When planning the new infragluteal fold, surgeons should not exceed the union of the semitendinous muscle with the biceps femoris laterally since this is the natural ending of the fold . The recovery time is at least two weeks but may be longer depending on your specific surgery. The diamond-shaped space turns into a straight line, which is less aesthetically appealing. The skin flap was designed along the gluteal fold. Cocke and Ricketson were the first to describe placing silicone breast implants in the subcutaneous plane with less than optimal results. In the article “Vectorial Treatment of Infragluteal Fold,” published as e4750 on January 11,. After 1 year, she under- gluteal fascia. 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. Concomitant fat transplantation to the infragluteal/posterior thigh junction region during circumferential liposuction of the thigh is effective in preventing postliposuction gluteal ptosis and improving patient satisfaction. 6 Those patients with some buttock volume and skin falling slightly below the infragluteal fold are described as having Grade I ptosis. Lower buttock sag is occurs when the superior skin and fat ‘fall’over the fixed infragluteal fold. This is not a good benefits vs risk proposition. 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. On the upper area, markings are shown for the gluteus. 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 purpose of this study was to perform an anatomical description of the infragluteal fold (IGF) matching radiological and anatomical findings in describing specifically raise of the fibrous component at the bone level. infragluteal fold is composed of fascial spicules extending . circular f's. Supragluteal fossettes. 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。. 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. 95, 4. 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. 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. 23. 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. However, there is no clear anatomical description of the 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. I hope this helps. FIG. 2) Loose skin from loss of buttock volume creates skin folds that obscures the infragluteal fold. D. The "sensuous triangle" is found at the junction of the lateral. Answer: Double gluteal fold. 1). 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. Infragluteal fold excision can be performed either before or after implantation (Fig. 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. ResultsThe infragluteal fold is a connectival fibrous band. The “sensuous triangle” is found at the junction of the lateral buttocks, the lateral thigh, and the posterior thigh. 2) The thin strips of skin and fat are worthless as grafts because of their very low volume. International Standards for the Classification of Spinal Cord InjuryShe also had infragluteal fold or the infragluteal banana roll. The thigh circumference measured at 3 predefined levels decreased on average by 2. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Dr. But what is really being done is that the loose lower buttock skin and the fold are being removed to create a less deep infragluteal fold and smoother transition between the buttock and the thighs. the infragluteal fold. Results: After treatment, there was an average reduction of 4. fashion, is an anatomic structure in its medial part and only a Despite this reality, the ideal gluteal shape has been crease laterally. 9. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. 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. It is the lower boundary of the breast and is an important element of the natural ptotic appearance of the breast. In the anchor thighplasty technique, the medial thigh lift is extended posteriorly into the infragluteal crease. 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. C2 – At least one cm lateral to the occipital protuberance at. But so doing it may also make your buttocks look a little less full because its roundness is decreased. PDF. This was sculpted for a national television program recently. The “sensuous triangle” is found at the junction of the lateral buttocks, the lateral thigh, and the posterior thigh. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. We define unaesthetic buttock ptosis as sagging. In the ideal buttock, the infragluteal fold should end. The width of the flap and. In my humble opinion you need nothing surgical. 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 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. But so doing it may also make your buttocks look a little less full because its roundness is decreased. Fig. The infragluteal area may be slightly improved after buttock augmentation resulting in less of a requirement for skin resection. Both adipofascial flaps were rotated downward for inset in the pockets created in the buttocks. My recommendation would be getting better contour on the left before addressing the right. Your infragluteal fold is barely noticeable, no women has perfect exact length, position and height of the infragluteal fold. 3) The length of the lower buttock lift excision should ideally not go beyond the. 3). 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. Therefore, in each case, the high points of the buttocks are relatively light while infragluteal fold and V-shaped crease areas are relatively dark. 12. An angulated cannula can be used to easily enter the superficial space. deformity and a pleasing buttock contour. 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. Abstract. Surgery was performed in the jackknife position, and flaps were elevated in the suprafascial plane. However, one of its key-component, the infragluteal fold, has not yet been clearly defined. In 1977 Gonzalez-Ulloa described correction of the ‘sad. Destruction of this. Recent Surge in BBL Demand. Oh et al 26 recently demonstrated a shortening of the infragluteal fold by performing a thread lift with an elastic silicone-polyester thread. The main difference with our technique is the design. It arises in the median gluteal crease and follows. The Infragluteal Thigh Lift Technique. Lower body lift procedures remove excess skin and lift sagging buttock tissue. Superiorly it is formed by the lower border of the gluteus maximus. Manipulation using a ball-spiked pusher under. Ini-tially, a deep plane is created by the 3-mm cannula. Infragluteal fold reconstruction is achieved by reconstruction of the buttock’s sustaining apparel through deepithelialized skin flaps anchored to deep gluteal fascia. The treatment should not focus on the central and lower. Methods: Six volunteers (three males and. Normally, its mean length is equal to the intergluteal fold length or 2/3 of it. Study record managers: refer to the Data Element Definitions if submitting registration or results information. Fig. A thigh lift is a procedure that involves the removal of excess skin and fat from either the inner or outer thighs. This is often tried but never. I think this would give a far better yield than the infragluteal fold excision or the buttock fold excision. Gozil R. V-shaped sacral triangle . 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. Sorry for your problem. amniotic fold the folded edge of the amnion where it rises over and finally encloses the embryo. An understanding of the anatomy of the gluteal region is essential in the evaluation and planning of surgery ( Fig. Shorter, less dimpled, and tight skinned buttocks are smoothly wider and better projecting at the mid-level. 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. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. Fee $6,000+ Best to virtual consult with. S3 provides innervation to the infragluteal fold . Sorry for your problem. It is one o…THE IGF. The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. Other procedures commonly done include lifts and changing the infragluteal fold length. 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 []. 5). This study focuses on the histological comparison of creases of the trunk and participation of the elastic fibers in their formation. 4). Flap reconstruction is efficient in severe cases of infragluteal fold deformity (5), but the low patient acceptance of the subsequent scars limits its application. The infragluteal folds and perineal region were treated with the patient in a prone jackknife position. circular f's the permanent. After the fat graft, thread lifting is performed considering the vector. 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. fold both histologically and anatomically. 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 therapy was found comfortable with a high satisfaction rate. 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 final result should be to attain a waist-to-hip ratio (WHR) close to 0. Grade II: The infragluteal fold is angulated downward, flattening at the lower 1/3 of buttock. Ozmen S. In the process of r. The procedure is indicated in patients with mild buttock ptosis with excess skin and subcutaneous tissue in the inferior gluteal fold or “banana fold. With this technique, the deepithelialized crescent-likeThe infragluteal fold/thigh junction (lower gluteal cleavage) also requires definition. The histologicalCreation of an infra gluteal fold is done in the same fashion as the medial thigh tuck first described by Ted Lockwood, M. 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. Search worldwide, life-sciences literature Search. In type 1 buttock ptosis the infragluteal Read More…Background: The shape of the buttocks can take on many different forms. This is a difficult area to fix. 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. The surgical anatomy of the subcutaneous screen on the gluteal region has aroused the interest of plastic surgeons because of the increasing. 2) Excision of the infragluteal overhang is the definitive and assorted treatment of lower buttock ptosis. The invasive nature of venography has led to the investigation of noninvasive imaging modalities for diagnosis of pelvic congestion syndrome. The procedure can be performed as a single procedure or as in cases of massive weight loss in the context of a lower body lift (circumferential abdominoplasty, belt. 3 An aged buttock region is marked. Also evaluate the angle of the infragluteal fold. 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. An injury specifically to the inferior gluteal nerve, which supplies the gluteus maximus muscle, results in weak extension of the hip. The infragluteal fold is where the bottom of the buttock meets the upper thigh. Considering its widespread innervation and many collateral branches, PFCN neuropathy has been commonly reported, primarily due to iatrogenic etiology. 2. situated between the buttocks… See the full definitionBackground: Anatomical features that make the buttocks attractive include adequate volume, projection, and a defined infragluteal fold. This study reevaluated the fold both histologically and anatomically. 