What is the best solution for a banana roll deformity?

I had lipo to the thighs 15 years ago and immediately experienced asymmetry & a subsequent banana roll deformity on the right gluteal fold. Is there a good solution for this or should I continue living with this fold?

Doctor Answers 7

Banana roll deformity

I find that being to aggressive in the area of the leg below the buttock can result in a banana roll or a dip.  A combination of gentle contouring of the bulge with careful fat injections around the bulge to bring areas above and below the banana roll into the same level.  

Shreveport Plastic Surgeon
4.7 out of 5 stars 4 reviews

Double Gluteal Fold -- Get Fat Transfer / VASER Hi Definition Liposculpture

The best treatment for this is VASER hi definition liposuction to tighten the area and fat transferred around it to lift the buttock and improve the fold.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 191 reviews

The fallacy of the banana roll

On occasion, I am asked to perform liposuction on the area known as the "banana roll". The area is fraught with complications and poor outcomes. The reason for this comes down to one of my most basic fundamental beliefs in surgery. First, you need to make the correct diagnosis, and then you apply the correct treatment. The banana roll is a skin-only condition and has nothing to do with fat.

Let me try to explain the physiology of the banana roll. At times, I love when patients come in to my office and lean forward and pinch one of their abdominal skin folds and say, "Doctor, look at this. It has to go." In general, this is when patients want liposuction. I then ask them to stand up and show them that the fat goes away when they stand up and that everyone has a roll when they lean forward.

The same is true for the upper back of the thigh. When we lean forward gently, there's no fold or roll of excess fat at all. When we stand up straight, the skin gets scrunched together, and the roll forms. It's because the skin is being scrunched together, and, therefore, the problem is not that there is excess fat in the area.

Since it's a skin condition and not fat, liposuction is surely not going to be an effective treatment. As you know, a banana roll can even be created by inappropriately performed liposuction. In your case, there is no simple answer since a definitive diagnosis needs to be made first.

If someone has a defect after liposuction, there are two generally two, and sometimes three, alternatives. They include doing revision liposuction to make things even, doing fat transfer to restore excessively removed amounts of fat that should not have been removed and, thirdly, doing a skin resection when indicated.

In your case, no one will be able to give you an accurate assessment or recommendation based on such limited information. To get an accurate assessment, you need an in-person evaluation. Please consult with a plastic surgeon who specializes in liposuction and fat transfer.

Best of luck,

Mats Hagstrom, M.D.

Mats Hagstrom, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 18 reviews

Banana rolls

Some banana rolls can be treated with liposuction, and some may need to tighten excess skin. Some laser liposuction is helpful in tightening skin. What you need specifically can be determined during the consultation. I would suggest meeting with a board certified plastic surgeon and discussing all your concerns. You do not have to just live with it.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

Banana Roll After Liposuction

Thank you for your question. The banana roll deformity you described come from extra skin along the gluteal fold. The way to correct this is to excise the skin with a buttock lift.

Lisa M. DiFrancesco, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 34 reviews

The nano role deformity of the thigh has to be treated carefully with liposuction.

Physical examination is necessary to see whether the banana role as a product of surplus fat or buckling of the skin. If that is the issue this areas susceptible to treatment. Skin buckling could be corrected with excision along the gluteal fold the most of the time the trade-off is not worth it.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Banana roll

Reducing your banana rolls, posterior upper thigh excess fat, if done properly and conservatively should give you improvement without making your buttocks drop.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.