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. Dr. No adverse events were recorded. Also evaluate the angle of the infragluteal fold. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. The infragluteal fold region is the lower edge of the buttocks. 6 The infragluteal area is a support zone for the buttock, and treatment of this area with liposuction should be avoided. The ischial region is the site most affected by pressure sores and has the highest recurrence and complication rates compared to other affected sites. More superficially, the infragluteal fold is formed by the fascial insertions into the skin. 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. Therefore, it may be preferable to wait several months after implantation to determine the amount of skin resection necessary. Procedure. Created for people with ongoing healthcare needs but benefits everyone. The average width of the skin excision was 8 cm and the average length was 25 cm. Additionally, I agree that a lower buttock tuck with the results scar is probably not the best of options for you. 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. &NA; The ideal skin‐flap reconstruction provides functional preservation and a good cosmetic outcome in both the. 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. 1 Excerpt; Save. Also evaluate theangle of the infragluteal fold. The advantage is that the posterior thigh is lifted and ptosis of the caudal buttock can be corrected. This was sculpted for a national television program recently. A, C, E, Preoperative views of a 50-year-old woman who complained of decreased gluteal projection and buttock ptosis after suction-assisted lipoplasty. The final result should be to attain a waist-to-hip ratio (WHR) close to 0. The infragluteal fold is one of the key elements that determines the gluteal contour and is recognized as an important characteristic of female beauty . This study reevaluated the fold both histologically and anatomically. gluteal fold: [ fōld ] plica; a thin margin curved back on itself, or doubling. 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. Procedure. Each buttock section has its own distinct shape. The procedure would take approximately 4 hours to complete. 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. Flap reconstruction is efficient in severe cases of infragluteal fold deformity (5), but the low patient acceptance of the subsequent scars limits its application. Open in a separate window. 1). The infragluteal fold is one of the major concerns in reshaping of the gluteal region. Urinary and bowel. The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. Clinical Presentation. It arises in the median gluteal crease and follows a. Tissue samples (6 cm long x 2 mm thick) were taken. Butt tuck surgery help people attain rounder, smoother and natural-looking buttocks. Key elements to be evaluated include the infragluteal crease, the gluteal fold and the outer thigh skin fold [28]. It is one o…THE IGF. A V-shaped proximal gluteal crease was accentuated by the. Purpose The gluteal region is a key element of beauty balance and sexual appearance. The procedure would take approximately 4 hours to complete. Indeed once this area is damaged, typically by liposuction, it is tricky to fully repair and re-create the normal infragluteal fold again. 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. This study reevaluated the fold both histologically and anatomically. 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. Infragluteal fold. excess skin just above the umbilicus, a redundant infragluteal fold and lack of gluteal projection. 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. 4). 5). Severe infragluteal fold. Five fixed cadavers. The structure of the infragluteal fold and the degree of ptosis are the main factors that determine the aesthetic appearance. The length and definition of the infragluteal fold play important roles in aesthetically pleasing buttocks. Expand. This study reevaluated the fold both histologically and anatomically. 2, 3, 4. The descending branches of the inferior gluteal vessels and its accompanying nerve enter the subcutaneous tissue of the gluteal thigh flap distal. 3) A lower buttock lift, better defined as a buttock tuck, removes loose skin and creates an infragluteal line. The therapy was found comfortable with a high satisfaction rate. The posterior femoral cutaneous nerve (PFCN) is an extensive nerve with numerous collateral branches which provide cutaneous innervation to 2/3rds of the posterior thigh, the infragluteal fold, as well as the lateral anal region, scrotum, and labia majora through its inferior cluneal and pudendal nerve branches. 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 anterior axillary fold is also included in this project in comparison with the inframammary, infragluteal, and inguinal creases. Does it have a downward 45º angle, run horizontally, or have an inverted upward. The superior tip of the intergluteal cleft. PDF. 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. Infragluteal fold. The infragluteal fold has been reconstructed, leading to an aesthetic appearance of the gluteal region soft tissue (skin and fat) will often lead to disappointing biceps femoris laterally since this is the natural ending of results, including wide scarring, recurrence of ptosis, and the fold [2]. 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, 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. Cosmetic surgery of the buttocks contemplates not only changes in volumes but also (and above all) a redefinition of the contours. 