All patients showed an improved definition of the infragluteal fold, with a symmetric shape of the gluteal region. We report a case of using autologous. The infragluteal fold/thigh junction (lower gluteal cleavage) also requires definition. 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 cannula should have one orifice and be thick (4 or 5 mm), long (32 cm), and directed to the IGF and beyond. It was not until 1973 that gluteal augmentation was performed for cosmetic purposes. Also evaluate the angle of the infragluteal fold. A banana fold may form for different reasons, among which an iatrogenic cause is recurrent. 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. Unit D has six subunits (D1–D6). 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 buttocks have three different sections, the upper buttock, the mid buttock, and the lower buttock. Tissue samples (6 cm long x 2 mm thick) were taken. 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. Four fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. By adding more volume on the left and matching the right, the fold will appear as a result of this added volume. This would go from the outer buttock fold and into the groin and possibly communicate with your prior thigh lift. Expand. 8 Zones in the inferior gluteal area: 1 lower internal ( light blue ), 2 lower external ( yellow ), 3 inner thigh ( purple ), 4 outer thigh ( red ). A banana fold may form for different reasons, among which an. On the plantar surface of the foot, Gluteal fold we find the transverse lines and the longitudinal lines [1]. On the upper area, markings are shown for the gluteus. 9. 39. With your feet shoulder width apart, place your hands on the barbell (whether on lifting blocks or in a Smith machine), with your palms either over or under the bar. 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. It is critical to appropriately and systematically analyze the complex regional anatomy. The aesthetic line of the infragluteal fold should generally be short, no longer than the. V-shaped sacral triangle . 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. Plastic Surgery 35 years experience. Results The infragluteal fold is a connectival brous band extending from the ramus of the ischium (but not involving the ischial tuberosity, for a length of 21 mm ± 2 and 21 mm ± 3), the apex of the sacrum (for a length of 13 ± 2 and 11 mm ± 2), and the coccyx (for a length of 19 mm± 2 and 20 mm± 2, all measures referring to volunteers. implant. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. 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]. It has been noted in multiple. Weight gain following thighplasty may negatively affect your surgery results. Time and important weight variation consid-erably affect this region combined with the gravity’s effect. A large redundant infragluteal crease probably cannot be repaired easily. Point “C” is marked in the center of the buttock, 3 cm above the infragluteal fold. The inferior gluteal area is divided into four zones by tracing a vertical line from the center of the gluteus and a horizontal line that crosses through the infragluteal fold (Fig. Methods: Six volunteers (three males and three females) underwent an MRI scan (Siemens Aera® 1. In 1977 Gonzalez-Ulloa described correction of the ‘sad. 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 treatment should not focus on the central and lower. 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. Good luck. The flap was composed of subcutaneous tissue, and dermis if desired, and was extended laterally to the length needed to approximately reach the infragluteal fold, and then rotated. In the present, precisely for this reason, it is believed that dissection should reach the level of the infragluteal fold. 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 2/3rds of the posterior thigh, the infragluteal fold, as. This causes movement of the infragluteal sulci in downward and lateral directions as well as lengthening of intergluteal sulcus. 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. FIG. The muscle fascial edges should approximate with ease and a “watertight” closure is performed using eight to ten simple interrupted 0 or 2-0. The 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. 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. Tissue samples (6 cm long x 2 mm thick) were taken. The infragluteal area may be slightly improved after buttock augmentation resulting in less of a requirement for skin resection. Your infragluteal fold is barely noticeable, no women has perfect exact length, position and height of the infragluteal fold. The infragluteal folds and perineal region were treated with the patient in a prone jackknife position. All patients judged the outcome as very good. Zone 3: Proximal inner thigh confluences with Zone 1 to recreate a round buttock and follow the infragluteal fold. 