What would a sacral dimple excision scar look like? (Photo)

Question

I will be getting a BBL next year, and I’ve thought about bringing up something to remove my sacral dimple and make my crack more symmetrical and aesthetically pleasing (something that I have always wanted to do) What would a excision scar look like? My sacral simple doesn’t cause any spinal issues, by the way.

Finny George, MD · Answer

Hi, thank you for sharing your question. The sacral indentation can be corrected during your BBL surgery or before. The scar would likely be a linear one just above your crease. An in person evaluation by your board certified plastic surgeon can give you the best answer.

Daniel Barrett, MD · Answer

Dear Boundbrst09,
it is hard to tell for sure without an examination. Based on your photo, it looks like excision would leave a small vertical scar. 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

Cagil Meric Erenoglu, MD · Answer

Hi, Boundbrst09! Thank you for your question and photo.
I would rather suggest sbcision (releasing underneath) and fat injection instead of excision, that will leave a scar.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Sacral dimple can be improved with a combination of fat grafting and/or excision if it is scarred down. The first maneuver is to attempt popping out the dimple with fat grafting technique. If this maneuver does not work, then it may require an excision. The best time to fix this issue is during your BBL. Please consider a virtual consultation with a high definition BBL expert.

Mats Hagstrom, MD (license on probation) · Answer

Sacral dimple is a small remnant that represents the smallest version of incomplete fusion of the lower back during embryological development.
The lack of midline fusion in this area happens from time to time just like some children are born with a failure to completely fuse the midline of their face during embryology. When it happens on the face typically it presents as a cleft lip, cleft palette or cleft face. and the sacral area a large defect or failure of complete closure is referred to as spina bifida. Sometimes it’s as little as a dimple and they can also be small pits with cysts that travel deep inside the body. In those cases they are yes prone to developing recurrent infections call pilotidle cysts. there are a few different approaches to exciting this area but healing can be challenging because of pressure on the area when sitting and also how the two butt cheeks can rub against each other. Direct excision is one option but a rotation flap like a rhomboid flap may be more effective. The problem with a flap closure is that it is a symmetrical and will not leave a straight line. If you want the area excised then you need to be ready for the area may have challenges with healing. I would not do that at the same time as the BBL procedure. Removing the dimple may be more complicated than you think.
In regards to getting a BBL here are some of my thoughts on that procedure.
Delivering consistent high-quality liposuction and fat transfer results is more difficult than most people believe in this is true for both patients and plastic surgeons. Most plastic surgeons think they are better at liposuction than they actually are. Liposuction and fat transfer has more variance or difference in outcome purely based on who does the procedure than any other surgical procedure I’ve ever seen. Being board-certified in plastic surgery with an overall good reputation is not sufficient to guarantee that somebody has mastered body contouring. Personally I view the torso as a single anatomic unit and either treated the entire torso or don’t do Liposuction. There are of course exceptions but for the most part I believe in treating the entire torso. A full torso includes upper abdomen, lower abdomen, love handles all the way down to the hip dips, waist, the entire back and under arm area all the way to the side of the breast. this leaves people with a natural thin fat distribution without transition zones between treated and entrteded areas. I’ve viewed the BBL as an enhancement to body contouring creating an ideal feminine S-curve that goes from the armpit to the knee. I did not emphasize a large buttocks with liposuction of the outer thigh creating a big round butt on the small leg which I sometimes called the “lollipop look”. Instead I emphasize long smooth harmonious curves creating a slightly hyper feminized balanced figure. To find the most talented and experienced provider in your community I suggest having multiple in person consultations. I do not recommend patients travel for elective surgical procedures and I recommend patients whenever possible avoid virtual consultations. During in person consultations ask each provider to show their entire collection of before and after pictures of BBL results. Always confirm that after pictures were taken at least three months from the time of surgery. anybody who shows early postoperative pictures such as pictures with patients still showing surgical drawings on them, being in the operating room or any evidence of recently having had surgery should be immediately discounted as showing “.fake news”. Early fat transfer results can look very impressive but do not at all represent final results. Ask the provider to show you examples of excellent outcomes, average outcomes and less than outcomes. Specifically ask each provider to show as many pictures as possible‘s of patients who have similar body characteristics to your own. An experienced provider should have no difficulty showing you a minimum of 50+ sets of before and after pictures. Simply seeing a handful of pre-selected sample pictures which in reality most likely represent the best results of that providers career is insufficient to get a clear understanding of what average results look like for that provider. Highly experienced providers will have hundreds or even thousands of before and after pictures and should be willing to give you access during the consultation to see as many pictures as possible. If somebody claims to of done a lot of surgery but doesn’t have a lot of before and after pictures then you should ask yourself why? Do not commit to surgery or pay a down payment during the time of consultation until you’ve finished all your consultations and have given yourself plenty of time to think about your decision. The results from these procedures are permanent and irreversible. When in doubt slow down and schedule more consultations. Finally I recommend patients read all reviews on all various physician review websites avoiding providers for any significant number of justified negative reviews. The absence of justified negative reviews is more important and more telling and having an abundance of positive reviews. Plastic surgeons with the biggest social media profiles are not necessarily any more talented than those who have no websites at all. Famous or likable does not equal talented. Find the right plastic surgeon and everything falls into place. 
Good luck, 
Mats Hagstrom MD

What would a sacral dimple excision scar look like? (Photo)

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