2. It is the deep furrow or groove that lies between the two gluteal regions (commonly known as the buttocks). The medial part of the infragluteal fold is formed by a fat pad that covers the inferior medial border of the gluteus maximus muscle. Once the fat has infiltrated, any PAL device can be used to equalize (distribute) the infiltrated fat (Images 15. T1. intragluteal injection. fold both histologically and anatomically. Ranch & Coast founder, Dr. By utilizing an FCI flap for the reconstruction of a contour deformity in the region, the gluteal sulcus can be sufficiently reconstructed, and a pleasing buttock. All patients showed an improved definition of the infragluteal fold, with a symmetric shape of the gluteal region. The ischial region is the site most affected by pressure sores and has the highest recurrence and complication rates compared to other affected sites. Poorly placed incisions also detract from the gluteal aesthetic. We recommend the lower buttock lift for patients who suffer from sagging skin beneath the lower fold of their buttocks (the infragluteal fold). This can include excess weight that has accumulated in the waist and buttock area. A banana fold may form for different reasons, among which an iatrogenic cause is recurrent. The average width of the skin excision was 8 cm and the average length was 25 cm. It extends from sacral level S3 or S4 and ends just inferior to the apex of the sacrum, at the level of the anus. 2 Patient Selection. The inframammary crease 5,13 lies o ver the fifth to sixth ribs. These implants may be placed through bilateral supragluteal incisions, the infragluteal fold, or the intergluteal cleft 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. Answer: Double gluteal fold. The width of the flap and. Barry Eppley. The infragluteal fold is one of the key elements that determines the gluteal contour and is recognized as an important characteristic of female beauty . A banana fold may form for different reasons, among which an. The infragluteal fold is one of the major concerns in reshaping of the gluteal region. 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 fold/thigh junction (lower gluteal cleavage) also requires definition. For a negative upward slant (see Fig. Unfortunately liposuction of the banana roll can cause additional lines to form which is why I avoid liposuction in that area if possible. The mid-buttock is also divided into a central and an outer zone which usually has a depression. The gluteal sulcus is formed by the posterior horizontal skin crease of the hip joint and overlying fat and is not formed by the lower border of the gluteus maximus muscle, which crosses the fold obliquely. Reply: Staying Safe during Gluteal Fat Transplantation. 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. The lateral part of the gluteus maximus muscle tapers between the long head of the biceps femoris and the vastus lateralis muscles. 24 The ideal direction of the infragluteal fold from medial to lateral is downward sloping. These considerations guide the technique, which includes three distinct approaches for PLLA injection based on patient input regarding the most. The "sensuous triangle" is found at the junction of the lateral. The power of this technique is granted through the lengthened anteroposterior scar and. 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. TLDR. The cannula should have one orifice and be thick (4 or 5 mm), long (32 cm), and directed to the IGF and beyond. 34 Ramanadham and Rohrich 35 showed that, in the face, volume is lost and the tissues sag down toward the central line as we age, producing jowls and marionette lines, which are signs of an aging face. The inferior border of the infragluteal fold is formed by the insertions of the semitendinous muscle and the belly of the biceps femoris. Two supragluteal fossettes (or dimples) on either side of the medial sacral crest which correspond to the posterior superior iliac spines. If too much fullness exists, the area that should be a diamond-shaped space is a straight line, which is much less appealing. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. S4/5 In the perianal area, less than one cm. 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 buttock can be infiltrated through the superior gluteal mid-incision, although infiltration can also be performed through the infragluteal fold. Plastic surgeons often reduce buttock lift with an incision under the buttocks or in the infragluteal fold. 39. It arises in the median gluteal crease and follows. Read more. This would go from the outer buttock fold and into the groin and possibly communicate with your prior thigh lift. For this we have applied a pedicled skin flap raised in the infragluteal fold, the technical details and surgical results of which are presented in this paper. The main difference with our technique is the design. 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. Zone 3: Proximal inner thigh confluences with Zone 1 to recreate a round buttock and follow the infragluteal fold. An anatomical study demonstrated that the perineal branch of. The gluteal region in patients with massive weight loss after gastric bypass is characterized by. Plan on a 2-3 week recovery. 1). 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. D1 has a posterior and a posteromedial surface. 臀下皱襞支撑性解剖学与美学研究进展. The lateral length of the infragluteal fold measures the degree of buttocks ptosis. Download : Download full-size image; Figure 6. It is then carried inferiorly over the greater trochanter to the level of the gluteal fold. PDF. Results: After treatment, there was an average reduction of 4. 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. Gozil R. 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. 