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. Abstract. the gluteal tissue passes over the infragluteal fold at the M line; the angle of the skin fold at the infragluteal fold is between 10 and 30 . The technical details and surgical results of a pedicled skin flap raised in the infragluteal fold, used to widen the. The inclusion criteria was ptosis of the lower pole of buttocks. Does it have a downward 45° angle, run horizontally, or have an inverted. This fold makes a usually Read More…Important dermatome & anatomical landmarks. A more objective, faster and shorter version of this scale, to be evaluated. Most patients had a deep infragluteal fold. 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. A banana fold may form for different reasons, among which an iatrogenic cause is recurrent. (D) The patient is turned to the supine position, and the legs remain spread on extender bars that are well padded. 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. Infragluteal fold. In this way, it's similar to a general lower body lift. The average width of the skin excision was 8 cm and the average length was 25 cm. Short gluteal fold. Limits implant movement. Normally, its mean length is equal to the intergluteal fold length or 2/3 of it. The postoperative results depicted in the article demonstrate a successful. Sagging of redundant skin and fat below the infragluteal fold is commonly observed in bariatric patients following massive weight loss and defines. 20. The key to success for this procedure is to. Undermining will not go beyond the infragluteal fold, so it is important to place the template 2 cm above the fold . The lateral part of the gluteus maximus muscle tapers between the long head of the biceps femoris and the vastus lateralis muscles. Manipulation using a ball-spiked pusher under. The buttock can be infiltrated through the superior gluteal mid-incision, although infiltration can also be performed through the infragluteal fold. 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. 9 and 10. Ozmen S. ” 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. circular f's. This 5 cm gap between the caudal edge of the flap and the infragluteal fold can appear empty. Combining Gluteal Shaping with High-Definition Liposuction. It is designed over the inferior portion of the buttock, with the resulting scar located just above the infragluteal fold. Infragluteal fold excision can be performed either before or after implantation (Fig. Oh et al 26 recently demonstrated a shortening of the infragluteal fold by performing a thread lift with an elastic silicone-polyester thread. 3 An aged buttock region is marked. Figure 6. PDF. Five fixed cadavers. The buttock skin and subcutaneous tissue were advanced superiorly and rotated medially to tighten the buttocks, lateral thigh, and posterior thigh. Care is taken not to remove the subcutaneous tissues at the level of the infragluteal crease. from the bone to the skin. The skin flap was designed along the gluteal fold. Patients with an apparent and angular infragluteal fold with. 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. 臀下皱襞（The infragluteal fold，IGF） [1，2]是臀区与股后区之间形成的皮肤皱褶。. 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. Fee $6,000+ Best to virtual consult with. Urinary and bowel. The infragluteal fold was marked as the lower limit to ensure preservation of the structure and thus avoid ptosis of the gluteal mass and implant displacement. 5,8 A. . 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. Some surgeons call this a removal of banana roll; more technically, it is an infragluteal fold incision for excision of upper posterior thigh. Background: Anatomical features that make the buttocks attractive include adequate volume, projection, and a defined infragluteal fold. Tissue. When the infragluteal fold line is horizontal (see Fig. 44 The infragluteal fold is an important indicator of gluteal. Thus, every effort should be undertaken to preserve or reconstruct this important anatomical landmark . 5 and 15. See full list on link. Hope this helps!Artistic rendition of relevant anatomy of the infragluteal approach. But so doing it may also make your buttocks look a little less full because its roundness is decreased. Butt tuck surgery help people attain rounder, smoother and natural-looking buttocks. The final result should be to attain a waist-to-hip ratio (WHR) close to 0. A, C, E, Preoperative views of a 50-year-old woman who complained of decreased gluteal projection and buttock ptosis after suction-assisted lipoplasty. D1 has a posterior and a posteromedial surface. Incisions with ports sutured in place on the superior intergluteal crease and over the mid inferior gluteal point bilaterally. Background. 10 The Mendieta and Sood classification is demonstrated in Fig. ” In contrast to the rest of the posterior thigh, this fatty roll is a rather common problem (see Fig. The lower buttock is the most difficult area to address. Expand. 