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 would go from the outer buttock fold and into the groin and possibly communicate with your prior thigh lift. ” 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. 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. Additionally, I agree that a lower buttock tuck with the results scar is probably not the best of options for you. Does it have a downward 45º angle, run horizontally, or have an inverted upward. Influence of the Recipient Site on the Outcomes of Fat Grafting in Facial Reconstructive Surgery. 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 . Care is taken not to remove the subcutaneous tissues at the level of the infragluteal crease. Five fixed cadavers were used. Infragluteal fold excision can be performed either before or after implantation (Fig. An anatomical study demonstrated that the perineal branch of. Each buttock section has its own distinct shape. We describe an optimized and individualized approach for injecting the collagen biostimulator PLLA in the gluteal region according to the needs of each patient. Its inferior border is formed by the insertions of the semitendinous muscle and the long belly of the biceps femoris in the ischial tuberosity. 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 inframammary crease 5,13 lies o ver the fifth to sixth ribs. The anatomical study. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Ranch & Coast founder, Dr. Therefore, indications for buttocks lifts range from subtle aesthetic reasons to a major recontouring following bariatric surgery. Skin creases of the trunk 1 (Fig 1) include the inframammary crease, the suprapubic crease, the oblique skin crease of the groin, and the infragluteal crease. Conclusion: Focused ultrasound is a safe, effective and well tolerated procedure for remodelling areas of the body. 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]. Medicine. The region of the infragluteal fold has been generally ignored or inadequately treated. Infragluteal fold. C3 provides innervation to the supraclavicular fossa . Tissue samples (6 cm long x 2 mm thick) were taken. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Cárdenas The infragluteal fold is one of the major concerns in reshaping of the gluteal region. A large redundant infragluteal crease probably cannot be repaired easily. Short gluteal fold. 6+/-0. Five fixed cadavers were used. This study reevaluated the fold both histologically and anatomically. 3 Excerpts; Save. 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 4 (mild ptosis): the gluteal tissue passes over the infragluteal fold at the M line; on the lateral view, we evaluate the angle of the skin fold at the infragluteal fold; in Grade 4, the angle is less than 10°. The range of indications for buttocks lifting includes discreet ptosis, moderate skin laxity in the gluteal or trochanteric areas, asymmetry, double infragluteal fold, long buttocks, and even the deformities that follow significant weight loss. The ideal candidates for FCI flap for breast reconstruction, as for any other free flaps, are non-smokers and non-obese patients. The appropriately selected gluteal implant is folded in half. Save. Hope this helps!Artistic rendition of relevant anatomy of the infragluteal approach. 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. Its inferior border is formed by the insertions of the semitendinous muscle and the long belly of the biceps femoris in the ischial tuberosity. 1. The surgical anatomy of the subcutaneous screen on the gluteal region has. MWL patients usually present with this negative angle and might need lifting procedures with or without skin resection at the infragluteal. A photograph or two of the area would be extremely helpful in determining what the problem may be and thus the solution, if any. The buttock skin and subcutaneous tissue were advanced superiorly and rotated medially to tighten the buttocks, lateral thigh, and posterior thigh. The structure of the infragluteal fold and the degree of ptosis are the main factors that determine the aesthetic appearance. 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. Limits implant movement. 00 µm). The inclusion criteria was ptosis of the lower pole of buttocks. ResultsThe infragluteal fold is a connectival fibrous band. In contrast, a shorter infragluteal fold contributes to a full, taught, and youthful buttock [Babuccu O. Sagging of redundant skin and fat below the infragluteal fold is commonly observed in bariatric patients following massive weight loss and defines. In my humble opinion you need nothing surgical. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. Both volume and projection of the buttocks may be improved. Retrospectively, however, it is clear that a better lifting effect and gluteal shortening could have been achieved if a longer scar had been used along the infragluteal fold for the patients in Figs. . Butt tuck surgery help people attain rounder, smoother and natural-looking buttocks. The need for liposuction of the lower back or hips is considered. 15. Expand 6 A gluteal ptosis classification scheme has also been devised by Mendieta, which is similar in design to that of breast ptosis described by Regnault. 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 []. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. buttock, infragluteal fold, or hips often produces sub-optimal aesthetic results. A. Tissue samples (6 cm long 9 2 mm thick) were taken at three points from each fold bloc: the most medial point, the middle. 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 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). Most patients had a deep infragluteal fold. implant. 