Download : Download full-size image; Figure 6. 17). (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. Also, evaluate the angle of the infragluteal fold. The radiation oncologist clinically outlined the areas. With sagging of the muscle belly, the infragluteal fold is decreased or lost, and atrophy of the buttock is obvious with time. The infragluteal fold is a connectival fibrous band extending from the ramus of the ischium (but not involving the ischial tuberosity, for a length of 21 mm ± 2 and 21 mm ± 3), the. The authors present a simple and effective technique for reconstruction of the gluteal fold by a deepithelialized skin flap that is applicable for patients who have lost their naturalgluteal sulcus, with a resultant altered buttock shape, after trauma or other causes. The power of this technique is granted through the lengthened anteroposterior. Undermining will not go beyond the infragluteal fold, so it is important to place the template 2 cm above the fold (Figure 6). Destruction of this. 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 final result should be to attain a waist-to-hip ratio (WHR) close to 0. The infragluteal fold is among the major characteristics of the gluteal region. Tissue samples (6 cm long x 2 mm thick) were taken. 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. In the process of r. Reply: Staying Safe during Gluteal Fat Transplantation. The fat graft is placed in the upper medial side for projection. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Good luck. 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. Preoperatively, the patient is examined and the buttock’s size and shape are evaluated. 6. 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. Our technique allows for the. 45 This results in a ptotic butt if it is longer. On the upper area, markings are shown for the gluteus. loss of the infragluteal fold [7]. Shorter, less dimpled, and tight skinned buttocks are smoothly wider and better projecting at the mid-level. 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. The "sensuous triangle" is found at the junction of the lateral. The main goal of a butt tuck procedure is to repair lost or obstructed infragluteal. This corrects the article "Vectorial Treatment of Infragluteal Fold" in volume 11, e4750. 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 ). 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 ]. 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. It is designed over the inferior portion of the buttock, with the resulting scar located just above the infragluteal fold. 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]. Thus, buttock ptosis is simply gluteal tissue below the skin fold, or infragluteal crease. The inferiorly oriented form of the muscle may be visible in males, but in. 0+/-1. 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. This is not a good benefits vs risk proposition. Waves and dimples can be improved down to the infragluteal fold at the junction to the thigh. Grade II: The infragluteal fold is angulated downward, flattening at the lower 1/3 of buttock. Dr. The inframammary crease 5 , 13 lies over the fifth to sixth ribs. The skin perforators of the pudendal artery were marked with a Doppler probe in the medial region of the gluteal fold. The gluteal region in patients with massive weight loss after gastric bypass is characterized by. 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. The infragluteal folds and perineal region were treated with the patient in a prone jackknife position. intragluteal injection. The iatrogenic forms of banana fold and sensuous triangle deformity are produced by excessive liposuction. 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 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. Clinical Presentation. This can include excess weight that has accumulated in the waist and buttock area. 15. 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. 2). From this point of view, in our opinion, there are four salient morphologic features to be considered in the preoperative planning: anterior and posterior views, the profile, and the infragluteal fold. 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. What you are seeking is to have a uniform infragluteal crease on both sides. Fig. from the bone to the skin. The infragluteal fold- thigh junction (lower gluteal cleavage) also requires definition. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. 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 . 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. 23. Save. D. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. Medicine. A more objective, faster and shorter version of this scale, to be evaluated. BackgroundThe gluteal fold represents an important aspect of the gluteal region. 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 . T3 provides innervation to the midclavicular line . 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 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. ” In contrast to the rest of the posterior thigh, this fatty roll is a rather common problem (see Fig. During this type of thigh lift, an incision is made around the waist. Higher IGF (infragluteal fold) results in a shorter buttock preferred by Asian Americans 123 Aesth. Infragluteal fold: formed superiorly by the inferior border of the gluteus maximus and inferiorly by the insertion of the semitendinosus and biceps femoris muscles in the ischial tuberosity. The medial part of the infragluteal fold is formed by a fat pad that covers the inferior medial border of the gluteus maximus muscle. Methods: Six volunteers (three males and three females) underwent an MRI scan (Siemens Aera® 1. 