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. Flap reconstruction is efficient in severe cases of infragluteal fold deformity (5), but the low patient acceptance of the subsequent scars limits its application. Tissue samples (6 cm long x 2 mm thick) were taken. It is the deep furrow or groove that lies between the two gluteal regions (commonly known as the buttocks). The infragluteal fold is a connectival fibrous band extending from the ramus of the ischium (but not involving the ischial tuberosity, for a length of 21 mm ± 2 and 21 mm ± 3), the apex of the sacrum (for a length of 13 ± 2 and 11 mm ± 2), and the coccyx (for a length of 19 mm ± 2 and 20 mm ± 2, all measures referring to volunteers and cadavers, respectively). The infragluteal fold is one of the key elements that determines the gluteal contour and is recognized as an important characteristic of female beauty ( 4 ). Plastic surgeons often reduce buttock lift with an incision under the buttocks or in the infragluteal fold. It has been noted in multiple. A long infragluteal fold can also be improved and a more youthful shape be obtained. S3 Over the ischial tuberosity or infragluteal fold (depending on the patient their skin can move up, down or laterally over the ischii). 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 skin perforators of the pudendal artery were marked with a Doppler probe in the medial region of the gluteal fold. 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 "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. The power of this technique is granted through the lengthened anteroposterior scar and. Dear Anna, judging from the picture posted on the forum, you seem to have buttock ptosis with a deep infra gluteal fold. Its inferior border is formed by the insertions of the semitendinous muscle and the long belly of the biceps femoris in the ischial tuberosity. Save. The infragluteal fold became less evident, the buttock mass was elevated, and augmentation was achieved with the maximum projection at midlevel of the gluteus. 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. Infragluteal fold. Plan on a 2-3 week recovery. T1. This study reevaluated the fold both histologically and anatomically. Sorry for your problem. 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. A direct excision was performed under general anesthesia. This study reevaluated the fold both histologically and anatomically. 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. 5, irrespective of the magnitude. circular f's the permanent. 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 . 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. 23. Lockwood cautioned against extending the thigh lift scar into the infragluteal fold and suggested limiting skin resection to 5 to 7 cm. The authors’ experience using. PDF. 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. This deepithelialized dermal flap allows for the creation of a well-defined stable infragluteal fold through an incision of the infragluteal fold and exposure of ischial tuberosity and anchor it to the ischial tuberosity. 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 diamond-shaped space turns into a straight line, which is less aesthetically appealing. 39. Preoperatively, the patient is examined and the buttock’s size and shape are evaluated. Thus, buttock ptosis is simply gluteal tissue below the skin fold, or infragluteal crease. in· tra· glu· te· al -ˈglüt-ē-əl, -glü-ˈtē-əl. After the fat graft, thread lifting is performed considering the vector. The key to success for this procedure is to. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. The "sensuous triangle" is found at the junction of the lateral buttocks, the lateral thigh, and the posterior thigh. Chasan, partook in a study examining the results of the infragluteal thigh lift. Saddlebags at the infragluteal fold level are replaced by tight flat skin. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Buttock Lifting Using Elastic Thread (Elasticum®) with a New Classification of Gluteal Ptosis. Eppley, MD, DMDIn some instances, insertion of a buttock implant with a subsequent infragluteal-fold skin excision can be beneficial. Open in a separate window. 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. These structures create the fixed, well-defined subgluteal sulcus [2]. The mid-buttock is also divided into a central and an outer zone which usually has a depression. The infragluteal crease [23] is found in several terms such as the gluteal crease, the infragluteal fold [24], the infragluteal sulcus [24], the horizontal gluteal fold [4], the gluteal fold [4. The ischial region is the site most affected by pressure sores and has the highest recurrence and complication rates compared to other affected sites. Additionally, I agree that a lower buttock tuck with the results scar is probably not the best of options for you. The length and definition of the infragluteal fold play important roles in aesthetically. 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 surgical anatomy of the subcutaneous screen on the gluteal region has. 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. Sorry for your problem. : situated within or introduced into the gluteal muscle. 15. This study reevaluated the fold both histologically and anatomically. Severe infragluteal fold. The postoperative resultsMethods: We describe a new technique for immediate reconstruction of GSCTs using buried dermal-fat flaps and a low transverse scar in the infragluteal fold. In contrast, a shorter infragluteal fold contributes to a full, taught, and youthful buttock [Babuccu O. It is divided into an inner, a central, and an outer zone. 2010. This study reevaluated the fold both histologically and anatomically. The fat is injected as the. Fee $6,000+ Best to virtual consult with. 