Q: Dr. Eppley, Thank you very much for responding about lower buttock lifts. Very rare doctors take that much interest. I do have a few more questions though, if you could again answer. 1) Is there anyway the scar in the lower buttock crease (infragluteal) can be made less conspicuous? (less wide or by tattooing after) 2) If a surgeon uses the buttock tissue removed to implant as a graft will it cause problems? (e.g., infection , circulation) Will it not add a bit more volume to my buttocks? 3)When you do the incision in the infragluteal fold do you tuck the extra tissue inside/under or cut it off? 4) Are there different ways of doing this operation. 5) Is there not a risk that there is no crease /projection left—in other words—does it create a flat butt? 6) It seems like an operation lasting more than 3 hrs. Do most patients do well–as I am a little scared–I prefer twilight sedation–seems like it is not the method used for this surgery. 7) If the saggy inner thigh skin is pulled up at the same time, will the scar descend with time to become visible within the groin area?
A: 1) Tattooing is not an effective form of scar camouflage anywhere on the body.
2) The thin strips of skin and fat are worthless as grafts because of their very low volume. And placing such a graft always runs the risk of causing an infection. This is not a good benefits vs risk proposition.
3) In a lower buttock lift in my hands, it is a combination of tissue removal AND the recreation of an infragluteal fold. (aka tuck)
4) The number of ways to do a buttock lift seem rather limited…but I can not speak for what other surgeons may or mat not do with this uncommon body contouring procedure.
5) If an attempt is not made to recreate an infragluteal fold and too much tissue is taken, the result cold very well be a flat lower buttocks contour.
6) How long it takes a surgeon to do any procedure is highly variable. Whether your buttock issues makes this 3 hour time long or appropriate I can not say since I don’t know what your buttocks look like. Because a lower buttock lift is done in the prone position, the only acceptable anesthetic is most cases would be a general with a controlled airway.
7) Many thigh lift scars can descend downward. Whether that occurs or not is both a function of how much tissue is removed and how the procedure is performed. (e.g., incision location, use of fascial fixation)
Dr. Barry Eppley