Shorter, less dimpled, and tight skinned buttocks are smoothly wider and better projecting at the mid-level. Liposhifting is a technique which free. The infragluteal crease is found in several terms such as the gluteal crease, the infragluteal fold , the infragluteal sulcus , the horizontal gluteal fold , the gluteal fold , the inferior buttock crease , the lower gluteal crease, and the inferior gluteal crease. 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. V-shaped sacral triangle . This supports the thigh tissue in its lifted position and enhances the infragluteal fold. Infragluteal fold. 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. 15. This study reevaluated the fold both histologically and anatomically. 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. This 5 cm gap between the caudal edge of the flap and the infragluteal fold can appear empty. 0+/-1. 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 "sensuous triangle" is found at the junction of the lateral buttocks, the lateral thigh, and the posterior thigh. unsatisfactory. 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 use of a deepithelialized. Butt tuck surgery help people attain rounder, smoother and natural-looking buttocks. Skin creases are features of major anatomical, morphological, surgical, and functional interest. &NA; Use of a local flap is often needed for closure of a defect in the. This is not a good benefits vs risk proposition. If ou still has residual excess skin and fat on the lower buttock and. 3). The lateral part of the gluteus maximus muscle tapers between the long head of the biceps femoris and the vastus lateralis muscles. The surgical anatomy of the subcutaneous screen on the gluteal region has aroused the interest of plastic surgeons because of the increasing. Outer/Lateral Thigh Lift. implant. 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. Tissue samples (6 cm long x 2 mm thick) were taken. The infragluteal fold is like a horizontal line. My recommendation would be getting better contour on the left before addressing the right. implant. Therefore, indications for buttocks lifts range from subtle aesthetic reasons to a major recontouring following bariatric surgery. 1 Anatomy of the gluteus maximus muscle and deeper structure. Increasing number of patients request body contouring and are increasingly aware of the numerous techniques now available for enhancing the gluteal region, which include the use of implants, autologous fat transfer, autologies, and combinations of more than one of these techniques often produce superior aesthetic. The infragluteal fold is one of the major concerns in reshaping of the gluteal region. PDF. Does it have a downward 45º angle, run horizontally, or have an inverted upward. These structures create the fixed, well-defined subgluteal sulcus [2]. It has been noted in multiple. excess skin just above the umbilicus, a redundant infragluteal fold and lack of gluteal projection. amniotic fold the folded edge of the amnion where it rises over and finally encloses the embryo. 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 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 (IGF) is a crucial anatomic landmark representing one of the major concerns in gluteal reshaping in plastic surgery. The infragluteal fold became less evident, the buttock mass was elevated, and augmentation was achieved with the maximum projection at midlevel of the gluteus. I hope this helps. Consistent features of beautiful buttocks: lateral depression, infragluteal fold, supragluteal fossettes. 2) The thin strips of skin and fat are worthless as grafts because of their very low volume. 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. The lateral border of the gluteus maximus muscle is easier to identify when the patient internally rotates the thigh. Fig. 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. 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. Although banana fold is a common problem, unrelished by most women, few procedures are targeted specifically to fight it. An injury specifically to the inferior gluteal nerve, which supplies the gluteus maximus muscle, results in weak extension of the hip. 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 fat graft is placed in the upper medial side for projection. It is critical to appropriately and systematically analyze the complex regional anatomy. The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. 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 would go from the outer buttock fold and into the groin and possibly communicate with your prior thigh lift. 11 The safest place to inject HA in the gluteal region is the subcu-Infragluteal fold created by the ischial tuberosity, the insertions of the semiten-dinous muscle and long belly of the biceps femoris, and the lower border of the gluteus maximus. Asymmetric lifts and reduction are to be performed on the buttock to correct for your present symmetry. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Open in new tab Download slide. While buttock sagging is a general term it has different types as defined by the level of the infragluteal fold. On the upper area, markings are shown for the gluteus medius muscle. It has been noted in multiple. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. The retromuscolar technique is preferred by patients requesting a natural, sporty result. Each buttock section has its own distinct shape. Does it have a downward 45° angle, run horizontally, or have an inverted. The “sensuous triangle” is found at the junction of the lateral buttocks, the lateral thigh, and the posterior thigh. situated between the buttocks… See the full definitionBackground: Anatomical features that make the buttocks attractive include adequate volume, projection, and a defined infragluteal fold. 5 and 6. Her operative photo shows a disproportionally increased amount of fat distributed along the lower third of her body, giving her a wide appearance. 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. 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. 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. Expand. 5 T) of the pelvic region. 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. The inferiorly oriented form of the muscle may be visible in males, but in. The ideal infragluteal cleft is none at all, but instead a smooth transition from buttocks to thigh. 