What can I do to improve back of thighs and banana roll? (photos)

Question

I’m 44, exercise 5x week & can’t seem to get rid of my problem area …… back of thighs & banana roll. I’ve had Kybella injections, 1 treatment of Morpheus & 1 round of Profound RF followed by 1 vial of Sculptra injections already. I’m considering Vaser Lipo for saddlebags & Renuvion on back of thighs followed by another round of Profound? As you can see when I raise the skin it’s “perfect”, so I’m starting to think it’s more skin laxity problem then cellulite.

Jason Emer, MD · Answer

You need a formal evaluation by an expert in body shaping and contouring to determine what is best. Nonsurgical options give only mild improvement as compared to surgical lifting. If there is a lot of skin laxity, a Thigh Lift procedure performed at the same time as a VASER Hi-Definition ​Liposuction procedure (with ThermiRF, Renuvion, and InMode BodyTite) would give the most improvement. Other options for skin tightening would be a combination approach with Vanquish, truSculpt iD, Venus Legacy, Exilis, and Cellutone / ZWave. I recommend getting a formal evaluation with a high-definition physique expert. Best, Dr. Emer​​

Darryl J. Blinski, MD · Answer

You do not have posterior thigh or banana rolls cellulite. It is the gravitational effect causing slight downward descent of the buttock. Either filling your buttock in the sub dermal/sub cutaneous plans with HA filler/Fat/Scuptra or all 3 to effect a lifting. Or a surgical upper buttock lift with the significant scars. Vs a directed lipo of the rolls can help improve not eliminate the roll.

Mats Hagstrom, MD (license on probation) · Answer

I guarantee you liposuction in that area will make your problem worse.

It’s a skin issue and removing the fat will make your skin worse.

If anything adding fat to the area is a better idea than removing it.

The area bulges in a standing position because the skin bulges as the skin on the back of the thigh is pushed into the buttocks.  it’s the same kind of fold that happens in the sitting position on the lower abdomen except in a standing position on the back of the thigh it’s reversed.  if you flex your hips you will see that the contour changes quite a bit.

Taking out fat while deflate the envelope and create problems.

Did your other treatments help?

Most likely not because none were addressing the primary problem and all of them could potentially make things worse.

The providers who offered those treatments did not understand the dynamic shape of this part of the body and were shooting from the hip in a dark room.

There’s room for improvement with body contouring by reducing your love handles and filling in the habit up but you should leave the banana roll alone unless fat is grafted in the area (for example hip dip) at which case subtle amounts of volume could be added in a beneficial way.

Trying to take the bulge out with Liposuction will create problems.

Consult with only the most experienced body contouring providers and those who think this is easy or do not see the pitfalls are the ones to stay away from.

This is an extremely difficult part of the body to make improvements in and the doctors you want will immediately recognize that and start seeing red flags and limit options drastically.

Anyone who thinks they can easily fix it or improve it it’s probably not the ones you want treating you.

Avoid a lifetime disfigurement by avoiding badly done liposuction in a treacherous area.

Best,

Mats Hagstrom MD

Randy Dean, MD - Account Suspended · Answer

Hi and welcome to our forum!
From your photos, I note moderate fullness of the flanks, hips, and thighs. While you did not provide height and weight data, you appear fit. With skin tightening from manual manipulation, the fullness of the lateral thigh and banana roll "disappear", suggesting skin laxity as the source of your problem. 
You have undergone a plethora of unsuccessful treatments to eliminate fatty tissue. 
You may wish to consider a buttock lift which will remove excess skin and tighten the area. You must be willing, however, to accept a surgical scar in the bikini line....and be within 15 pounds of your desired body weight.
Best wishes...

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