51. The infragluteal fold is one of the major concerns in reshaping of the gluteal region. 5 and 6. 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. Five fixed cadavers were used. TLDR. Both adipofascial flaps were rotated downward for inset in the pockets created in the buttocks. It has been noted in multiple. 23. In the article “Vectorial Treatment of Infragluteal Fold,” published as e4750 on January 11,. The "sensuous triangle" is found at the junction of the lateral. Superiorly it is formed by the lower border of the gluteus maximus. It was not until 1973 that gluteal augmentation was performed for cosmetic purposes. A banana fold may form for different reasons, among which an. 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. 3 Excerpts; Save. 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. This study reevaluated the fold both histologically and anatomically. Ini-tially, a deep plane is created by the 3-mm cannula. Keep your arms straight as you lift the weight with your hips and glutes. Infragluteal fold revision Buttock lift The author prefers tostageexcisionalcontouring procedures in association with gluteal implants. An understanding of the anatomy of the gluteal region is essential in the evaluation and planning of surgery ( Fig. The infragluteal area may be slightly improved after buttock augmentation resulting in less of a requirement for skin. Tissue. 2. Five fixed. 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 banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. 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. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. Adequate gluteal projection and a well-defined infragluteal fold are two of the main criteria defining aesthetically pleasant buttocks [4, 5]. Answer: Double gluteal fold. A disadvantage is that the lower floor of the buttocks often remains ‘emptied’, while good vascularization can be cited as an advantage. 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. To our knowledge, only two variations to the classic chevron technique have been described in an attempt to improve buttock contouring following GSCT excision. 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. Download scientific diagram | Definitions of the lines drawn between reference points from publication: Gluteal Region Morphology: The Effect of the Weight Gain and Aging | The gluteal region is. Your options are to carefully suction the fold and to either do a surgical buttock crease lift or fat injections to to butt just above the crease, or a combination thereof. The author has simply combined the incisions. D2 and D3 are located in the posterior portion. Flap reconstruction is efficient in severe cases of infragluteal fold deformity (5), but the low patient acceptance of the subsequent scars limits its application. 5 cm, 3-month follow-up). (aka tuck) The most important factor to guide implant selection is its base’s vertical and horizontal dimensions, which should fit the buttock leaving at least 5 cm between the pocket dissection limit and the infragluteal fold and 2 cm lateral to the sacrum. The superior border is formed by the lower border of the gluteus maximus. 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. A direct excision was performed under general anesthesia. Indeed once this area is damaged, typically by liposuction, it is tricky to fully repair and re-create the normal infragluteal fold again. 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 ideal infragluteal cleft is none at all, but instead a smooth transition from buttocks to thigh. The Infragluteal Thigh Lift Technique. . 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 . 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. Lower buttock sag is occurs when the superior skin and fat ‘fall’over the fixed infragluteal fold. The infragluteal fold (IGF) is a crucial anatomic landmark representing one of the major concerns in gluteal reshaping in plastic surgery. The advantage is that the posterior thigh is lifted and ptosis of the caudal buttock can be corrected. The diamond-shaped space turns into a straight line, which is less aesthetically appealing. The final result should be to attain a waist-to-hip ratio (WHR) close to 0. The Scarpa’s. 5). My recommendation would be getting better contour on the left before addressing the right. The skin flap was designed along the gluteal fold. Expand. In the article “Vectorial Treatment of Infragluteal Fold,” published as e4750 on January 11, 2023, in Plastic and Surgery Global Open, corrections have been made to the author list and affiliations. By adding more volume on the left and matching the right, the fold will appear as a result of this added volume. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. Infragluteal fold. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. Supragluteal fossettes (one on either side), over the posterior superior iliac spine, created by the multifidus muscle, the lumbodorsal aponeurosis and the insertion. 1 Excerpt; Save. Results The mean operating time was 210 min, and the volume resected ranged from 550 to 640 g in each of the gluteal areas. 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. Time and important weight variation consid-erably affect this region combined with the gravity’s effect. 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. The invasive nature of venography has led to the investigation of noninvasive imaging modalities for diagnosis of pelvic congestion syndrome. Normally, its mean length is equal to the intergluteal fold length or 2/3 of it. Purpose The gluteal region is a key element of beauty balance and sexual appearance. Key elements to be evaluated include the infragluteal crease, the gluteal fold and the outer thigh skin fold [28]. A thigh lift is a procedure that involves the removal of excess skin and fat from either the inner or outer thighs. I hope this helps. In contrast, a shorter infragluteal fold contributes to a full, taught, and youthful buttock. Infragluteal fold reconstruction is achieved by reconstruction of the buttock’s sustaining apparel through deepithelialized skin flaps anchored to deep gluteal fascia. Most patients had a deep infragluteal fold. Supragluteal fossettes. These implants may be placed through bilateral supragluteal incisions, the infragluteal fold, or the intergluteal cleft incision. Helpful Barry L. 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. 1 Anatomy of the gluteus maximus muscle and deeper structure. Good luck. Once the fat has infiltrated, any PAL device can be used to equalize (distribute) the infiltrated fat (Images 15. 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. Limits implant movement. If too much fullness exists, the area that should be a diamond-shaped space is instead a straight line, which is much less appealing. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. The flap width was designed to match the broadest width of the defect, which was assessed from the inner. Infragluteal fold. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. PMID: 15940397 DOI: 10. All patients showed an improved definition of the infragluteal fold, with a symmetric shape of the gluteal region. The procedure would take approximately 4 hours to complete. Also evaluate theangle of the infragluteal fold. Paraspinous muscles cannot be forgotten in the lower abdomen. Patients with skin laxity and infragluteal fold ptosis may require a buttock lift or direct fold excision in order to obtain an acceptable result. 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 []. 39. One can not liposuction between the two and create a single infragluteal crease. 3 cm, with the greatest change at the level of 10 cm below the infragluteal fold (-3. After the fat graft, thread lifting is performed considering the vector. Unfortunately liposuction of the banana roll can cause additional lines to form which is why I avoid liposuction in that area if possible. Peter Fisher M. Patients with skin laxity and infragluteal fold ptosis may require a buttock lift or direct fold excision in order to obtain an acceptable result. Results Our. Since its initiation, this technique has proven to be both clinically and cost-effective, with demonstratable benefits achieved with a lower. However, there is no clear anatomical description of the infragluteal fold,. T1. New flank tapered feminine depressed contours are limited by high and narrow pelvic rims, which help define high hipsHide glossary Glossary. Expand. Point “C” is marked in the center of the buttock, 3 cm above the infragluteal fold. The main goal of a butt tuck procedure is to repair lost or obstructed infragluteal. fold is also included in this project in comparison with the inframammary, infragluteal, and inguinal creases. Four fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. The infragluteal fold/thigh junction (lower gluteal cleavage) also requires definition. 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. Consistent features of beautiful buttocks: lateral depression, infragluteal fold, supragluteal fossettes. Between 2. 5 Mendieta’s ptosis evaluation utilizing skin fold angles for classification. 3) In a lower buttock lift in my hands, it is a combination of tissue removal AND the recreation of an infragluteal fold. The postoperative results depicted in the article demonstrate a successful. On the other hand, some slight to moderate redundant infragluteal creases might be candidates for simple surgical repair. Urinary and bowel. The infragluteal fold is where the bottom of the buttock meets the upper thigh. Therefore, in each case, the high points of the buttocks are relatively light while infragluteal fold and V-shaped crease areas are relatively dark. Your infragluteal fold is barely noticeable, no women has perfect exact length, position and height of the infragluteal fold. But so doing it may also make your buttocks look a little less full because its roundness is decreased. Transversal slice passing through bony structures. Expand. The gluteal region in patients with massive weight loss is characterized by excessive skin and exaggerated fat loss. The entry point for fat injection is near the infragluteal fold and around the sacral triangle, which is the same as that for thread insertion. The "sensuous triangle" is found at the junction of the lateral. No major complications or. deformity and a pleasing buttock contour. Many of the early proponents of the procedure were not open to discussing complications. 