4. circular f's the permanent. 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 patient’s position is prone or lateral decubitus. 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 ]. Does it have adownward 45º angle, run horizontally, or havean inverted. The infragluteal fold is one of the major concerns in reshaping of the gluteal region. FIG. 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 banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. This study reevaluated the fold both histologically and anatomically. Between 2. 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 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. Grade III ptosis has the most skin and volume below the fold, with significant skin laxity and a more angular infragluteal fold. Download scientific diagram | MRI sequence of the infragluteal fold with T1 VIBE MORPHO sequence (Thickness slice = 900. The major drawback of implant augmentation is the substantially high rate of complications associated with its techniques. 1 Excerpt; Save. TLDR. 23. com The infragluteal fold (IGF) is a crucial anatomic landmark representing one of the major concerns in gluteal reshaping in plastic surgery. What you are seeking is to have a uniform infragluteal crease on both sides. The posterior thigh is the area least requested for liposuction with the exception of the proximal infragluteal fold or so-called “banana fold. By adding more volume on the left and matching the right, the fold will appear as a result of this added volume. 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. A: Thank you for your inquiry and sending your picture. 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. In the anchor thighplasty technique, the medial thigh lift is extended posteriorly into the infragluteal crease. 5 Mendieta’s ptosis evaluation utilizing skin fold angles for classification. PMID: 15940397 DOI: 10. Four fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. The infragluteal fold is where the bottom of the buttock meets the upper thigh. 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 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]. S4/5 In the perianal area, less than one cm. The current trend is towards more fat grafting and less implant use, as fat grafting, when carefully applied, is seen as less likely to have complications. Some surgeons call this a removal of banana roll; more technically, it is an infragluteal fold incision for excision of upper posterior thigh. Perception of ideal buttocks varies across cultures. A Jackson Pratt drain is then placed in each implant pocket and brought out laterally in the infragluteal fold through a separate stab incision. The skin perforators of the pudendal artery were marked with a Doppler probe in the medial region of the gluteal fold. 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. Care must be taken when completing the last portion of the. Infragluteal fold. Sorry for your problem. Incisions with ports sutured in place on the superior intergluteal crease and over the mid inferior gluteal point bilaterally. 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. This is not a good benefits vs risk proposition. A V-shaped proximal gluteal crease was accentuated by the. By means of MR imaging of volunteers and dissection of fresh cadavers, a here presented study revealed the infragluteal fold as a connectival fibrous band extending from the ramus of the ischium, the coccyx and the apex of sacrum, without significant. Butt tuck surgery help people attain rounder, smoother and natural-looking buttocks. 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. loss of the infragluteal fold [7]. 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. Time and important weight variation. Conclusion: Focused ultrasound is a safe, effective and well tolerated procedure for remodelling areas of the body. C2 – At least one cm lateral to the occipital protuberance at. A banana fold may form for different reasons, among which an iatrogenic cause is recurrent. Liposhifting is a technique that. The superior border is formed by the lower border of the gluteus maximus. 3), the buttock contour has a smooth C shape, without depression and ptosis. The infragluteal fold is one of the key elements that determines the gluteal contour and is recognized as an important characteristic of female beauty . 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. 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. The gluteal region in patients with massive weight loss after gastric bypass is characterized by. 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. fold is also included in this project in comparison with the inframammary, infragluteal, and inguinal creases. 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. 2) Excision of the infragluteal overhang is the definitive and assorted treatment of lower buttock ptosis. Additionally, I agree that a lower buttock tuck with the results scar is probably not the best of options for you. 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 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. We recommend the lower buttock lift for patients who suffer from sagging skin beneath the lower fold of their buttocks (the infragluteal fold). Cadaveric dissection reveals that the IGF is a connective fibrous band extending from the ramus of the ischium, the apex of the sacrum, and the coccyx, to the. The power of this technique is granted through the lengthened anteroposterior. 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. A longer infragluteal fold suggests an aged, ptotic, and deflated-looking buttock with skin and fascial excess. Also known as the Dimples of. The muffin bottom can be sculpted using the tumescent technique under either IV sedation or general anesthesia. Since you already have a belt lipectomy or a 360 circumferential lower body lift, the skin and fat of the buttocks have already been raised. The "sensuous triangle" is found at the junction of the lateral. A longer infragluteal fold suggests an aged, ptotic, and deflated-looking buttock with skin and fascial excess. A case of using autologous fat transplantation to correct severe post-liposuction infragluteal fold deformity in a. Also evaluate the angle of the infragluteal fold. Time and important weight variation consid- erably affect this region combined with the gravity’s effect. Limited inferiorly by infragluteal fold. 