Five fixed cadavers were used. These implants may be placed through bilateral supragluteal incisions, the infragluteal fold, or the intergluteal cleft incision. It is divided into an inner, a central, and an outer zone. 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]. in· tra· glu· te· al -ˈglüt-ē-əl, -glü-ˈtē-əl. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. Care is taken not to remove the subcutaneous tissues at the level of the infragluteal crease. The lateral length of the infragluteal fold measures the degree of buttocks ptosis. A banana fold may form for different reasons, among which an. 3). 8): Fig. Helpful Barry L. 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. It is our preference not to use this flap much because of the scar location and occasional sciatic nerve irritation due to swelling around. The "sensuous triangle" is found at the junction of the lateral. 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. 3 cm, with the greatest change at the level of 10 cm below the infragluteal fold (-3. Infragluteal fold. Your infragluteal fold is barely noticeable, no women has perfect exact length, position and height of the infragluteal fold. In my humble opinion you need nothing surgical. 0+/-1. Answer: Double gluteal fold. Also, evaluate the angle of the infragluteal fold. Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in esthetic defects in the gluteal contour . If too much fullness exists, the area that should be a diamond-shaped space is a straight line, which is much less appealing. Infragluteal fold. the infragluteal fold. Created for people with ongoing healthcare needs but benefits everyone. 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 ideal infragluteal cleft is none at all, but instead a smooth transition from buttocks to thigh. D1 has a posterior and a posteromedial surface. 00 µm). CárdenasThe infragluteal fold is one of the major concerns in reshaping of the gluteal region. Time and important weight variation consid- erably affect this region combined with the gravity’s effect. An outer thigh lift removes skin and fat from the outside of the thigh. 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. Open in new tab Download slide. The average width of the skin excision was 8 cm and the average length was 25 cm. An understanding of the anatomy of the gluteal region is essential in the evaluation and planning of surgery ( Fig. 2. The infragluteal fold region is the lower edge of the buttocks. All patients showed an improved definition of the infragluteal fold, with a symmetric shape of the gluteal region. The author has simply combined the incisions. The infragluteal fold is one of the major concerns in reshaping of the gluteal region. 45 This results in a ptotic butt if it is longer. The lower buttock is the most difficult area to address. Lower buttock sag is occurs when the superior skin and fat ‘fall’over the fixed infragluteal fold. The gluteal sulcus (also known as the gluteal fold, tuck, fold of the buttock, or horizontal gluteal crease) is an area of the body of humans and anthropoid apes, described by a horizontal crease formed by the inferior aspect of the buttocks and the posterior upper thigh. The surgical anatomy of the subcutaneous screen on the gluteal region has. Study record managers: refer to the Data Element Definitions if submitting registration or results information. Five fixed cadavers were used. New flank tapered feminine depressed contours are limited by high and narrow pelvic rims, which help define high hipsHide glossary Glossary. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. The power of this technique is granted through the lengthened anteroposterior scar and. These considerations guide the technique, which includes three distinct approaches for PLLA injection based on patient input regarding the most. 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. A thigh lift is a procedure that involves the removal of excess skin and fat from either the inner or outer thighs. Read more. Tissue samples (6 cm long × 2 mm thick) were taken at three. A direct excision was performed under general anesthesia. The Buttock Lift with Hyaluronic Acid and Threads. 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. Background: Anatomical features that make the buttocks attractive include adequate volume, projection, and a defined infragluteal fold. Furthermore, a diamond-shaped space should be formed between the gently sloping infragluteal fold and the inner thigh. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. infragluteal fold [2–4]. Results Our. Closure of the implant pocket should be tension-free. PDF. 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. This study focuses on the histological comparison of creases of the trunk and participation of the elastic fibers in their formation. 1). Most patients had a deep infragluteal fold. We report a case of using autologous. The infragluteal fold length and definition play important roles in esthetically. 5 and 15. The inferior border of the infragluteal fold is formed by the insertions of the semitendinous muscle and the belly of the biceps femoris. Paraspinous muscles cannot be forgotten in the lower abdomen. Supragluteal fossettes. PMID: 15940397 DOI: 10. All patients judged the outcome as very good. On the left gluteal region, markings are shown for the muscle-fiber orientation for the gluteus maximus muscle. The buttock skin and subcutaneous tissue were advanced superiorly and rotated medially to tighten the buttocks, lateral thigh, and posterior thigh. There are few. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. The infragluteal fold is where the bottom of the buttock meets the upper thigh. The sciatic nerve is identified deep to the gluteus maximus muscle and superficial to the quadratus femoris muscle with the ischial tuberosity medially and the greater trochanter laterally. 23. Answer: Double gluteal fold. Infragluteal fold: It is the horizontal crease under the ischial tuberosity composed of the lower edge of the gluteus maximus muscle and usually does not extend beyond the union of the semitendinous muscle with the biceps femoris. 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. Expand. 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. Background: Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in aesthetic defect of gluteal contour. The infragluteal fold 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. A: Thank you for your inquiry and sending your picture. Short gluteal fold. 