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. What separates the lower buttocks from the other two sections is the infragluteal fold. 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]. An anatomical description of the infragluteal fold (IGF) matching radiological and anatomical findings in describing specifically raise of the fibrous component at the bone. spiraling anteriorly to the flank and posteriorly to the infragluteal fold, thus joining the previous flank and infragluteal. 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. 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. The invasive nature of venography has led to the investigation of noninvasive imaging modalities for diagnosis of pelvic congestion syndrome. 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. This would go from the outer buttock fold and into the groin and possibly communicate with your prior thigh lift. An angulated cannula can be used to easily enter the superficial space. From here we can easily access the lower gluteal area and the internal and external posterior thigh (Fig. The descending branches of the inferior gluteal vessels and its accompanying nerve enter the subcutaneous tissue of the gluteal thigh flap distal. Final skin laxity classification results from the sum of each item grade multiplied. 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. Thomas Fiala answered. 1). The gluteal sulcus is formed by the posterior horizontal skin crease of the hip joint and overlying fat and is not formed by the lower border of the gluteus maximus muscle, which crosses the fold obliquely. Cocke and Ricketson were the first to describe placing silicone breast implants in the subcutaneous plane with less than optimal results. The flap length, determined from the distance between the perforator and the distal flap margin, was designed to be slightly longer than the defect itself. implant. The short answer is yes. 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 []. &NA; Use of a local flap is often needed for closure of a defect in the. But so doing it may also make your buttocks look a little less full because its roundness is decreased. S4/5 In the perianal area, less than one cm. FIG. The second incision is placed at the midpoint of the infragluteal fold. The infragluteal fold length and definition play important roles in esthetically. If too much fullness exists, the area that should be a diamond-shaped space is instead a straight line, which is much less appealing. Unfortunately liposuction of the banana roll can cause additional lines to form which is why I avoid liposuction in that area if possible. 6. The iatrogenic forms of banana fold and sensuous triangle deformity are produced by excessive. Expand. the market share of other surgical as well as non-surgical body contouring approaches. The use of a deepithelialized. 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. 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. adjective. Tissue samples (6 cm long 9 2 mm thick) were taken at three points from each fold bloc: the most medial point, the middle. On the left gluteal region, markings are shown for the muscle-fiber orientation for the gluteus maximus muscle. The infragluteal area may be slightly improved after buttock augmentation resulting in less of a requirement for skin resection. Indeed once this area is damaged, typically by liposuction, it is tricky to fully repair and re-create the normal infragluteal fold again. 95, 4. The average width of the skin excision was 8 cm and the average length was 25 cm. Volume in this area is restored with careful fat. 15. 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. 3 cm, with the greatest change at the level of 10 cm below the infragluteal fold (-3. Shorter, less dimpled, and tight skinned buttocks are smoothly wider and better projecting at the mid-level. Most patients in the study had a deep infragluteal fold (the fold at the bottom of the buttocks), which is the exact issue this procedure will address. Infragluteal fold reconstruction is achieved by reconstruction of the buttock’s sustaining apparel through deepithelialized skin flaps anchored to deep gluteal fascia. implant. Popularity of injectable fillers. 3. Five fixed cadavers were used. ResultsThe infragluteal fold is a connectival fibrous band. 1. Dr. All patients showed an improved definition of the infragluteal fold, with a symmetric shape of the gluteal region. 7) . It has been noted in multiple. And placing such a graft always runs the risk of causing an infection. The most significant changes in circumference were found at the level of 5 to 10 cm below the infragluteal fold, corresponding to the treated area on the lateral thigh. The Buttock Lift with Hyaluronic Acid and Threads. 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. Ini-tially, a deep plane is created by the 3-mm cannula. Save. 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 Scarpa’s. 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. A. A new technique for correction of a buttock ptosis resulting from a degloving injury is presented. To our knowledge, only two variations to the classic chevron technique have been described in an attempt to improve buttock contouring following GSCT excision. 