerns in reshaping of the gluteal region. The "sensuous triangle" is found at the junction of the lateral. Medicine. The original buttock lift dates back many decades before BBL surgery became popular and refers to a direct excision at the lower buttocks. Cosmetic surgery of the buttocks contemplates not only changes in volumes but also (and above all) a redefinition of the contours. 1) A shapely buttocks, regardless of its size, has an infragluteal crease that separates the buttocks from the posterior thigh. The advantage is that the posterior thigh is lifted and ptosis of the caudal buttock can be corrected. Tissue samples (6 cm long x 2 mm thick) were taken. It is critical to appropriately and systematically analyze the complex regional anatomy. 23. Furthermore, the infragluteal fold should form a diamond-shaped space with the inner thigh. It is then carried inferiorly over the greater trochanter to the level of the gluteal fold. Open in new tab Download slide. In this study, 84. Here, it continues to the midline of the thigh (halfway between the greater trochanter and the ischial tuberosity). By adding more volume on the left and matching the right, the fold will appear as a result of this added volume. 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 infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. This study reevaluated the fold both histologically and anatomically. Drains are placed via stab incisions in the infragluteal fold using a #15 blade scalpel. A long, deflated. 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. Five fixed cadavers were used. Indianapolis, Indiana. Background. 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 . 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. A. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. This horizontal crease is under the ischial tuberosity. Reply: Staying Safe during Gluteal Fat Transplantation. 1 Excerpt; Save. The ideal infragluteal cleft is none at all, but instead a smooth transition from buttocks to thigh. This study reevaluated the fold both histologically and anatomically. 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]. 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 []. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. 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 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 infragluteal fold length and definition play important roles in esthetically pleasing buttocks. However, there is no clear anatomical description of the infragluteal fold,. From here we can easily access the lower gluteal area and the internal and external posterior thigh (Fig. The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. Key elements to be evaluated include the infragluteal crease, the gluteal fold and the outer thigh skin fold [28]. 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. 1. The gluteal region in patients with massive weight loss is characterized by excessive skin and exaggerated fat loss. 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 posterior knee-fold incisions can be closed or left open for. The postoperative results depicted in the article demonstrate a successful. from the bone to the skin. Plastic Surgery 35 years experience. spiraling anteriorly to the flank and posteriorly to the infragluteal fold, thus joining the previous flank and infragluteal. Some surgeons call this a removal of banana roll; more technically, it is an infragluteal fold incision for excision of upper posterior thigh skin and fat. Outer/Lateral Thigh Lift. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. ResultsThe infragluteal fold is a connectival fibrous band. Although banana fold is a common problem, unrelished by most women, few procedures are targeted specifically to fight it. S2 S1 S3 S4/5. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. Sagging of redundant skin and fat below the infragluteal fold is commonly observed in bariatric patientsFlap reconstruction is e cient in severe cases of infragluteal fold deformity [5], but the low patient's acceptance of sequel scar limits its application. Then other planes are created using the same cannula in different trajectories, always from the deeper aspect to the more superficial plane. Once the shapes are more symmetric, volume enhance can be done on both sides simultaneously. The buttock can be infiltrated through the superior gluteal mid-incision, although infiltration can also be performed through the infragluteal fold. A direct excision was performed under general anesthesia. Read more. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. The superior tip of the intergluteal cleft. Abstract. 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. The infragluteal fold, which is one of the main determinants for gluteal attractiveness, is located in this unit . To our knowledge, only two variations to the classic chevron technique have been described in an attempt to improve buttock contouring following GSCT excision. Five fixed cadavers were used. When the infragluteal fold line is horizontal (see Fig. I think this would give a far better yield than the infragluteal fold excision or the buttock fold excision. Infragluteal fold. 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. BackgroundThe gluteal fold represents an important aspect of the gluteal region. It is indicated when the maximum point of buttock fullness is at the mid to upper portion of the buttocks, which should coincide with the level of the pubic symphysis [ 4 ]. It is used for correcting sagging lower buttock tissue that either hangs over the existing infragluteal fold or when the infragliuteal folds has dropped creating an elongated buttock shape. The intergluteal cleft is a surface anatomy landmark of the pelvis and lower limb. 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. Normally, its mean length is equal to the intergluteal fold length or 2/3 of it. Answer: Double fold. The cannula should have one orifice and be thick (4 or 5 mm), long (32 cm), and directed to the IGF and beyond. com The infragluteal fold (IGF) is a crucial anatomic landmark representing one of the major concerns in gluteal reshaping in plastic surgery. 