Lower Body Lift with Incision Under Buttocks?

Question

Is there anyone out there willing to do lower body lifts with an incision *under* the buttocks?

	I tried it with an incision in the belt line, skin undermined, etc, but excess butt and thigh skin was not addressed. I know it's not an 'accepted' technique but I also know the lower the incision to the problem area the more effective the result, and I can't live like this anymore.

	Already underwent lower body lift with belt-lipectomy scar line and thigh undermining -- no improvement to butt/thigh area, so why won't any surgeons try this other approach?

Douglas L. Gervais, MD · Answer

I think you are finding out why many surgeons do not like or do this operation. The lower incision will not lift your buttocks. This is not mechanically possible. Secondly, these incisions almost always migrate lower than where they started and as a rule are very unsightly. However, if you are willing to accept the scars and have significant laxity of your posterior and lateral thighs( these are areas treated with this incision/procedure) then proceed with caution and be sure your surgeon has experience with this particular surgery.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding whether a plastic surgeon can perform a lower body lift with an incision under the buttocks. The short answer is yes. Plastic surgeons often reduce buttock lift with an incision under the buttocks or in the infragluteal fold. 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. If ou still has residual excess skin and fat on the lower buttock and want it removed, then infragluteal or excision underneath the buttock may be necessary. This procedure is uncommon for patients with excess skin and fat in this region. Please seek an experienced board-certified plastic surgeon. I hope I helped answer your question regarding whether a plastic surgeon can perform a lower body lift with an incision under the buttocks. 
Sincerely,
Dr. Katzen

Richard J. Bruneteau, MD · Answer

Incisions located transversely beneath the buttock cannot be equated with a lower body lift procedure because they have no impact upon the buttocks. In addition this procedure is associated with unsightly scars that tend to spread and migrate in an inferior direction. For these reasons, this procedure is rarely indicated when patients have lower body sag.In your particular case, it's difficult to make recommendations without pictures or a physical examination. In light of the fact that you've already had a lower body lift and continue to have problems with your posterior and lateral thighs, this procedure may offer some value. Under these circumstances, redundant thigh skin can be removed and the thigh lifted in an upward direction. This procedure would not impact the buttock area. The benefits of this maneuver must be weighed against the high probability of scarring.It's important to realize that no two patients are ever exactly the same. For this reason, it's important to tailor procedures to meet the patients specific needs. Under these circumstances, excision of the skin at the junction of the thigh and buttock may be occasionally indicated.If you're considering this type of procedure, it's important to consult a board certified plastic surgery with experience in this area. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Thomas Fiala, MD, FACS, FRCSC · Answer

This is the classic Pitanguy operation.  It has largely been replaced by more modern procedures, as it had several problems.  It tended to flatten the curve of the buttock, and the scar tended to drift out of the buttock crease, onto the back of the thigh, where they could be quite visible.  Painful scars could make sitting difficult.

	Modern lower body lifts do a better job of lifting the buttock, and placing the scar where it will be concealed by underwear or swimsuits.

	That being said, sometimes, even after a well-performed LBL, a few patients will have some skin redundancy in the buttock crease area, and may benefit from a skin excision there.

Siamak Agha, MD, PhD, FACS · Answer

I am affraid that there are many surgeons who are calling a circunferentiaol tummy tuck, a lower body lift. These use the smae incision but are not the same. A lower body lift in my practice has the following componenets: circumferential tummy tuck, buttock lift, formal outer thigh lift, thigh lift in front, and correction of pubic laxity. Most patients will also want a buttock augmentation at the same time. Like many patients who I have seen recently, you will need a lower body lift revision. See my gallery for more information.

Kevin Brenner, MD, FACS · Answer

An incision at the bottom of the buttocks (in the fold) can frequently be used for contouring of hanging skin at the lower portion of the buttocks. However, this does not truly constitute a lower body lift, as it does not lift the lower body skin.

Armando Soto, MD, FACS · Answer

Hi there,
I understand your concerns with your outcome from your prior surgery, and that you would like to achieve more tightening of the buttocks and thighs.  I'm not sure I agree with you that this would only be possible through the more radical approach you describe though, as the traditional approach to body lifting is usually extremely successful in addressing these areas, even in patients with extreme amounts of loose, stretchy skin.
In addition to probably not being necessary to achieve your goals, the approach you describe would put you at high risk of having a scar that creates long term discomfort when you sit, and the greater potential for injury to your Sciatic Nerve (one of the largest and most important nerves in the body); that's why you haven't been able to find a surgeon who would do this.  I would return to your original surgeon and review this with them. See if a revision might make you happier.

Thomas B. Lintner, MD, FACS · Answer

I consider thispart of a posterior thigh lift, vs a lower body lift. It is sometimes hard to hide this incision right in the crease below the buttocks, sometimes the incision will extend too far laterally and is hard to hide and it can flatten the buttocks, which most women don't care for. Ultimately in all massive weight loss reconstruction, the patient is trading shape for scar.

Steven Wallach, MD · Answer

A buttock crease incision is certianly an option for patients that have posterior thigh laxity .  AS for the buttock itself after a lower body lift, fat injections may help to fill out the buttocks.

Jeffrey Kenkel, MD · Answer

on occasion I will place an incision in an "atypical" location such as you described. It may result in a more predictable result for a recurrent problem or challenging area. All weight loss patients are different so the operation and incision location must be tailored to the individual patient needs.

Lower Body Lift with Incision Under Buttocks?

Answers (14)

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