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. 5). 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 iatrogenic forms of banana fold and sensuous triangle deformity are produced by excessive. 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. 1. TLDR. On the left gluteal region, markings are shown for the muscle-fiber orientation for the gluteus maximus muscle. 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. 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. The flap width was designed to match the broadest width of the defect, which was assessed from the inner. The posterior thigh is the area least requested for liposuction with the exception of the proximal infragluteal fold or so-called “banana fold. 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. 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. Normally, its mean length is equal to the intergluteal fold length or 2/3 of it. 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. The inframammary crease 5,13 lies o ver the fifth to sixth ribs. fold both histologically and anatomically. 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. Abstract. Results were maintained at 6 months. Each buttock section has its own distinct shape. The planned implication of the Sustaining Aparell may determine, through an observation of its structure, a flattening or a ptosis of the gluteal region, allowing a better understanding of the aesthetic of this region. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. The intergluteal cleft or just gluteal cleft, also known by a number of synonyms, including natal cleft, butt crack, and cluneal cleft, is the groove between the buttocks that runs from just below the sacrum to the perineum, [1] so named because it forms the visible border between the external rounded protrusions of the. Results The mean operating time was 210 min, and the volume resected ranged from 550 to 640 g in each of the gluteal areas. The treatment should not focus on the central and lower. Also known as the Dimples of. The superior border is formed by the lower border of the gluteus maximus. 5,8 A. 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. The infragluteal fold is a connectival fibrous band extending from the ramus of the ischium (but not involving the ischial tuberosity, for a length of 21 mm ± 2 and 21 mm ± 3), the apex of the sacrum (for a length of 13 ± 2 and 11 mm ± 2), and the coccyx (for a length of 19 mm ± 2 and 20 mm ± 2, all measures referring to volunteers and. The infragluteal fold is among the major characteristics of the gluteal region. Barry Eppley. loss of the infragluteal fold [7]. Therefore, it may be preferable to wait several months after implantation to determine the amount of skin resection necessary. A large redundant infragluteal crease probably cannot be repaired easily. Influence of the Recipient Site on the Outcomes of Fat Grafting in Facial Reconstructive Surgery. This study reevaluated the fold both histologically and anatomically. Case presentation: We report. I think this would give a far better yield than the infragluteal fold excision or the buttock fold excision. The second incision is placed at the midpoint of the infragluteal fold. Superiorly it is formed by the lower border of the gluteus maximus. Medicine. 2010. Superiorly it is formed by the lower border of the gluteus maximus. The radiation oncologist clinically outlined the areas. Answer: Double fold. The "sensuous triangle" is found at the junction of the lateral. FIG. 22), liposuction of the inner thigh and infragluteal area may be indicated. To our knowledge, only two variations to the classic chevron technique have been described in an attempt to improve buttock contouring following GSCT excision. What you are seeking is to have a uniform infragluteal crease on both sides. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. 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. (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. Infragluteal fold reconstruction is fracture was diagnosed, and she underwent surgery achieved by reconstruction of the buttock’s sustaining ap- for posterior instrumentation to stabilize the fracture parel through deepithelialized skin flaps anchored to deep in orthopaedic department. This fold makes a usually Read More…Important dermatome & anatomical landmarks. 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 key to success for this procedure is to. The muscle fascial edges should approximate with ease and a “watertight” closure is performed using eight to ten simple interrupted 0 or 2-0. On the other hand, some slight to moderate redundant infragluteal creases might be candidates for simple surgical repair. Recent Surge in BBL Demand. For this we have applied. Supragluteal fossettes (one on either side), over the posterior superior iliac spine, created by the multifidus muscle, the lumbodorsal aponeurosis and the insertion. Infragluteal fold excision can be performed either before or after implantation (Fig. 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. Great posted photos. The inferior gluteal area is divided into four zones by tracing a vertical line from the center of the gluteus and a horizontal line that crosses through the infragluteal fold (Fig. The area between the iliac crest and the infragluteal fold was divided into 3 equal parts, with the upper third left undisturbed, the middle third marked for placement of the implant. Background: 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 infragluteal fold- thigh junction (lower gluteal cleavage) also requires definition. The infragluteal fold is where the bottom of the buttock meets the upper thigh. 9 and 10. During this type of thigh lift, an incision is made around the waist. 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. Preoperatively, the patient is examined and the buttock’s size and shape are evaluated. The authors’ experience using. 5 Mendieta’s ptosis evaluation utilizing skin fold angles for classification. 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. 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 []. 2). The patient has difficulty arising from a sitting position or climbing steps. A longer infragluteal fold suggests an aged, ptotic, and deflated-looking buttock with skin and fascial excess. In this way, it's similar to a general lower body lift. FIG. Oh et al 26 recently demonstrated a shortening of the infragluteal fold by performing a thread lift with an elastic silicone-polyester thread. Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in esthetic defects in the gluteal contour ( 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. The anatomical study. 2, 3, 4. The length and definition of the infragluteal fold play important roles in aesthetically pleasing buttocks. Also evaluate the angle of the infragluteal fold. The procedure would take approximately 4 hours to complete. from the bone to the skin. All patients showed an improved definition of the infragluteal fold, with a symmetric shape of the gluteal region. Does it have a downward 45° angle, run horizontally, or have an inverted. 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. The Scarpa’s. 1) A shapely buttocks, regardless of its size, has an infragluteal crease that separates the buttocks from the posterior thigh. In most cases, the infragluteal fold ends at the midpoint of the inferior buttock. 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. Does it have a downward 45º angle, run horizontally, or have an inverted upward. It is one o…THE IGF. Ozmen S. The descending branches of the inferior gluteal vessels and its accompanying nerve enter the subcutaneous tissue of the gluteal thigh flap distal. Care must be taken when completing the last portion of the. The author tried not to trespass the thigh midline with the incision along the infragluteal fold. 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. Autologous gluteal augmentation with circumferential body lift in the massive weight loss and aesthetic patient. 9. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. 17). Mendieta, on the other hand, described a procedure to eliminate the square shape of the inferomedial area of the gluteous in massive weight loss patients, with the hanging tissue removed by means of an incision that goes along the inner infragluteal fold and then upward lateral to the anus []. The lateral part of the gluteus maximus muscle tapers between the long head of the biceps femoris and the vastus lateralis muscles. It is based at the midline and extends laterally a distance dependent on the length needed to approach the infragluteal fold when transposed if limits on the width of the flap allow. 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. Plan on a 2-3 week recovery. The flap length, determined from the distance between the perforator and the distal flap margin, was designed to be slightly longer than the defect itself. Grade II: The infragluteal fold is angulated downward, flattening at the lower 1/3 of buttock. : situated within or introduced into the gluteal muscle. The hyperechoic BFL tendon might be a reliable soft tissue landmark for ultrasound localization of the infragluteal sciatic nerve. gluteal fold: [ fōld ] plica; a thin margin curved back on itself, or doubling. 7) . Infragluteal fold excision can be performed either before or after implantation . Final skin laxity classification results from the sum of each item grade multiplied. . 45 This results in a ptotic butt if it is longer. fold is also included in this project in comparison with the inframammary, infragluteal, and inguinal creases. 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. 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. Good luck. My recommendation would be getting better contour on the left before addressing the right. What separates the lower buttocks from the other two sections is the infragluteal fold. We recommend the lower buttock lift for patients who suffer from sagging skin beneath the lower fold of their buttocks (the infragluteal fold). The key to success for this procedure is to. 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]. A direct excision was performed under general anesthesia. Both volume and projection of the buttocks may be improved. Hope this helps!Artistic rendition of relevant anatomy of the infragluteal approach. Time and important weight variation consid-erably affect this region combined with the gravity’s effect. S4/5 In the perianal area, less than one cm. 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. An injury specifically to the inferior gluteal nerve, which supplies the gluteus maximus muscle, results in weak extension of the hip. The technical details and surgical results of a pedicled skin flap raised in the infragluteal fold, used to widen the. Thomas Fiala answered. Procedure. Skin creases are features of major anatomical, morphological, surgical, and functional interest. A, C, E, Preoperative views of a 50-year-old woman who complained of decreased gluteal projection and buttock ptosis after suction-assisted lipoplasty. This is a difficult area to fix. 2. &NA; The ideal skin‐flap reconstruction provides functional preservation and a good cosmetic outcome in both the. Tissue samples (6 cm long x 2 mm thick) were taken. Patients with a long buttock may. 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. This would go from the outer buttock fold and into the groin and possibly communicate with your prior thigh lift. This is often tried but never. Cuenca described the ideal buttocks for women as follows: mild lateral depression at the femoral greater trochanter, a short infragluteal fold, the supragluteal fossette corresponding to the posterior superior iliac spine, and a V-shaped sacral triangle (Fig. Note anterior abdominal wall. The main goal of a butt tuck procedure is to repair lost or obstructed infragluteal. 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 banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. This fold is the horizontal crease under the ischial tuberosity. 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。. 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 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 . 39. A. 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. the market share of other surgical as well as non-surgical body contouring approaches. 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. 23. All patients showed an improved definition of the infragluteal fold, with a symmetric shape of the gluteal region. S3 provides innervation to the infragluteal fold . Complete 10 to 15 reps. 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. 