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. 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. PAP flap breast reconstruction leads to improved aesthetic proportions of the proximal thigh and buttock, ideal for patients with ptotic tissue of the inferior buttocks and medial thigh, a poorly defined infragluteal fold, and inadequate anterior-posterior buttock projection. Buttock ptosis or sag can also occur when the infragluteal fold attachments are lost or disrupted. 6+/-0. Therefore, it may be preferable to wait several months after implantation to determine the amount of skin resection necessary. 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. Thus, buttock ptosis is simply gluteal tissue below the skin fold, or infragluteal crease. Furthermore, a diamond-shaped space should be formed between the gently sloping infragluteal fold and the inner thigh. Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in esthetic defects in the gluteal contour. It has been noted in multiple. The infragluteal fold should stop in the midbuttock or slightly lateral, in which a short fold has a youthful appearance. It arises in the median gluteal crease and follows a. The infragluteal fold is one of the key elements that determines the gluteal contour and is recognized as an important characteristic of female beauty . 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 was marked as the lower limit to ensure preservation of the structure and thus avoid ptosis of the gluteal mass and implant displacement. With this technique, the deepithelialized crescent-likeThe infragluteal fold/thigh junction (lower gluteal cleavage) also requires definition. Helpful Barry L. 15. Le Louarn and Pascal’s incision was made horizontally along the inguinal fold without descending into the gluteal crease; they also treated the excess fat with liposuction and the skin laxity with serial resections. 1. D. The final result should be to attain a waist-to-hip ratio (WHR) close to 0. I hope this helps. This corrects the article "Vectorial Treatment of Infragluteal Fold" in volume 11, e4750. Save. Search worldwide, life-sciences literature Search. This study focuses on the histological comparison of creases of the trunk and participation of the elastic fibers in their formation. The iatrogenic forms of banana fold and sensuous triangle deformity are produced by excessive. 15. In the article “Vectorial Treatment of Infragluteal Fold,” published as e4750 on January 11,. In the ideal buttock, the infragluteal fold should end. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. 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. However, one of its key-component, the infragluteal fold, has not yet been clearly defined. A thigh lift is a procedure that involves the removal of excess skin and fat from either the inner or outer thighs. Urinary and bowel. Four fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. And placing such a graft always runs the risk of causing an infection. 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 most cases, the infragluteal fold ends at the midpoint of the inferior buttock. 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. Note anterior abdominal wall. 6 Innervation The sciatic nerve is the largest nerve in the human body, measuring around 2 cm in diameter in adults. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. L3 provides innervation to the medial femoral condyle . 2). A. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Save. Infragluteal fold reconstruction is achieved by reconstruction of the buttock’s sustaining apparel through deepithelialized skin flaps anchored to deep gluteal fascia. Excess tissue was removed, and wound closure was performed in multiple layers. The region of the infragluteal fold has been generally ignored or inadequately treated. Eppley, MD, DMDIn some instances, insertion of a buttock implant with a subsequent infragluteal-fold skin excision can be beneficial. The "sensuous triangle" is found at the junction of the lateral. You have a beautiful result after the fat grafting and the “tuck” of the infragluteal fold may be messed up forever, doing direct incision. It has been noted in multiple. For this we have applied. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. 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. Abstract. She underwent liposculpture using the tumescent technique with infiltrated fluid, sodium chloride, epinephrine and Lidocaine in the. One can not liposuction between the two and create a single infragluteal crease. Although the gluteal shape is open to the effects of demographic factors such as ethnicity, feeding habits, and lifestyle, according to these findings, it might be advised that in the assessment of the gluteal region. Procedure. 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. D. The treatment should not focus on the central and lower. The inclusion criteria was ptosis of the lower pole of buttocks. A flap involving the whole gluteal area was dissected superficially to the gluteal fascia. In my humble opinion you need nothing surgical. The author tried not to trespass the thigh midline with the incision along the 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. The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. 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. Tissue samples (6 cm long x 2 mm thick) were taken. in· tra· glu· te· al -ˈglüt-ē-əl, -glü-ˈtē-əl. Popularity of injectable fillers. 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. In my humble opinion you need nothing surgical. The infragluteal area may be slightly improved after buttock augmentation resulting in less of a requirement for skin resection. Figure 6. 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. Save. Hello and thank you for your question. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. Tissue samples (6 cm long x 2 mm thick) were taken. 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. Patients with an apparent and angular infragluteal fold with skin drooping below it are classified as having Grade II ptosis. Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in esthetic defects in the gluteal contour . Grade II: The infragluteal fold is angulated downward, flattening at the lower 1/3 of buttock. I think this would give a far better yield than the infragluteal fold excision or the buttock fold excision. A minor surgery: These are usually treated with a minor surgery, where the cyst, and it's entire lining, is removed. Since its initiation, this technique has proven to be both clinically and cost-effective, with demonstratable benefits achieved with a lower. Good luck. Infragluteal fold excision can be performed either before or after implantation (Fig. (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. Before the Implantation. 5, irrespective of the magnitude. 1). Once the shapes are more symmetric, volume enhance can be done on both sides simultaneously. ResultsThe infragluteal fold is a connectival fibrous band. Anterior viewIn a large buttock, the infragluteal fold is more horizontal and assumes an upward inverse slope (negative angle). The descending branches of the inferior gluteal vessels and its accompanying nerve enter the subcutaneous tissue of the gluteal thigh flap distal. Hello and thank you for your question. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. 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. We report a case of using autologous fat transplantation to correct severe post-liposuction infragluteal fold deformity. 39. The histologicalCreation of an infra gluteal fold is done in the same fashion as the medial thigh tuck first described by Ted Lockwood, M. The infragluteal fold, which The concept of the ideal shape for the gluteal region has attaches to both the ischium and the sacrum in a continuous changed over time and over cultures and still is evolving. 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. 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 . This horizontal crease is under the ischial tuberosity. An understanding of the anatomy of the gluteal region is essential in the evaluation and planning of surgery ( Fig. The aesthetic line of the infragluteal fold should generally be short, no longer than the. Once the fat has infiltrated, any PAL device can be used to equalize (distribute) the infiltrated fat (Images 15. Cocke and Ricketson were the first to describe placing silicone breast implants in the subcutaneous plane with less than optimal results. 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 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. Barry Eppley. A. No major complications or. 3) The length of the lower buttock lift excision should ideally not go beyond the. S2 S1 S3 S4/5. The "banana fold," or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. 51. 44 The infragluteal fold is an important indicator of gluteal aesthetics. The only way to create a sharper erase/line at the underside of the buttocks is an excisional tuck, making the existing infragluteal fold deeper. Sensory fibers from a dermatome and cutaneous nerves provide innervation to the gluteal region. Point “C” is marked in the center of the buttock, 3 cm above the infragluteal fold. 23. Detailed Procedure Information. 3) A lower buttock lift, better defined as a buttock tuck, removes loose skin and creates an infragluteal line. fold both histologically and anatomically. 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. 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. &NA; The ideal skin‐flap reconstruction provides functional preservation and a good cosmetic outcome in both the. 3 Excerpts; Save. 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. But so doing it may also make your buttocks look a little less full because its roundness is decreased. 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. 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. All patients showed an improved definition of the infragluteal fold, with a symmetric shape of the gluteal region. Hope this helps!Artistic rendition of relevant anatomy of the infragluteal approach. 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. Fig. 5 cm, 3-month follow-up). 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 need for liposuction of the lower back or hips is considered. 2 Patient Selection. 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 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. A banana fold may form for different reasons, among which an. Subscribe Now:More:exercise to define. The infragluteal fold length and definition play important roles in esthetically pleasing buttocks. Combining Gluteal Shaping with High-Definition Liposuction. Both volume and projection of the buttocks may be improved. Tissue samples (6 cm long x 2 mm thick) were taken. 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. 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. Lower body lift procedures remove excess skin and lift sagging buttock tissue. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Medicine. 39. 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 therapy was found comfortable with a high satisfaction rate. A large redundant infragluteal crease probably cannot be repaired easily. 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 ). dermal flap will be performed for lifting the ptotic buttocks with ill-defined infragluteal fold. D2 and D3 are located in the posterior portion. The length and definition of the infragluteal fold play important roles in aesthetically pleasing buttocks. PDF. With your feet shoulder width apart, place your hands on the barbell (whether on lifting blocks or in a Smith machine), with your palms either over or under the bar. 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. amniotic fold the folded edge of the amnion where it rises over and finally encloses the embryo. Infragluteal fold revision Buttock lift The author prefers tostageexcisionalcontouring procedures in association with gluteal implants. The flaps are undermined by only one cm. The mid-buttock is also divided into a central and an outer zone which usually has a depression. 88 and 3 cm in the circumference of the abdomen, hips and thighs, respectively. 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. Liposhifting is a technique that. Five fixed cadavers were used. FIG. 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.