3 An aged buttock region is marked. Peter Fisher M. Thomas Fiala answered. 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 infragluteal fold should stop in the midbuttock or slightly lateral, in which a short fold has a youthful appearance. 6+/-0. The key to success for this procedure is to. in· tra· glu· te· al -ˈglüt-ē-əl, -glü-ˈtē-əl. 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 infragluteal fold needs to be approached carefully, by suctioning just under the skin. The infragluteal fold- thigh junction (lower gluteal cleavage) also requires definition. In the present, precisely for this reason, it is believed that dissection should reach the level of the infragluteal fold. The short answer is yes. Fig. Methods: Six volunteers (three males and three females) underwent an MRI scan (Siemens Aera® 1. Initially, percutaneous reduction was attempted through a small transverse incision in the infragluteal fold (figure 2). A. Four fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. Infragluteal fold excision can be performed either before or after implantation . 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. 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 procedure is indicated in patients with mild buttock ptosis with excess skin and subcutaneous tissue in the inferior gluteal fold or “banana fold. Save. 2. Most patients had a deep infragluteal fold. Buttock ptosis or sag can also occur when the infragluteal fold attachments are lost or disrupted. In contrast, a shorter infragluteal fold contributes to a full, taut, and youthful-looking buttockFour fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. 6. Infragluteal fold. 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 . 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. PMID: 15940397 DOI: 10. Tissue samples (6 cm long x 2 mm thick) were taken. My recommendation would be getting better contour on the left before addressing the right. T3 provides innervation to the midclavicular line . Characteristic features include short intergluteal cleft, flattened buttocks, narrow hips, distal leg atrophy, and talipes deformities. 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. Eppley, MD, DMDIn some instances, insertion of a buttock implant with a subsequent infragluteal-fold skin excision can be beneficial. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. But so doing it may also make your buttocks look a little less full because its roundness is decreased. Waves and dimples can be improved down to the infragluteal fold at the junction to the thigh. 6 Those patients with some buttock volume and skin falling slightly below the infragluteal fold are described as having Grade I ptosis. Common Butt Lift Factorslaterally, resulting in a long 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. The inclusion criteria was ptosis of the lower pole of buttocks. Dr. 3), the buttock contour has a smooth C shape, without depression and ptosis. Five fixed. In either case, a lower buttock lift or tuck is done to remove the overhanging tissues and recreate a fixed infragluteal fold position. 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 became less evident, the buttock mass was elevated, and augmentation was achieved with the maximum projection at midlevel of the gluteus. The upper-inner thigh holds a high stem. 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. . The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. This causes movement of the infragluteal sulci in downward and lateral directions as well as lengthening of intergluteal sulcus. Oh et al 26 recently demonstrated a shortening of the infragluteal fold by performing a thread lift with an elastic silicone-polyester thread. 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. Infragluteal fold The creases on the plantar surface of the foot are not as Infragluteal sulcus complex or constant or so well marked as on the palmar Horizontal gluteal fold surface of the hand [1]. 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. Five fixed cadavers were used. Tissue samples (6 cm long x 2 mm thick) were taken. Normally, its mean length is equal to the intergluteal fold length or 2/3 of it. 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 []. 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. Search for termsThis area is known as a safety triangle with its apex between the sacral dimples and its base along the medial two-thirds of the infragluteal fold, on both sides. Undermining will not go beyond the infragluteal fold, so it is important to place the template 2 cm above the fold (Figure 6). 44 The infragluteal fold is an important indicator of gluteal aesthetics. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. FIG. 2) The thin strips of skin and fat are worthless as grafts because of their very low volume. Many of the early proponents of the procedure were not open to discussing complications. 1) A shapely buttocks, regardless of its size, has an infragluteal crease that separates the buttocks from the posterior thigh. Good luck. Notice in the center photograph that a fuller. Its exact dimensions, including its thickness, are determined by the volume of tissue deemed necessary to fill out the buttock contour. Superiorly it is formed by the lower border of the gluteus maximus. &NA; Use of a local flap is often needed for closure of a defect in the. The dissection and volume this flap provides are similar to that of the SGAP flap. infragluteal fold [2–4]. Annotations in Figures 4 to to6 6 highlight improvements in skin condition and localized depression, improvement of gluteal shape, and shorter infragluteal fold, thus representing successful treatment. The inframammary crease 5,13 lies o ver the fifth to sixth ribs. Results were maintained at 6 months. The descending branches of the inferior gluteal vessels and its accompanying nerve enter the subcutaneous tissue of the gluteal thigh flap distal. What separates the lower buttocks from the other two sections is the infragluteal fold. A banana fold may form for. Hope this helps!Artistic rendition of relevant anatomy of the infragluteal approach. The invasive nature of venography has led to the investigation of noninvasive imaging modalities for diagnosis of pelvic congestion syndrome. 