Can this scar incision be fixed with a revision? Why is it on my glutes? (Photo)

Thank you for your inquiry! There are multiple approaches for thigh lift. Scars are typically placed in the natural crease of your body. We would love to meet with you to discuss your options. Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

Hello, and thank you for your question regarding whether your crescent or mini thigh lift can be revised and why your crescent thigh lift scar appears to extend onto your glutes. Thank you for your detailed history and the photos you provided.

Based on your images, it appears that you underwent a crescent thigh lift, which is designed to remove excess skin and fat from the upper inner thigh. During this procedure, an incision is typically made high in the groin crease where the thigh meets the pubic area. However, the crescent thigh lift is technically challenging and carries a higher-than-average complication rate. One common issue is scar migration, where the incision pulls downward over time and becomes visible on the inner thigh or buttocks. This scar migration can occur when the deeper tissues of the thigh are not adequately anchored to the pelvic periosteum (the tough covering of the pelvic bone) with permanent sutures during the original procedure. Without that secure fixation, gravity, movement, and healing forces can allow the scar to drift.

Regarding your concern about the scar placement on your glutes: this is actually not unusual in crescent thigh lifts, especially when a dog ear (a fold of excess skin at the edge of the incision) needs to be addressed. To eliminate this excess tissue at the back of the thigh, the incision often must extend under the buttock crease (banana roll area). In fact, many experienced plastic surgeons performing crescent thigh lifts begin the procedure with the posterior incision first — while the patient is lying face down. An incision is made from the ischium (sitting bone) to the inner thigh, removing skin and fat in the back. The patient is then turned over to complete the anterior thigh lift. Therefore, the scar often wraps from the groin crease around to the crease beneath the buttocks.

If you are unhappy with the scar placement or the results of your previous thigh lift, a revision is possible, but it must be done carefully. During a revision crescent thigh lift, a new incision is made approximately 1 mm below the existing scar. A counter-incision is created higher up, allowing for the removal of a new ellipse of skin and fat. The key step in preventing further migration and improving results is anchoring the lower (inferior) thigh flap securely to the pelvic periosteum with permanent sutures. This technique helps prevent the scar from dropping again and reduces the risk of complications like labial spread or vaginal gaping.

Revision thigh lifts are technically complex, and success depends heavily on the surgeon’s experience. I strongly recommend consulting a board-certified plastic surgeon who has performed at least 100 thigh lifts and can show consistent, high-quality results, especially in revision cases.

Thank you for your thoughtful question and photos. I hope this provides clarity on your scar placement and revision options. Please don’t hesitate to reach out if you have more questions regarding crescent thigh lifts or any form of thigh contouring.

Sincerely,
Dr. Katzen

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon