Workout and eat healthy, have tried HiFu, T shape and Em Sculpt. What procedure would help to get rid of banana rolls? (Photos)

Question

Hi! Please help! I cannot get rid of my lumpy leg. The right leg is much worse than the left. I’m 37, 5ft 7, 9st I train daily Cardio 45 mins bike daily Leg weights 3x per week Clean diet prioritising protein I have tried HiFu, T shape and Em Sculpt Do I need lipo or Kybella? TY!

Daniel Barrett, MD · Answer

Dear KellyH1985,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Mats Hagstrom, MD (license on probation) · Answer

The banana role is often misunderstood by both patients and providers.
It is often assumed that it is excess fat that’s causing a bulge on the upper back of the thigh.
It is primarily a skin fold or skin bulge.
Parts of the body that have great range of motion like certain joints require skin laxity in order to have full range of motion. each one of these areas of mobility while having the skin be taught or laxed depending on which position the joint is placed in.
Most people have no problems understanding why we get a bulge and a fold of our lower abdomen in a sitting position. if domino skin is being pushed together with less space as we flex our hips and the bulge forms.
When we stand the skin is pulled tight and the bolts of the lower abdomen goes away or at least improves.
The back of the thigh exhibit the opposite of the lower abdomen. The skin on the back of the thigh is in the tight or snug skin condition when the hips are fully flexed. in an upright standing position the skin on the back of the thigh is pushed into the buttocks in the skin fold forms and some individuals and we sometimes called is the banana roll.
The skin and the fat layer on the back of the thigh and buttocks it’s also somewhat unique because they represent pressure bearing areas.
Areas of the body that can tolerate significant amounts of pressure typically have much more connective tissue anchoring the skin to the underlying fascia.
We’re on the way to demonstrate this is to examine the hand. you can pinch and lift the skin on the back of the hand quite easily. if you try the same and pinch and lift the skin in your mid palm you’ll recognize that you can’t. it’s like the skin is stuck and can’t be tented up.
The back of the thigh and the buttocks has lots of the same connective tissue which gives rigidity and limits skin mobility. this to some degree contributes to why the skin creates a bulge in an upright standing position because there’s no place else for the skin tension to be distributed.
If you flex your hips by simply leaning forward or bending over you’ll recognize the fold shrinks and generally goes away or at least reduces substantially in size.
Areas that are improved by putting tension on the skin generally are skin related and not fat related.
Areas that do well with fat removal procedures like liposuction generally don’t have much impact if you put the skin under tension. The fat is there whether the skin is loose or tight.
Liposuction of the body on role will leave individuals with an abnormal fat distribution that was shown as an unnatural deficit with flexion of the hip. The results rarely deliver what was intended and the most usual outcome is some type of disfigurement with the banana role still being present.
There is no good treatment for the banana roll
Inexperienced plastic surgeons will jump at the opportunity I’m doing liposuction because they don’t have sufficient experience and don’t have a clear understanding of dynamics regarding contour of this part of the body.
Sufficiently experienced providers will recognize that the area does not respond to Liposuction in a way that would first seems possible.
I’ve never seen the banana role have an impressive improvement from Liposuction but I’ve seen far too many people having regretful outcomes leaving them needing complex and expensive revision surgeries which generally still leave the patient worse than they were before the first procedure.
 If there was a correct treatment for the banana role it would be skin excision but this leaves an unacceptable scar so it is generally not done.
Anybody tells you that this can easily be fixed with Liposuction should show you at least 20 convincing sets up before and after pictures.
Lots of people have tried without success.
It’s much better to live with the banana role then to spend thousands of dollars having surgery that leaves you disfigured.
The first step in the surgical solution is having a clear understanding of what the problem is.
We called is making an accurate assessment or in other words making a correct diagnosis.
Applying surgical technique with an incorrect assessment or diagnosis is unlikely to give quality outcomes.
Best,
Mats Hagstrom MD

Workout and eat healthy, have tried HiFu, T shape and Em Sculpt. What procedure would help to get rid of banana rolls? (Photos)

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