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. 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. This is a horizontal crease under the ischial tuberosity. It has been noted in multiple. International Standards for the Classification of Spinal Cord InjuryShe also had infragluteal fold or the infragluteal banana roll. dermal flap will be performed for lifting the ptotic buttocks with ill-defined infragluteal fold. After 1 year, she under- gluteal fascia. 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. Our technique allows for the. The “banana fold,” or the infragluteal fold, is a fat deposit on the posterior thigh near the gluteal crease and parallel to it. 10 The Mendieta and Sood classification is demonstrated in Fig. 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. Buttock Lifting Using Elastic Thread (Elasticum®) with a New Classification of Gluteal Ptosis. com The infragluteal fold (IGF) is a crucial anatomic landmark representing one of the major concerns in gluteal reshaping in plastic surgery. Here, it continues to the midline of the thigh (halfway between the greater trochanter and the ischial tuberosity). 3) The length of the lower buttock lift excision should ideally not go beyond the. 15. Grade II ptosis includes moderate skin and volume below the fold, with a more angular infragluteal fold moving inferomedially from the lateral thigh. The infragluteal fold is where the bottom of the buttock meets the upper thigh. Point “C” is marked in the center of the buttock, 3 cm above the infragluteal fold. 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 technical details and surgical results of a pedicled skin flap raised in the infragluteal fold, used to widen the. Then other planes are created using the same cannula in different trajectories, always from the deeper aspect to the more superficial plane. The infragluteal fold on the right side was explored by dissection, whereas the infragluteal fold of the contralateral side was removed en bloc. Patients with a long buttock may. All patients showed an improved definition of the infragluteal fold, with a symmetric shape of the gluteal region. Unit D has six subunits (D1–D6). CárdenasThe infragluteal fold is one of the major concerns in reshaping of the gluteal region. Sorry for your problem. Save. The infragluteal fold became less evident, the but- buttock lift and augmentation with the dermal fat flap tock mass was elevated, and augmentation was achieved described was performed, resulting in correction of the with the maximum projection at midlevel of the gluteus. 00 µm). The lower buttock is the most difficult area to address. Superiorly it is formed by the lower border of the gluteus maximus. We define unaesthetic buttock ptosis as sagging. &NA; Use of a local flap is often needed for closure of a defect in the perineogenital area. amniotic fold the folded edge of the amnion where it rises over and finally encloses the embryo. In most cases, the infragluteal fold ends at the midpoint of the inferior buttock. 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. Helpful Barry L. A minor surgery: These are usually treated with a minor surgery, where the cyst, and it's entire lining, is removed. Infragluteal fold. Fig. 12. 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 (Figure 4). Five fixed cadavers were used. 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. The posterior thigh is the area least requested for liposuction with the exception of the proximal infragluteal fold or so-called “banana fold. A thigh lift is a procedure that involves the removal of excess skin and fat from either the inner or outer thighs. 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. A more objective, faster and shorter version of this scale, to be evaluated. The inframammary crease 5 , 13 lies over the fifth to sixth ribs. Patients with buttock ptosis and medial thigh skin laxity without lateral thigh redundancy are ideal candidates. Your infragluteal fold is barely noticeable, no women has perfect exact length, position and height of the infragluteal fold. 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. 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 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. 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. 3) In a lower buttock lift in my hands, it is a combination of tissue removal AND the recreation of an infragluteal fold. Background: Overaggressive liposuction of the infragluteal region can lead to iatrogenic infragluteal fold deformity and result in aesthetic defect of gluteal contour. 17 The ideal infragluteal fold should be short and fixed without ptosis of the skin. The patient’s position is prone or lateral decubitus. Flap reconstruction is efficient in severe cases of infragluteal fold deformity (5), but the low patient acceptance of the subsequent scars limits its application. S3 Over the ischial tuberosity or infragluteal fold (depending on the patient their skin can move up, down or laterally over the ischii). Paraspinous muscles cannot be forgotten in the lower abdomen. 