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. 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. While idiopathic neuropathy of the PFCN has been described [4], iatrogenic neuropathyFollowing administration of general anaesthesia, the patient was placed prone on a radiolucent table with a bump under the pelvis to create approximately 30° of hip flexion. deformity and a pleasing buttock contour. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. 4). 45 This results in a ptotic butt if it is longer. 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. Fig. 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. Closure of the implant pocket should be tension-free. On the left gluteal region, markings are shown for the muscle-fiber orientation for the gluteus maximus muscle. Superiorly, it is formed by the lower border of the gluteus maximus. 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. A longer infragluteal fold suggests an aged, ptotic, and deflated-looking buttock with skin and fascial excess. Both volume and projection of the buttocks may be improved. S3 provides innervation to the infragluteal fold . 2. It arises in the median gluteal crease and follows. Time and important weight variation. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. 4% of subjects reported increased muscle. A Jackson Pratt drain is then placed in each implant pocket and brought out laterally in the infragluteal fold through a separate stab incision. The gluteal region in patients with massive weight loss after gastric bypass is characterized by. PMID: 15940397 DOI: 10. Infragluteal fold. Hello and thank you for your question. Flap reconstruction is efficient in severe cases of infragluteal fold deformity (5), but the low patient acceptance of the subsequent scars limits its application. Asymmetric lifts and reduction are to be performed on the buttock to correct for your present symmetry. A photograph or two of the area would be extremely helpful in determining what the problem may be and thus the solution, if any. Results: After treatment, there was an average reduction of 4. I hope this helps. The procedure would take approximately 4 hours to complete. The retromuscolar technique is preferred by patients requesting a natural, sporty result. 6 The infragluteal area is a support zone for the buttock, and treatment of this area with liposuction should be avoided. L3 provides innervation to the medial femoral condyle . intragluteal injection. 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. We report a case of using autologous fat transplantation to correct severe post-liposuction infragluteal fold deformity. 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 infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Liposhifting is a technique which free. Notice in the center photograph that a fuller. A long, deflated. The "sensuous triangle" is found at the junction of the lateral. 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 . We describe an optimized and individualized approach for injecting the collagen biostimulator PLLA in the gluteal region according to the needs of each patient. 6+/-0. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. For this we have applied. It is then carried inferiorly over the greater trochanter to the level of the gluteal fold. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. The flap width was designed to match the broadest width of the defect, which was assessed from the inner. An anatomical study demonstrated that the perineal branch of. 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. Clinical Presentation. The FCI flap is a good choice for. The spelling of co-author Felipe De Bacco’s surname name was misspelled, and the same author’s affiliation information was incorrect. Most patients had a deep infragluteal fold. Outer/Lateral Thigh Lift. The thigh circumference measured at 3 predefined levels decreased on average by 2. Fig. &NA; Use of a local flap is often needed for closure of a defect in the perineogenital area. The posterior thigh is the area least requested for liposuction with the exception of the proximal infragluteal fold or so-called “banana fold. Search worldwide, life-sciences literature Search. Tissue samples (6 cm long × 2 mm thick) were taken at three. Right now you have a partial double fold, a higher medial partial crease and a lower complete crease. Intergluteal crack height is unchanged. The infragluteal area may be slightly improved after buttock augmentation resulting in less of a requirement for skin. lateral to the mucocutaneous junction. Once the shapes are more symmetric, volume enhance can be done on both sides simultaneously. 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. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. Grade III ptosis has the most skin and volume below the fold, with significant skin laxity and a more angular infragluteal fold. 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. 2, 3, 4. 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 ]. If done by an experienced surgeon, you should see improvement but it is not easy to create a single crisp infragluteal fold.