2. The original buttock lift dates back many decades before BBL surgery became popular and refers to a direct excision at the lower buttocks. 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 patient’s position is prone or lateral decubitus. Advanced SearchUndermining using electrocautery was performed to create two pockets in both buttocks bilaterally down to few centimeters above the infragluteal fold. Hope this helps!Artistic rendition of relevant anatomy of the infragluteal approach. Keep your arms straight as you lift the weight with your hips and glutes. 4% of subjects reported increased muscle. 45 This results in a ptotic butt if it is longer. 22), liposuction of the inner thigh and infragluteal area may be indicated. 3 Excerpts; Save. 5 T) of the pelvic region. The histologicalCreation of an infra gluteal fold is done in the same fashion as the medial thigh tuck first described by Ted Lockwood, M. Five fixed cadavers were used. What you are seeking is to have a uniform infragluteal crease on both sides. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. the market share of other surgical as well as non-surgical body contouring approaches. On the left gluteal region, markings are shown for the muscle-fiber orientation for the gluteus maximus muscle. Once the shapes are more symmetric, volume enhance can be done on both sides simultaneously. The use of a deepithelialized. Thus, buttock ptosis is simply gluteal tissue below the skin fold, or infragluteal crease. Poorly placed incisions also detract from the gluteal aesthetic. 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. A flap involving the whole gluteal area was dissected superficially to the gluteal fascia. Most patients had a deep 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. The FCI flap is a good choice for. 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 banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. Additionally, I agree that a lower buttock tuck with the results scar is probably not the best of options for you. The infragluteal fold (IGF) is a crucial anatomic landmark representing one of the major concerns in gluteal reshaping in plastic surgery. The thigh circumference measured at 3 predefined levels decreased on average by 2. Although banana fold is a common problem, unrelished by most women, few procedures are targeted specifically to fight it. 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. Destruction of this. Gozil R. The lateral part of the gluteus maximus muscle tapers between the long head of the biceps femoris and the vastus lateralis muscles. Methods: Six volunteers (three males and. However, one of its key-component, the infragluteal fold, has not yet been clearly defined. Helpful Barry L. Care must be taken when completing the last portion of the. . Patients with skin laxity and infragluteal fold ptosis may require a buttock lift or direct fold excision in order to obtain an acceptable result. C2 – At least one cm lateral to the occipital protuberance at. T3 provides innervation to the midclavicular line . 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 ( Fig. Liposhifting is a technique that. 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. Cárdenas The infragluteal fold is one of the major concerns in reshaping of the gluteal region. in· tra· glu· te· al -ˈglüt-ē-əl, -glü-ˈtē-əl. 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. fold [fōld] plica; a thin margin curved back on itself, or doubling. 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. 88 and 3 cm in the circumference of the abdomen, hips and thighs, respectively. 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. 3) In a lower buttock lift in my hands, it is a combination of tissue removal AND the recreation of an infragluteal fold. 1. In the ideal buttock, the infragluteal fold should end. Transversal slice passing through bony structures. 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. It arises in the median gluteal crease and follows. Patients with a long buttock may. Infragluteal fold reconstruction is achieved by reconstruction of the buttock’s sustaining apparel through deepithelialized skin flaps anchored to deep gluteal fascia. International Standards for the Classification of Spinal Cord InjuryShe also had infragluteal fold or the infragluteal banana roll. Good luck. Considering its widespread innervation and many collateral branches, PFCN neuropathy has been commonly reported, primarily due to iatrogenic etiology. The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. 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. Once the fat has infiltrated, any PAL device can be used to equalize (distribute) the infiltrated fat (Images 15. Augmentation of the fold with fat would help you achieve a smoother transition between the butt. Consistent features of beautiful buttocks: lateral depression, infragluteal fold, supragluteal fossettes. 2, 3, 4. The diamond-shaped space turns into a straight line, which is less aesthetically appealing. 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. The average width of the skin excision was 8 cm and the average length was 25 cm. When planning the new infragluteal fold, surgeons should not exceed the union of the semitendinous muscle with the biceps femoris laterally since this is the natural ending of the fold . 6+/-0. Tissue samples (6 cm long x 2 mm thick) were taken. 6 Innervation The sciatic nerve is the largest nerve in the human body, measuring around 2 cm in diameter in adults. 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. 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. 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. excess skin just above the umbilicus, a redundant infragluteal fold and lack of gluteal projection. