butts lift abstract

Introduction

The immediate buttocks lift is a new weapon for plastic surgeons, cosmetic dermatologists and aesthetic medicine practitioners thanks to the techniques so called, Endopeel, which have like mechanisms of action a myotension, a myoplasty and a myopexy which duration does not exceed 6 months.
These techniques can be proposed to patients wishing to get a buttocks lift, to patients which are not candidates for a surgical gluteoplasty, to patients which refuse elastic sutures, to surgeons who want to complete their operation of lipoplasty and lipofilling with a gluteopexy, to sports men and women who have increased their muscular mass too much in rapport of their body, to patients who have lost weight after bariatric surgery or diet, to patients following the fashion and which main desire is to have a model buttocks adapted to the last fashion fit jeans .
The advantages of these techniques are appreciated by the patients, because the effect is immediate, with absence of scar, with absence of down time, with absence of social eviction, and if rare complications may appear, they are just limited to short time duration of edema and ecchymosis.
The Endopeel techniques for buttocks lift can reshape the gluteal muscles following exactly the wishes of patient and physician. There are no standard method, no standard result. Each patient will have the buttocks he/she wants.
Very important is that the chemical myoplasty and myopexy is a personalized technique, for men, women, boys, girls following their tastes and muscles can be tailor shaped instead of ready to wear standard ones offered by prosthesis for ex!

Benefits and Advantages of this abstract

The basic technique first for male then for female will be exposed to carry out with minimum anatomical knowledge an immediate gluteal area improvement (lifting and tightening effect of the buttocks giving more projection at the selected point) as a lifting of the banana fold.

Similar techniques can be applied for other areas as brachial lift, crural lift, thighs lift, internal knee lift, mini abdominopexy, oranges skin lifting. Other indications (décolleté lift, hands lift and other non cosmetic indications) with their own techniques can be done too with principles most similar to facial endopeel treatments.
Patients' selection

All patients who desire a surgical or a not surgical buttocks reshaping can be candidates, as those not being candidate for any kind of filler (the fillers are too often sources of complications like granulomas, necrosis, migration, nodules etc), and those wanting to complete or to maintain the benefits of elastic sutures. Contra indication is oversize gluteal area as the tightening effect is limited.
Best indications are the buttocks lift after lipoplasty, the sagging down buttocks. The sportsmen with gluteus muscular mass augmentation, the patients with stretch marks on the buttocks (who lost some weight after diet) as the asymmetries of the buttocks due to congenital, post trauma, lipofilling or paralysis diseases.

Our criters of exclusion are: pregnant women, subjects under 18 years .patients allergic to peanuts or those having antecedents mentioning a Quincke edema, as patients affected with a cardiopathy, nephropathy and liver problems. Patients with antecedents of PMMA injected in their gluteal muscles should be informed that Endopeel methods would not interfere with a granuloma due to PMMA.

The ideal candidate is not fat and without big excess of skin, without treatments using fillers or sutures or prosthesis since 3 months, in apparent good health, with an age range between 20 and 70 years, eager of immediate scar less buttocks reshaping.

Benefits and Advantages envisaged

The buttocks reshaping effect is immediate and is perfectly visible 60 minutes after the end of the treatment with a maximum result 2 to 3 days after the procedure.
The gluteopexy effect is early and will be relayed by the late peeling effect, specific to the techniques Endopeel, which can be too potentialized by Peeling de Luxe (immediate effect).
The treatment can be ineffective in 8% of the cases (bad technique).
The effectiveness of this treatment increases with the number or the repetition of the procedures because the basic muscular tone will be thus increasingly high on the scale of the tension of this last
It is easy to prove objectively the effectiveness of this treatment by treating for example only one side only on the same patient and by making a comparison between the treated side and the controlateral untreated one by pure visual inspection, or by photographic images, or by using points of reference. Results can be not only appreciated by inspection but also by palpation.
These same parameters are taken again to evaluate the duration of the results objectively
The procedure is made comfortable for the pusillanimous patients thanks to the special anesthetic lipogel applied before the Endopeel procedure and giving satisfaction of painless technique to each patient, because the protocol can be adapted perfectly according to the timetable of the patient and also according to his social requirements
In the field of safety, so far and since 16 years these techniques started to be used, no legal procedure against a physician using the techniques Endopeel was announced and/or indexed to our knowledge. The only complications known until today are only transitory, like edema ecchymosis.
The report/ratio benefit cost of the treatment is accepted in the large majority of the cases.

Techniques

The selection of the patients has been described above.
The material to be used is the following :
- The medical device like specific and patented oily acid carbolic formula Tenenbaum

- Syringes 1 ml luer lock

- Flexible needles for the body 25 or 27g

- 1 needle 18g to aspire the solution of oily carbolic acid

- An anesthetic specific gel containing lidocaine 23%, tetracaine 7%, using an emollient lipophilic lubricating gel like vector

- A post ,, Endopeel,, ,, cold cream,,

- Finally one not alcoholic disinfecting product, gloves and gauzes 10x10 cm

The technique known as standard treats: the whole gluteal area on all sides, the banana fold, eventually the areas under the banana fold as the area above the trochanteric line.
Areas of, love handles, can be treated as well if there is no fat excess. In case of fat excess a prior lipoplasty should be done and Endopeel technique can follow 1 month after the lipoplasty procedure.

The basic technique consists in injecting in subcutaneous perpendicular to the plan of the muscles 0.10 ml of oily acid carbolic each 4cm2 and same in the perpendicular plan to the precedent following the direction and the sense to obtain the wished lifting effect

Errors: The intra vascular injection of carbolic acid cannot be regarded as an error, considering the sclerosing effect of this substance. The injection into the motor plate or any nerve of carbolic acid may slow down the speed of nervous conduction for one short duration.

Safety: It is recommended for toxicity reasons not to inject more than 25 ml/ day/ patients. In case a patient needs more than 25 ml, this technique can be divided in consecutive days,

Side effects, complications and alternative treatments.
The side effects or complications are only transitory and are summarized with an early edema and some ecchymosis easily treated and being able to be avoided. As for late edema occurring at the 10th day after the procedure, it is related to an allergy to peanuts and is treated only with antihistaminic. 2% of the Asian population is allergic to peanuts. A preliminary test is useless. It does not exist actually any alternative to the myotension, myopexy and myoplasty using other products and techniques than Endopeel. But the Endopeel techniques can be potentialized using chemical peelings as other existing treatments in medicine and cosmetic surgery.

Conclusion
Until now, the concept of gluteoplasty was based only on volume augmentation concept, without taking care of the gluteopexy as the gluteal shape. From now and thanks to the Endopeel a technique one acts not only on the myotension by preserving the muscular mass and without affecting the muscular contraction but also on the myoplasty and the myopexy. With this fact the indications of the fillers become more restricted and will apply only to the depressions that remain after tissue tension of the selected area. Indications of sutures will be too more restricted as they are not only painful but such technics are standard for males and females!

Finally chemical gluteopexies with a handing-over in tension of tissues with tightening effect like the Endopeel techniques give a better shape of the gluteal area, project a nice convexity of the new gluteal shape, which is tighten too, with redraping of the oranges skin due to cellulitis (which gets the, iron effect, with Endopeel). Also the eventual stretch marks will disappear (optically), being as well redraped through the, iron effect, of Endopeel.

The techniques Endopeel are thus a new strategic weapon for the cosmetic dermatologists, plastic surgeons and aesthetic medicine practitioners enabling them to complete and/or maintain a gluteoplasty and to propose an alternative to the surgery. .

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