5 Mendieta’s ptosis evaluation utilizing skin fold angles for classification. 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. A V-shaped proximal gluteal crease was accentuated by the. This is a difficult area to fix. From 1985 until 1995, this infragluteal flap has been used to widen the vaginal introitus in 6 patients, to reconstruct the labia majora in 5, to close a rectovaginal fistula in 4, and. 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 . Red line. By adding more volume on the left and matching the right, the fold will appear as a result of this added volume. 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. Once the shapes are more symmetric, volume enhance can be done on both sides simultaneously. Background: Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in aesthetic defect of gluteal contour. 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. 这个皱褶并不反映臀大肌的下缘，有肌肉表面与深筋膜的纤维性连接，起源于臀部内侧三分之一的真皮，以坚固的隔膜形式与臀筋膜交织在一. The inframammary crease 5,13 lies o ver the fifth to sixth ribs. A. Outer/Lateral Thigh Lift. 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. Five fixed cadavers were used. 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. The lateral length of the infragluteal fold measures the degree of buttocks ptosis. 23. 39. 45 This results in a ptotic butt if it is longer. Tissue samples (6 cm long x 2 mm thick) were taken. The infragluteal fold, which is one of the main determinants for gluteal attractiveness, is located in this unit . The ischial region is the site most affected by pressure sores and has the highest recurrence and complication rates compared to other affected sites. Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in esthetic defects in the gluteal contour ( 5 ). Patients with an apparent and angular infragluteal fold with skin drooping below it are classified as having Grade II ptosis. ResultsThe infragluteal fold is a connectival fibrous band. 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. 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. Once the fat has infiltrated, any PAL device can be used to equalize (distribute) the infiltrated fat (Images 15. 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 . What separates the lower buttocks from the other two sections is the infragluteal fold. The buttocks have three different sections, the upper buttock, the mid buttock, and the lower buttock. It was not until 1973 that gluteal augmentation was performed for cosmetic purposes. The lateral border of the gluteus maximus muscle is easier to identify when the patient internally rotates the thigh. Dr. Anterior viewIn a large buttock, the infragluteal fold is more horizontal and assumes an upward inverse slope (negative angle). 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 superior border is formed by the lower border of the gluteus maximus. Answer: Double 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. Gluteal fat injection mortality is approximately 1/3000 patients. Abstract. The procedure would take approximately 4 hours to complete. 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. A long infragluteal fold can also be improved and a more youthful shape be obtained. The descending branches of the inferior gluteal vessels and its accompanying nerve enter the subcutaneous tissue of the gluteal thigh flap distal. 15. 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 . This study reevaluated the fold both histologically and anatomically. All patients showed an improved definition of the infragluteal fold, with a symmetric shape of the gluteal region. Indianapolis, Indiana. [1] The Vertical Technique This approach is performed vertically from above the IGF. On the other hand, some slight to moderate redundant infragluteal creases might be candidates for simple surgical repair. Infragluteal fold excision can be performed either before or after implantation . The history of butt augmentation, especially in gender diverse populations, has, unfortunately, seen. The infragluteal fold should stop in the midbuttock or slightly lateral, in which a short fold has a youthful appearance. The dissection and volume this flap provides are similar to that of the SGAP flap. 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. Save. Limited inferiorly by infragluteal fold. The infragluteal fold/thigh junction (lower gluteal cleavage) also requires definition. 1 Excerpt; Save. Save. Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in esthetic defects in the gluteal contour. Read more. The infragluteal fold length and definition play important roles in esthetically pleasing buttocks. Initially, percutaneous reduction was attempted through a small transverse incision in the infragluteal fold (figure 2). Severe infragluteal fold. 39. 4% of subjects reported increased muscle. the banana fold and the sensuous triangle is gained through the one incision on each side of the infragluteal fold. With sagging of the muscle belly, the infragluteal fold is decreased or lost, and atrophy of the buttock is obvious with time. The length and definition of the infragluteal fold play important roles in aesthetically pleasing buttocks. Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in esthetic defects in the gluteal contour . S4/5 In the perianal area, less than one cm. Dear Anna, judging from the picture posted on the forum, you seem to have buttock ptosis with a deep infra gluteal fold. Time and important weight variation. Therefore, it may be preferable to wait several months after implantation to determine the amount of skin resection necessary. These implants may be placed through bilateral supragluteal incisions, the infragluteal fold, or the intergluteal cleft incision. (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. 