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. This study focuses on the histological comparison of creases of the trunk and participation of the elastic fibers in their formation. Answer: Double gluteal fold. C3 provides innervation to the supraclavicular fossa . This is a horizontal crease under the ischial tuberosity. 7) . Intergluteal crack height is unchanged. Expand. Fig. 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 aesthetic line of the infragluteal fold should generally be short, no longer than the. The spelling of co-author Felipe De Bacco’s surname name was misspelled, and the same author’s affiliation information was incorrect. implant. 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. 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. It extends from sacral level S3 or S4 and ends just inferior to the apex of the sacrum, at the level of the anus. Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in esthetic defects in the gluteal contour. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. An anatomical description of the infragluteal fold (IGF) matching radiological and anatomical findings in describing specifically raise of the fibrous component at the bone. The average width of the skin excision was 8 cm and the average length was 25 cm. A. Detailed Procedure Information. 15. On the other hand, some slight to moderate redundant infragluteal creases might be candidates for simple surgical repair. Grade 3 (borderline pre-ptosis): the fold is over the M line, but still there is no ptotic tissue at the M line. 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. The buttocks have three different sections, the upper buttock, the mid buttock, and the lower buttock. This study reevaluated the fold both histologically and anatomically. Therefore, indications for buttocks lifts range from subtle aesthetic reasons to a major recontouring following bariatric surgery. The infragluteal fold/thigh junction (lower gluteal cleavage) also requires definition. This is not a good benefits vs risk proposition. 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. 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. 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 final result should be to attain a waist-to-hip ratio (WHR) close to 0. Dr. The anterior axillary fold is also included in this project in comparison with the inframammary, infragluteal, and inguinal creases. The surgical anatomy of the subcutaneous screen on the gluteal region has aroused the interest of plastic surgeons because of the increasing. The procedure would take approximately 4 hours to complete. The infragluteal fold is one of the key elements that determines the gluteal contour and is recognized as an important characteristic of female beauty . Infragluteal fold revision Buttock lift The author prefers tostageexcisionalcontouring procedures in association with gluteal implants. FIG. The APEX thighlift takes advantage of the hidden scar described in earlier techniques, using an incision along the medial thigh inguinal crease (or inside that if thinning of a widened pubis is desired) that extends posteriorly into the infragluteal fold (Figure 4). The dissection and volume this flap provides are similar to that of the SGAP flap. Cadaveric dissection reveals that the IGF is a connective fibrous band extending from the ramus of the ischium, the apex of the sacrum, and the coccyx, to the. The infragluteal fold is where the bottom of the buttock meets the upper thigh. Independent of the filler chosen, the marking of the area to be filled follows some of the landmarks described above in order to achieve the desired gluteal contour. 2. Four fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. There are few. 3), the buttock contour has a smooth C shape, without depression and ptosis. Both volume and projection of the buttocks may be improved. Answer: Lower butt lift. If ou still has residual excess skin and fat on the lower buttock and. Liposhifting is a technique that. 3) In a lower buttock lift in my hands, it is a combination of tissue removal AND the recreation of an infragluteal fold. Dr. A longer infragluteal fold suggests an aged, ptotic, and deflated-looking buttock with skin and fascial excess. Infragluteal fold. Following is a list of spinal nerves and points that are characteristically belonging to the dermatome of each nerve. One can not liposuction between the two and create a single infragluteal crease. 2) Excision of the infragluteal overhang is the definitive and assorted treatment of lower buttock ptosis. A. Surgery was performed in the jackknife position, and flaps were elevated in the suprafascial plane. On the plantar surface of the foot, Gluteal fold we find the transverse lines and the longitudinal lines [1]. The infragluteal sulcus is created right below. Background: The Skin Laxity Severity Scale for the buttocks was previously developed to separately assess buttock ptosis, a scalloped appearance of the skin, infragluteal fold, localized fat on the lower third of the buttocks, and linear depressed lesions. 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. &NA; Use of a local flap is often needed for closure of a defect in the. The infragluteal fold- thigh junction (lower gluteal cleavage) also requires definition. (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. Plan on a 2-3 week recovery. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. 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. Lower body lift procedures remove excess skin and lift sagging buttock tissue. The infragluteal fold is one of the key elements that determines the gluteal contour and is recognized as an important characteristic of female beauty ( 4 ). The infragluteal fold (red lines) may have a downward slope (ideal with a well-defined diamond zone), be horizontal, or have an upward slope. This is a difficult area to fix. 5 and 6. These implants may be placed through bilateral supragluteal incisions, the infragluteal fold, or the intergluteal cleft incision. Besides the excessive fat accumulation, insufficient muscle tone may also contribute to the formation of saddlebags. Combining Gluteal Shaping with High-Definition Liposuction. Procedure. 