What is the best procedure for my saddle bags and banana roll? (photos)

Question

I have prominent saddle bags. I am not overweight and eat healthy and exercise. However, my saddle bags remain. I have tried everything and nothing seems to make them go away so I am opting for surgery. I do not know which procedure would be best, liposuction or coolsclupting or whichever

Shahram Salemy, MD, FACS · Answer

Liposuction in the areas of the saddlebags can be very effective to help balance out your contour.  The area just under the buttocks on the posterior thighs can be less predictable and it will be very important to have a consultation by a Board-Certified Plastic Surgeon to review the pros and cons of liposuction in this area prior to proceeding.

Jerome H. Liu, MD · Answer

Whether liposuction or CoolSculpting is the best procedure for you depends on your individual aesthetic goals. Liposuction is one option for body contouring, and you are able to reduce a larger percentage of fat quickly. CoolSculpting, however, is non-invasive and requires no downtime or post-procedure garment. Cost can be similar based on how many areas you are wanting to treat. While it seems you would be a candidate for both types of body contouring procedures, photos are not a substitute for an examination by a board-certified plastic surgeon. Schedule a consultation to discuss your treatment options! Good luck in your research!

George Marosan, MD · Answer

Thank you for your question and photos. Based on these photos, you have a violin deformity: saddle bags, large hip rolls and depressions in the lateral buttocks. This is a tricky area to treat, and choose your plastic surgeon well. I use VASER Hi Def liposuction to contour this area. To give you the best results, you need all three areas addressed and the banana rolls. You need the hips, saddlebags and banana rolls suctioned and need some fat grafting to the buttocks to give a more feminine shape to this area. In my practice, I see an increasing number of patients who come in for correction when these areas are over suctioned and create a male contour with flattening of the lateral thighs and also unintended suction of the lateral buttocks with resultant "shark bites". These are very difficult to correct, can take 2-4 surgeries to return to normal shape. Coolsculpting causes mass fat death, not very precise, requires multiple treatments. You are better off finding a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

Jed H. Horowitz, MD, FACS · Answer

hello kareebear1 vaser liposuction can be done, it is a minimally invasive fat removal and body contouring liposuction procedure, and it is an alternative technique to the traditional liposuction methods. I believe it is easier to sculpt and contour the body.  Improving areas such as the back rolls, abdominal definition, and waistline are just a few of the common areas that can be treated with better results. #options #exercise

Jason Emer, MD · Answer

For best results, I recommend a hi definition procedure like VASER liposuction. I use VASER HI DEF with ThermRF and fat grafting to get the most fat removal, skin tightening, contour and definition. This combination will improve the saddle bags, banana roll and give you the most toned result. I recommend getting a formal evaluation with a hi definition physique expert. Best, Dr. Emer

Manuel Ventura Gonzalez, MD · Answer

Hello
A liposuction and transfer of fat to the buttocks (BBL) to define them more by the sides, but in truth you have a nice figure you only need a bilateral filling in the buttocks.
Always To Serve You, Dr. Manuel Ventura
Certified, Medical Research Institute of Plastic Surgery in Sao Bernardo do Campo, Sao Paulo, Brazil.

Dean P. Kane, MD, FACS · Answer

Dear Kareebear1:
Thanks for sharing your photos. You appear to have firm tissues and no “saddlebags”. Saddlebags are the redundant skin folds following stretched tissues along the outer thighs. You appear to have genetic or familial fullness of the outer thigh and hip; in the natural and expected areas surrounding the buttock.
  
You seem to be looking for a BBL (Brazilian Butt Lift) result without the need for fat grafting; ie "lipo-framing" your buttock. 
I agree that liposuction or CoolSculpting are your best options.
  
There are benefits and limitations to both.
  
CoolSculpting is limited in fat reduction to “up to 25%” fat loss of the area under the applicator. There is no surgery and you can return to all your activities right after the procedure sessions. You may easily return for a second session for more fat reduction and limited contouring. 
  Liposuction will leave you with surgical puncture-sized skin scars but better contour and reduce (up to 90%) the underlying fat and better “frame” the buttock. It is surgery and you will require a compression garment and may not submerge in water until the incision sites are healed. Your activities will be limited for several weeks. 
  Both will take 3 months to visualize your initial appearance.
  
Being summer-time, you may wish to begin with CoolSculpting to return to all your sunshine activities and then decide whether you wish for more CoolSculpting or more fat reduction / contouring with liposuction.
  
With both options, consult first with a talented and skillful, Board Certified Plastic Surgeon who does both so you will receive his/her best evaluation for the optimal procedure for you. 
  
I wish you the best!

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

High definition liposuction would work great for your case. Be sure you seek treatment with high definition lipo that includes three key elements: VASER technology, PowerX liposuction cannulas, and cool helium plasma skin tightening.

Mats Hagstrom, MD (license on probation) · Answer

your saddlebags will be treatable with liposuction. Your saddlebags will be treatable with liposuction.You also have a hip dip or a lack of projection just above the saddlebag area.This makes the saddlebags look bigger than they actually are.There is not a good treatment for the banana roll. Avoid liposuction love this area. There is not a good treatment for the banana roll. Avoid liposuction of this area.Occationalky fat transfer can help but most people should avoid treatment for this. Best,Mats Hagstrom M.D.

Ronald V. DeMars, MD (Retired) · Answer

The saddle bag area is typically recontoured with liposuction, it does not matter which type, that is all hype. Surgeons have tried treating the banana roll for years with liposuction, and inexperienced surgeons still try that. It doesn't work. Direct excision leaves a scar that most patients do not want. Best to leave that alone. It could easily be made worse by a well meaning but not well experienced doctor.

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