Best way to get rid of wrinkles/creases banana roll? (Photo)

Question

I had cool sculpting done a few years ago and recently lost weight. I’ve noticed that the more I lose the worse my rear view looks. I’m most bothered by the crease lines. Would a derma filler make these less prominent?

J. Timothy Katzen, MD, FACS · Answer

Hi resourceful382177,

Thank you for your question regarding the best ways to eliminate wrinkles and creases in the banana roll area, and for sharing your history and picture. After analyzing your picture, it's clear that you have excess skin in the banana rolls. It appears that CoolSculpting might have significantly reduced the fat in this area without tightening the skin. Additionally, your weight loss could have further loosened the skin by reducing fat volume. To minimize the wrinkles, there are two main approaches: soft tissue augmentation or banana roll skin resection.

In terms of soft tissue augmentation, autologous fat transfer would be my suggestion. This involves harvesting fat from one area of your body, such as the abdomen, love handles, or inner thigh, and transferring it to the banana roll areas to smooth out these creases. While dermal fillers are another option, they tend to be expensive and usually get fully resorbed within 8 to 12 months. Transferred fat, on the other hand, tends to last much longer.

Another method to address excess banana roll skin is through a medial thigh lift. This procedure involves making an incision underneath the buttock to remove a crescent-shaped area of inner thigh skin. The resulting scar is discreetly placed underneath the buttock at the point where it meets the posterior thigh. Though this might be considered a more "radical" approach, it permanently eliminates the banana skin rolls in that area.

A more conservative approach, such as fat transfer, might be the best solution for you. Good luck. I hope I've provided a helpful overview of the best ways to address wrinkles and creases in the banana roll.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Zoran Potparic, MD · Answer

It would be very difficult to give you appropriate plan of treatment without in person evaluation and discussion about your goals. It appears that very selected liposuction (saddle bags),  fat grafting of buttocks and hipps and, possibly, fixation of infragluteal creases may be needed. In person consultation with a board certified plastic surgron with experience with this type of surgery, is recommended. Good luck.

Mats Hagstrom, MD (license on probation) · Answer

Any joint that has significant range of motion needs to have some skin redundancy in certain anatomic positions. The hip has a substantial degree of flexion, and this becomes obvious when we are in a sitting position where the skin redundancy on the lower abdomen becomes obvious.
The opposite of lower abdominal skin redundancy in a sitting position is the skin redundancy on the upper back of the thigh in an upright standing position.
Removing fat from that area, tends to not fix the problem and create other contour issues. I generally do not recommend Liposuction or any type of fat removal for the banana role because the problem is not related to fat distribution.
Fillers will be prohibitively expensive. Fat grafting is the only realistic option. Considering that you had cool sculpting which is generally not all that effective for the transfer may be a very viable option to restore the volume in the area.
Delivering consistent quality, Liposuction and fat transfer result is more difficult than most people realize. The number of plastic surgeons of mastered these procedures, or in a small minority. To find the right provider I suggest patients have multiple in person consultations. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of a similar type of cases. For most commonly performed procedures, I often suggest that an experience provider should have no difficulty showing you the before and after pictures of at least 50 previous patients. your situation is somewhat unique and providers may or may not have restored previous fat removal in that particular area. You’ll have to figure out on your own which provider to choose but I will say that provider selection is absolutely the most important variable, and patients should be more selective than they think necessary. The best way to find the right provider is to have multiple in person consultations.
Best,
Mats Hagstrom, MD

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