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. D. Infragluteal fold. Infragluteal fold. But what is really being done is that the loose lower buttock skin and the fold are being removed to create a less deep infragluteal fold and smoother transition between the buttock and the thighs. 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 lower buttock is the most difficult area to address. The inclusion criteria was ptosis of the lower pole of buttocks. I hope this helps. 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. Undermining will not go beyond the infragluteal fold, so it is important to place the template 2 cm above the fold . 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. 1 Anatomy of the gluteus maximus muscle and deeper structure. . 39. Plastic surgeons often reduce buttock lift with an incision under the buttocks or in the infragluteal fold. Its exact dimensions, including its thickness, are determined by the volume of tissue deemed necessary to fill out the buttock 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. Severe infragluteal fold. Expand. This study reevaluated the fold both histologically and anatomically. 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. Both flaps were fixed with interrupted 0-Vicryl. Weight gain following thighplasty may negatively affect your surgery results. The iatrogenic forms of banana fold and sensuous triangle deformity are produced by excessive. 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 medial part of the infragluteal fold is formed by a fat pad that covers the inferior medial border of the gluteus maximus muscle. The mid-buttock is also divided into a central and an outer zone which usually has a depression. D2 and D3 are located in the posterior portion. The power of this technique is granted through the lengthened anteroposterior scar and. Grade II ptosis includes moderate skin and volume below the fold, with a more angular infragluteal fold moving inferomedially from the lateral thigh. The Scarpa’s. In either case, a lower buttock lift or tuck is done to remove the overhanging tissues and recreate a fixed infragluteal fold position. D1 has a posterior and a posteromedial surface. The therapy was found comfortable with a high satisfaction rate. 23. An angulated cannula can be used to easily enter the superficial space. Infragluteal fold. 2. Results The mean operating time was 210 min, and the volume resected ranged from 550 to 640 g in each of the gluteal areas. She underwent liposculpture using the tumescent technique with infiltrated fluid, sodium chloride, epinephrine and Lidocaine in the. If too much fullness exists, the area that should be a diamond-shaped space is instead a straight line, which is much less appealing. While buttock sagging is a general term it has different types as defined by the level of the infragluteal fold. The "sensuous triangle" is found at the junction of the lateral buttocks, the lateral thigh, and the posterior thigh. 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. Point “C” is marked in the center of the buttock, 3 cm above the infragluteal fold. 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. The posterior thigh is the area least requested for liposuction with the exception of the proximal infragluteal fold or so-called “banana fold. The invasive nature of venography has led to the investigation of noninvasive imaging modalities for diagnosis of pelvic congestion syndrome. All patients judged the outcome as very good. We describe an optimized and individualized approach for injecting the collagen biostimulator PLLA in the gluteal region according to the needs of each patient. infragluteal fold, and small portions of the lateral anal/perineal region [1,3]. Grade III ptosis has the most skin and volume below the fold, with significant skin laxity and a more angular infragluteal fold. Red line. Before the Implantation. 3. An outer thigh lift removes skin and fat from the outside of the thigh. T1. Grade II: The infragluteal fold is angulated downward, flattening at the lower 1/3 of buttock. You have a beautiful result after the fat grafting and the “tuck” of the infragluteal fold may be messed up forever, doing direct incision. 8): Fig. 6. Closure of the implant pocket should be tension-free. 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 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. 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 width of the flap and. Five fixed. 44 The infragluteal fold is an important indicator of gluteal aesthetics. 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. These considerations guide the technique, which includes three distinct approaches for PLLA injection based on patient input regarding the most. 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. 5, irrespective of the magnitude. This fold makes a usually Read More…Important dermatome & anatomical landmarks. The "sensuous triangle" is found at the junction of the lateral. Which of these fibers provides. circular f's the permanent. Barry Eppley. 2) The thin strips of skin and fat are worthless as grafts because of their very low volume. Therefore, it may be preferable to wait several months after implantation to determine the amount of skin resection necessary. Expand. The main goal of a butt tuck procedure is to repair lost or obstructed infragluteal. 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. Tissue samples (6 cm long x 2 mm thick) were taken. With sagging of the muscle belly, the infragluteal fold is decreased or lost, and atrophy of the buttock is obvious with time. The ischial region is the site most affected by pressure sores and has the highest recurrence and complication rates compared to other affected sites. The superior border is formed by the lower border of the gluteus maximus.