Some people have two folds just below the buttocks in an upright standing position. The contour is caused by skin compression in an upright standing position. If you flex your hips, by leaning forward, you’ll see that the contour changes and both folds goes away. The hips have a substantial amount of range of motion and the skin surrounding joints with the range of motion. Have to have skin laxity to allow full range of motion. Everybody understands that they get a skin fold of their lower abdomen when they’re sitting. This is obvious because the body is flexed. The back of the thigh is the opposite of the lower abdomen. In an upright standing position, the skin is contracted and a fold created on some people. Just like the abdomen becomes flat when you stand up straight the skin on the back of the thigh, becomes tight when you flex your hips. The contour is not related to fat distribution, but it’s a skin related issue. For this reason Liposuction almost always fails to correct the fold, and it should be left alone and not treated. Sometimes adding volume such as a BBL procedure can give a slight improvement, but it is not justified for the single purpose of changing the skin fold. This is a normal anatomic variant and should not be treated.You may be a good candidate for cosmetic surgery, including Liposuction, but not for the area you describe, or stated as your area of concern. You’re a great candidate for Liposuction of your love handles waste back and abdomen. Do you have the potential for getting an exceptional S-curve from well done Liposuction, but treating the double fold or banana roll should just simply be avoided. You were most likely get far more enthusiasm during consultations with other providers for treating that area, especially using liposuction. My practice has been devoted exclusively to Liposuction and fat transfer for the last decade. I’m a 59-year-old plastic surgeon and I’ve done over 8000 liposuction procedures. Most of the experienced and talented providers I respect in the community view the banana roll in a similar light.Delivering consistent quality, liposuction results is far more difficult than most people believe. The number of plastic surgeons who can predictively deliver. Excellent results is relatively few. Being board-certified, and plastic surgery with years of experience and overall good reputation does not mean somebody has mastered Liposuction. Patient should be far more selective about using providers for Liposuction than they think necessary.I recommend anybody considering cosmetic surgery, especially Liposuction or fat transfer to have at least five in person, consultations and consider scheduling more unless they feel very confident they find one of the best providers for this procedure. During in person, consultations ask providers to open up their portfolio and show you their entire collection of before, and after pictures of previous patients, who have very similar body characteristics to your own. An experience provider should have no difficulty showing you at least 50 sets of before and after pictures of commonly performed procedures like Liposuction of the torso or the BBL procedure. Being shown a handful of preselected images, representing the best results of the providers career is completely insufficient to get a clear understanding of what average results look like in the hands of each provider or how many procedures anyone surgeon has actually done.Liposuction results are permanent and irreversible. If done poorly patients are left disfigured.Being board-certified in plastic surgery does not mean that somebody knows how to do liposuction well. Plastic surgeons generally believe they are far better at Liposuction and they actually are. This is not the same. They’re not plenty of talented plastic surgeons who do exceptionally good liposuction work. It is, however, a procedure that has more variation in outcomes based on provider selection than any other plastic surgery operation I’ve ever seen.Please be more selective than you ever thought necessary.Generally speaking, I do not recommend patients have virtual consultations, if an in person consultation is possible. I don’t think you can get an accurate assessment or proper leave that plastic surgeons without meeting them in person. I also do not recommend traveling long distances for elective surgical procedure if avoidable.Best,Mats Hagstrom, MD