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 . Via its numerous collateral branches, the posterior femoral cutaneous nerve innervates a very extensive territory including the posterior. She underwent liposculpture using the tumescent technique with infiltrated fluid, sodium chloride, epinephrine and Lidocaine in the. With this technique, the deepithelialized crescent-likeThe infragluteal fold/thigh junction (lower gluteal cleavage) also requires definition. Selective fat reduction centrally and laterally. intragluteal injection. Sorry for your problem. Asymmetric lifts and reduction are to be performed on the buttock to correct for your present symmetry. 5 T) of the pelvic region. It has been noted in multiple. With sagging of the muscle belly, the infragluteal fold is decreased or lost, and atrophy of the buttock is obvious with time. Infragluteal fold. Once the shapes are more symmetric, volume enhance can be done on both sides simultaneously. My recommendation would be getting better contour on the left before addressing the right. The infragluteal fold (red lines) may have a downward slope (ideal with a well-defined diamond zone), be horizontal, or have an upward slope. 1. The gluteal‐fold flap is very useful for various vulvar and buttock reconstructions because it can be adjusted to the required volume and the usefulness of this flap for anal and pelvic‐floor reconstruction was demonstrated. The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. Five fixed cadavers. Results: After treatment, there was an average reduction of 4. Dr. 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. On the upper area, markings are shown for the gluteus. Combining Gluteal Shaping with High-Definition Liposuction. 6). 5 ). It is critical to appropriately and systematically analyze the complex regional anatomy. Five fixed cadavers were used. For this we have applied a pedicled skin flap raised in the infragluteal fold, the technical details and surgical results of which are presented in this paper. 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. Dr. The original buttock lift dates back many decades before BBL surgery became popular and refers to a direct excision at the lower buttocks. It is critical to appropriately and systematically analyze the complex regional anatomy. 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. Some surgeons call this a removal of banana roll; more technically, it is an infragluteal fold incision for excision of upper posterior thigh. Characteristic features include short intergluteal cleft, flattened buttocks, narrow hips, distal leg atrophy, and talipes deformities. The flaps are undermined by only one cm. Plan on a 2-3 week recovery. Also evaluate theangle of the infragluteal fold. Patients with buttock ptosis and medial thigh skin laxity without lateral thigh redundancy are ideal candidates. Good luck. Does it have adownward 45º angle, run horizontally, or havean inverted. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. A Jackson Pratt drain is then placed in each implant pocket and brought out laterally in the infragluteal fold through a separate stab incision. implant. 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. 2, 3, 4. The power of this technique is granted through the lengthened anteroposterior scar and. In 1977 Gonzalez-Ulloa described correction of the ‘sad. It has been noted in multiple. If ou still has residual excess skin and fat on the lower buttock and. Once the shapes are more symmetric, volume enhance can be done on both sides simultaneously. 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. 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. A banana fold may form for different reasons, among which an. 3) In a lower buttock lift in my hands, it is a combination of tissue removal AND the recreation of an infragluteal fold. Notice in the center photograph that a fuller. The infragluteal fold/thigh junction (lower gluteal cleavage) also requires definition. I hope this helps. A V-shaped proximal gluteal crease was accentuated by the. The “sensuous triangle” is found at the junction of the lateral buttocks, the lateral thigh, and the posterior thigh. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. (D) The patient is turned to the supine position, and the legs remain spread on extender bars that are well padded. 6 Those patients with some buttock volume and skin falling slightly below the infragluteal fold are described as having Grade I ptosis. implant. 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 infragluteal fold is a fixed and well-defined structure that serves as the inferior border of the buttock proper and is formed by subcutaneous fat and thick fascial insertions from the femur and pelvis through the intermuscular fascia to the skin . It has been noted in multiple. Our technique allows for 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. 1007/s00266-004-0133-2 Abstract The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. The long axis of the flap was arranged in parallel with the infragluteal fold axis. Chasan, partook in a study examining the results of the infragluteal thigh lift. A longer infragluteal fold suggests an aged, ptotic, and deflated-looking buttock with skin and fascial excess. Care is taken not to remove the subcutaneous tissues at the level of the infragluteal crease. In this study, 84. Urinary and bowel. By adding more volume on the left and matching the right, the fold will appear as a result of this added volume. A case of using autologous fat transplantation to correct severe post-liposuction infragluteal fold deformity in a. 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 fold is the horizontal crease under the ischial tuberosity. However, one of its key-component, the infragluteal fold, has not yet been clearly defined. 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. 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. The infragluteal fold needs to be approached carefully, by suctioning just under the skin. The infragluteal fold (IGF) is a crucial anatomic landmark representing one of the major concerns in gluteal reshaping in plastic surgery. Save. 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 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. This horizontal crease is under the ischial tuberosity. After the fat graft, thread lifting is performed considering the vector. The inclusion criteria was ptosis of the lower pole of buttocks.