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. Intergluteal cleft. &NA; The ideal skin‐flap reconstruction provides functional preservation and a good cosmetic outcome in both the. This study reevaluated the fold both histologically and anatomically. 20. Dear Anna, judging from the picture posted on the forum, you seem to have buttock ptosis with a deep infra gluteal fold. All patients judged the outcome as very good. It has been noted in multiple. ResultsThe infragluteal fold is a connectival fibrous band. The anterior axillary fold is also included in this project in comparison with the inframammary, infragluteal, and inguinal creases. Does it have a downward 45° angle, run horizontally, or have an inverted. Infragluteal fold. The authors’ experience using autologous fat transplantation to treat tissue defects led them to use this technique for correcting iatrogenic forms of banana fold and sensuous triangle deformity. The structure of the infragluteal fold and the degree of ptosis are the main factors that determine the aesthetic appearance. Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in esthetic defects in the gluteal contour. The average width of the skin excision was 8 cm and the average length was 25 cm. Grade III: The skin. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. Chasan, partook in a study examining the results of the infragluteal thigh lift. This maneuver is important to delineate the lateral margin on the gluteal area to adequately define the lower lateral transition area. 22), liposuction of the inner thigh and infragluteal area may be indicated. Augmentation of the fold with fat would help you achieve a smoother transition between the butt. The posterior knee-fold incisions can be closed or left open for. Fig. Butt tuck surgery help people attain rounder, smoother and natural-looking buttocks. The cannula should have one orifice and be thick (4 or 5 mm), long (32 cm), and directed to the IGF and beyond. 5 ). Your infragluteal fold is barely noticeable, no women has perfect exact length, position and height of the infragluteal fold. The iatrogenic forms of banana fold and sensuous triangle deformity are produced by excessive. 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. 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。. 5 T) of the pelvic region. 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. There are few. By adding more volume on the left and matching the right, the fold will appear as a result of this added volume. These considerations guide the technique, which includes three distinct approaches for PLLA injection based on patient input regarding the most. 35. Combining Gluteal Shaping with High-Definition Liposuction. 2) The thin strips of skin and fat are worthless as grafts because of their very low volume. The width of the flap and. fold is also included in this project in comparison with the inframammary, infragluteal, and inguinal creases. Anterior viewIn a large buttock, the infragluteal fold is more horizontal and assumes an upward inverse slope (negative angle). This fold is the horizontal crease under the ischial tuberosity. 4). If toomuch fullness exists, the area that should be a di-amond-shaped space is instead a straight line,which is much less appealing. A photograph or two of the area would be extremely helpful in determining what the problem may be and thus the solution, if any. S2 S1 S3 S4/5. adjective. 8): Fig. 6. Abstract. The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. 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. Weight gain following thighplasty may negatively affect your surgery results. This study reevaluated the fold both histologically and anatomically. 3). A longer infragluteal fold suggests an aged, ptotic, and deflated-looking buttock with skin and fascial excess. Patients with a long buttock may. 6. The infragluteal fold is where the bottom of the buttock meets the upper thigh. I think this would give a far better yield than the infragluteal fold excision or the buttock fold excision. Procedure. 4). 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. A flap involving the whole gluteal area was dissected superficially to the gluteal fascia. 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. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. PDF. The upper-inner thigh holds a high stem. 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. A. 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. Sorry for your problem. You have a beautiful result after the fat grafting and the “tuck” of the infragluteal fold may be messed up forever, doing direct incision. This is typically done under local anesthesia. Volume in this area is restored with careful fat. 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. 1. 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. com The infragluteal fold (IGF) is a crucial anatomic landmark representing one of the major concerns in gluteal reshaping in plastic surgery. Initially, percutaneous reduction was attempted through a small transverse incision in the infragluteal fold (figure 2). 