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. 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. 1. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. The key to success for this procedure is to. . If toomuch fullness exists, the area that should be a di-amond-shaped space is instead a straight line,which is much less appealing. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. thigh, IGD (infragluteal diamond), G (Gluteus) 123 246 Aesth Plast Surg (2023) 47:245–259. 6). On the left gluteal region, markings are shown for the muscle-fiber orientation for the gluteus maximus muscle. 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 Muffin Bottom consists of sculpting three different regions at one time, the infragluteal fold, the medial posterior thigh and the lateral posterior saddlebag region. The infragluteal fold incisions should always be closed by subdermal sutures, since these are the ports of entry of fat grafting, to prevent protrusion of fat or migration. The infragluteal fold is where the bottom of the buttock meets the upper thigh. 2010. Plastic surgeons often reduce buttock lift with an incision under the buttocks or in the infragluteal fold. from the bone to the skin. A case of using autologous fat transplantation to correct severe post-liposuction infragluteal fold deformity in a. From here we can easily access the lower gluteal area and the internal and external posterior thigh (Fig. . Chasan, partook in a study examining the results of the infragluteal thigh lift. 5 cm distal to the subgluteal fold, the sciatic nerve was consistently identified directly at the ventral end of the hyperechoic structure in all volunteers. Grade III: The skin. Infragluteal fold. 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. Flap reconstruction is efficient in severe cases of infragluteal fold deformity (5), but the low patient acceptance of the subsequent scars limits its application. While buttock sagging is a general term it has different types as defined by the level of the infragluteal fold. Expand. 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. 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. Does it have a downward 45° angle, run horizontally, or have an inverted. 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. 22), liposuction of the inner thigh and infragluteal area may be indicated. Tissue samples (6 cm long x 2 mm thick) were taken. An anatomical description of the infragluteal fold (IGF) matching radiological and anatomical findings in describing specifically raise of the fibrous component at the bone level is performed. In this way, it's similar to a general lower body lift. 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. 1) A shapely buttocks, regardless of its size, has an infragluteal crease that separates the buttocks from the posterior thigh. 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. It has been noted in multiple. 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. The patient’s position is prone or lateral decubitus. Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in esthetic defects in the gluteal contour. 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. Infragluteal fold. T1. A minor surgery: These are usually treated with a minor surgery, where the cyst, and it's entire lining, is removed. Infragluteal fold. 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. 1). Results: Our technique allows wide exposure for tumour resection and functional restoration of the pelvic floor while placing the scars in anatomical locations and restoring buttock. Open in a separate window. Tissue. It is the deep furrow or groove that lies between the two gluteal regions (commonly known as the buttocks). All patients showed an improved definition of the infragluteal fold, with a symmetric shape of the gluteal region. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. Asymmetric lifts and reduction are to be performed on the buttock to correct for your present symmetry. Results: The Buttocks' SLSS is composed by 5 clinical aspects of skin laxity graded from absent (0) to severe (3): buttocks ptosis, skin scalloped appearance, infragluteal fold, localized fat on the lower third of the buttocks, and linear depressed lesions. Peter Fisher M. 2. On the plantar surface of the foot, Gluteal fold we find the transverse lines and the longitudinal lines [1]. Note anterior abdominal wall. 1 Anatomy of the gluteus maximus muscle and deeper structure. CárdenasThe infragluteal fold is one of the major concerns in reshaping of the gluteal region. Fig. Complete 10 to 15 reps. 15. 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 infragluteal fold needs to be approached carefully, by suctioning just under the skin. A short infragluteal fold lying in the horizontal crease under the ischial tuberosity, which does not extend beyond the medial two-thirds of the posterior thigh. 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 (red lines) may have a downward slope (ideal with a well-defined diamond zone), be horizontal, or have an upward slope. Figure 6. Esthetic results can be individualized to patient’s wishes/expectations: by flap design (shape, width, length, thickness), by pocket dissection (shape, width, depth), and by flap fixation (sutures, infragluteal fold reconstruction). 4). It arises in the median gluteal crease and follows.