Question Regarding Sacral Fat Pad and Low Back Liposuction? (photo)

Question

I am looking forward to an upcoming consultation in 3 weeks for abdominoplasty with liposuction of flanks, possibly low back. I carry extra skin on the front, but I have always noticed a sacral fat pad, regardless of weight, and with the flank and upper posterior hip fullness, it gives my bottocks a flatter appearance. Does the sacral fat pad respond well to lipo? Given its proximity to the bone and lack of underlying tissue are there any special considerations that I should ask my surgeon about?

Michael Kreidstein, MD, FRCS(C) · Answer

The area you illustrate does respond very well to liposuction. We have also used this fat to graft the buttock area and further improve the contour of the sacral/buttock area. The underlying skeleton does not pose a unique problem to an experienced surgeon.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Liposuction of the lower back responds beautifully.  You may ask if the surgeon is particularly aggressive in this area does he/she use a small drain.

	Good luck.

	Dr. ES

Kenneth Hughes, MD · Answer

I routinely suction this area to improve contours and give the illusion of a more prominent buttock when performing the Brazilian buttlift. The area responds nicely to liposuction and should not have any contour irregularity afterwards.

Vincent N. Zubowicz, MD · Answer

Excess fat over the sacrum is occasionally seen. Liposuction often yields an excellent result because the amount of surplus fat is modest and the skin is almost always in excellent condition.

Scott C. Sattler, MD, FACS · Answer

I always suction the sacral area thoroughly during flank and hip liposuction - a nice sacral contour creates the illusion of more buttock projection. Sacral liposuction is very effective.

Darryl J. Blinski, MD · Answer

Though the posted photo of very poor quality I offer coccyx liposuction more often than most think. Results are very good.

Barry L. Eppley, MD, DMD · Answer

The pre-sacral fat pad is very resistant to any form of diet and exercise and can quite nicely be reduced with small cannula liposuction. It is also an area that will hold a result very well and is unlikely to re-accumulate fat in the future.

Scott E. Kasden, MD, FACS · Answer

The pre-sacral fat pad you describe is quite common.  It tends to be quite resistant to exercise and diet.  There is nothing particularly unique about it and so it responds well to liposuction.  Not to worry about bone, etc., as an experienced surgeon should be able to knock this out safely, no prob.

	 

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Steven M. Lynch, MD · Answer

The buttock profile is greatly enhanced by suctioning the area in the presacral region just above the buttock crease.  I take it all.  The skin is thick in this area.

	  Interestingly, this fat is a bright yellow (with tucescent) as compared to love handle fat that is somewhat darker yellow in most cases.  Not a biggie as far as the patient is concerned but when you do thousands of these, you notice this difference.

	  Tell your plastic surgeon that you want nice curves in the areas that you are approaching and tell him/her that you are bothered by this region.  There is little to no downside to take it all and the upside is a nicer curvature of the buttocks.  Of course, you need to make sure that you do the rest of the areas  that you need to get the overall thinner look rather than the "heavy" look that you have.

	  Your case is really great for significant liposuction in the areas adjacent to the sacral fat besides going to the hips/waist/upper back.  Remember, as mentioned, the skin is very thick in the back so it is good to get pretty agressive with this fatty tissue.

	  Good luck.

	     Steven M. Lynch, M.D.  Albany, New York

James Motlagh, MD · Answer

The sacral fat pad is bothersome to some people and indeed it can be liposuctioned. I think it is a safe procedure and carries minimal risk to underlying bone and muscle as long as the surgeon has experience doing that area. Overall the liposuction has to be done conservatively over the sacral area.

Question Regarding Sacral Fat Pad and Low Back Liposuction? (photo)

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