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. In this way, it's similar to a general lower body lift. Abstract. [1] The Vertical Technique This approach is performed vertically from above the IGF. A. amniotic fold the folded edge of the amnion where it rises over and finally encloses the embryo. 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 flap width was designed to match the broadest width of the defect, which was assessed from the inner. The posterior femoral cutaneous nerve (PFCN) is an extensive nerve with numerous collateral branches which provide cutaneous innervation to 2/3rds of the posterior thigh, the infragluteal fold, as well as the lateral anal region, scrotum, and labia majora through its inferior cluneal and pudendal nerve branches. In my humble opinion you need nothing surgical. 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 . Does it have a downward 45° angle, run horizontally, or have an inverted. 3 Excerpts; Save. Save. 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. One can not liposuction between the two and create a single infragluteal crease. 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 infragluteal fold length and definition play important roles in esthetically pleasing buttocks. An injury specifically to the inferior gluteal nerve, which supplies the gluteus maximus muscle, results in weak extension of the hip. The radiation oncologist clinically outlined the areas. To our knowledge, only two variations to the classic chevron technique have been described in an attempt to improve buttock contouring following GSCT excision. The gluteal region in patients with massive weight loss after. What you are seeking is to have a uniform infragluteal crease on both sides. 22), consider infragluteal, as well as inner thigh liposuction, and possible resection of infragluteal fold skin excess . PDF. Both flaps were fixed with interrupted 0-Vicryl. Complete 10 to 15 reps. It is used for correcting sagging lower buttock tissue that either hangs over the existing infragluteal fold or when the infragliuteal folds has dropped creating an elongated buttock shape. The thigh circumference measured at 3 predefined levels decreased on average by 2. 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. Subscribe Now:More:exercise to define. The iatrogenic forms of banana fold and sensuous triangle deformity are produced by excessive liposuction. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. On the left gluteal region, markings are shown for the muscle-fiber orientation for the gluteus maximus muscle. 15. Detailed clinical assessments of infragluteal fold, degree of flaccidity, projection, gluteal shape, and skin surface irregularities are required to define the overall objectives of the procedure. Answer: Lower butt lift. 3. The aesthetic line of the infragluteal fold should generally be short, no longer than the. The infragluteal sulcus is created right below. Asymmetric lifts and reduction are to be performed on the buttock to correct for your present symmetry. 5,8 A. Since its initiation, this technique has proven to be both clinically and cost-effective, with demonstratable benefits achieved with a lower. A fusiform excision located in the posteromedial portion of the infragluteal fold is least likely to produce a visible scar (Figure 36-13). The hyperechoic BFL tendon might be a reliable soft tissue landmark for ultrasound localization of the infragluteal sciatic nerve. The infragluteal fold (red lines) may have a downward slope (ideal with a well-defined diamond zone), be horizontal, or have an upward slope. The appropriately selected gluteal implant is folded in half. Detailed Procedure Information. A longer infragluteal fold suggests an aged, ptotic, and deflated-looking buttock with skin and fascial excess. A new technique for correction of a buttock ptosis resulting from a degloving injury is presented. 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. 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°. Skin creases are features of major anatomical, morphological, surgical, and functional interest. Once the shapes are more symmetric, volume enhance can be done on both sides simultaneously. While idiopathic neuropathy of the PFCN has been described [4], iatrogenic neuropathyFollowing administration of general anaesthesia, the patient was placed prone on a radiolucent table with a bump under the pelvis to create approximately 30° of hip flexion. The intergluteal cleft is a surface anatomy landmark of the pelvis and lower limb. 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. All patients judged the outcome as very good. 3). Between 2. In type 1 buttock ptosis the infragluteal Read More…Background: The shape of the buttocks can take on many different forms. By adding more volume on the left and matching the right, the fold will appear as a result of this added volume. circular f's. fashion, is an anatomic structure in its medial part and only a Despite this reality, the ideal gluteal shape has been crease laterally. 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. 1 Anatomy of the gluteus maximus muscle and deeper structure. Four fresh cadavers (two males, two females, accounting for 8 hemipelvis) were dissected in order to compare the radiological findings. Indianapolis, Indiana. The “sensuous triangle” is found at the junction of the lateral buttocks, the lateral thigh, and the posterior thigh. The structure of the infragluteal fold and the degree of ptosis are the main factors that determine the aesthetic appearance. This study reevaluated the fold both histologically and anatomically. Expand. ResultsThe infragluteal fold is a connectival fibrous band. 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.