Butt crack too high after LBL (intergluteal crease) (Photo)

Hi practical5751,

Thank you for your question about the challenges you're facing after a lower body lift, and for sharing your history and picture. Addressing this issue is indeed complex, but let's break down the possibilities.

When performing a lower body lift, the incision across the buttocks allows for dissection down onto the butt, with the aim of lifting it. This is a common desire among patients. Moreover, the lower back, especially the lumbar region, has firm adhesions that prevent it from being significantly lifted or pulled down, making this area relatively fixed.

In your case, the key to improvement lies in addressing the vertical gluteal cleft. The goal would be to elevate this area up to the incision level. This involves lifting and spreading out each side of the vertical gluteal cleft, akin to opening a fan, which would help to alleviate the protruding areas on each side of the buttock crease.

A revision procedure might involve a 6 to 8 inch alteration of the lower back incision and would likely require the placement of a drain for one or two weeks post-surgery.

I hope this provides some clarity on your options following a lower body lift, and what can be done to improve your current situation.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Thank you for your inquiry! Communicate your concerns with your physician. Scar revision is an option. Schedule a consult with a Board-Certified Plastic Surgeon.

I can see your problem in the photos. Elevating the crease is always a concern. It looks to me that your surgeon may have raised your crease by trying to completely remove the tattoo.Discuss options with your surgeon. Good luck.

It is very common to observe the lengthen of the buttocks cleft amongst LBL patients. Unfortunately It is very difficult to shorten it again. Some surgeons use the high incisions to improve the waist line but the result will be lengthening the cleft. You may tatoo it. Dr. Cárdenas 

Hi. Sorry for this problem. This is a main concern for this kind of surgery, because incision is always prone to get a little bit higher. Certain techniques when painting the patient before surgery allow us to place the incision trying to avoid this issue. More pictures and time, a year after surgery, are required to give you an option to try to correct or diminish this problem.International Member of the American Society of Plastic Surgeons (ASPS)
Member of the International Society of Aesthetic Plastic Surgery (ISAPS)
25 year experience

I  am sorry  to hear that you are having these issues after surgery.  From your photos I can tell that this is a difficult problem to fix especially now that your skin is tight and contoured. You have some success with excision of the crease with primary  closure or a z plasty. Both these options would leave a visable scar. It is possible a tissue expander could assist in lowering the scar as well but you would need to be seen in person to decide what is best for you. At any rate since you have had recent surgery I would recommend you wait and give your body a chance to fully recover before doing more surgery.
Best Wishes.

Sorry to hear about your concerns.  That is a difficult thing to fix.   It is usually easier to raise than it is to lower.   I'm sure it can be lowered a little, but not likely enough for it to be covered in some of the clothing you show.   It could possibly be shortened by excising the "Crack" and sewing it back together so that it would be smooth.   Although the scar would still be visible, it wouldn't be a visible butt crack anymore.   DiscoverTheBeauty.com