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. See full list on link. D1 has a posterior and a posteromedial surface. Saddlebags at the infragluteal fold level are replaced by tight flat skin. ExpandThese implants may be placed through bilateral supragluteal incisions, the infragluteal fold, or the intergluteal cleft incision. 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 . A, C, E, Preoperative views of a 50-year-old woman who complained of decreased gluteal projection and buttock ptosis after suction-assisted lipoplasty. 23. The infragluteal fold, often ignored or inadequately treated, is one of the most challenging areas to treat and requires a complete knowledge of the anatomy of the buttock to achieve the best aesthetic result. The “sensuous triangle” is found at the junction. Following is a list of spinal nerves and points that are characteristically belonging to the dermatome of each nerve. Undermining will not go beyond the infragluteal fold, so it is important to place the template 2 cm above the fold . You have a beautiful result after the fat grafting and the “tuck” of the infragluteal fold may be messed up forever, doing direct incision. Its inferior border is formed by the insertions of the semitendinous muscle and the long belly of the biceps femoris in the ischial tuberosity. Each buttock section has its own distinct shape. 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. 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 FCI flap is a good choice for. Recent Surge in BBL Demand. 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 infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. 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 infragluteal fold needs to be approached carefully, by suctioning just under the skin. Tissue samples (6 cm long × 2 mm thick) were taken at three. In the ideal buttock, the infragluteal fold should end. 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. 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. Selective fat reduction centrally and laterally. PDF. The author tried not to trespass the thigh midline with the incision along the infragluteal fold. In my humble opinion you need nothing surgical. Sensory fibers from a dermatome and cutaneous nerves provide innervation to the gluteal region. 6 Those patients with some buttock volume and skin falling slightly below the infragluteal fold are described as having Grade I ptosis. Study record managers: refer to the Data Element Definitions if submitting registration or results information. 3 An aged buttock region is marked. 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 ideal candidates for FCI flap for breast reconstruction, as for any other free flaps, are non-smokers and non-obese patients. The midpoints of the infragluteal sulci were marked, and then the right and left infragluteal sulci were bilaterally excised en bloc, from the ischium to the most lateral part of the gluteal-thigh junction, with 3 cm of tissue taken from the inferior and superior parts of the infragluteal fold by an elliptic incision including the skin. Superiorly it is formed by the lower border of the gluteus maximus. Butt tuck surgery help people attain rounder, smoother and natural-looking buttocks. 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. The region of the infragluteal fold has been generally ignored or inadequately treated. Asymmetric lifts and reduction are to be performed on the buttock to correct for your present symmetry. 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 appropriately selected gluteal implant is folded in half. Excess tissue was removed, and wound closure was performed in multiple layers. 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. the infragluteal fold. 24 The ideal direction of the infragluteal fold from medial to lateral is downward sloping. The need for liposuction of the lower back or hips is considered. implant. The major drawback of implant augmentation is the substantially high rate of complications associated with its techniques. Poorly placed incisions also detract from the gluteal aesthetic. The histologicalCreation of an infra gluteal fold is done in the same fashion as the medial thigh tuck first described by Ted Lockwood, M. Autologous gluteal augmentation with circumferential body lift in the massive weight loss and aesthetic patient. ResultsThe infragluteal fold is a connectival fibrous band. Therefore, it may be preferable to wait several months after implantation to determine the amount of skin resection necessary. Manipulation using a ball-spiked pusher under. 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. Care is taken not to remove the subcutaneous tissues at the level of the infragluteal crease. Fig. The power of this technique is granted through the lengthened anteroposterior scar and. 9. Thomas Fiala answered. Gluteal fat injection mortality is approximately 1/3000 patients. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Limited inferiorly by infragluteal fold. Drains are placed via stab incisions in the infragluteal fold using a #15 blade scalpel. If too much fullness exists, the area that should be a diamond-shaped space is a straight line, which is much less appealing. ResultsThe infragluteal fold is a connectival fibrous band.