Chapter: Cosmetic Dermatology
Scarless Immediate Isovolumetric Gluteoplasty
Physicians will learn that with minimum material, low investment,with some techniques called Endopeel completely different and safer than fillers,mesotherapy,apparatology,threads or sutures,an alternative to surgery is proposed to reshape the gluteal area, allowing to lift, tighten and project at same moment in 3D the butts. Figure1
These techniques can be proposed to patients who wish to get a gluteoplasty, to patients who are not candidates for a surgical gluteoplasty, to patients who refuse threads and/or sutures, to patients who refuse fillers,to surgeons who wish to complete their surgical procedure of gluteoplasty with a medical method avoiding the surgical look of any prosthesis at the gluteal contraction. Figure2
The advantages of these techniques called Endopeel are important for the patients,because of
- THE IMMEDIATE EFFECT,
- THE ABSENCE OF SCAR,
- THE ABSENCE OF DOWN TIME,
- THE ABSENCE OF SOCIAL EVICTION
- THE ABSENCE OF PAIN DURING AND AFTER THE PROCEDURE
The immediate butts lift realized by isovolumetric gluteoplasty by chemical myoplasty, myopexy and myotension ( so called Endopeel) is a new weapon for plastic surgeons, cosmetic dermatologists or aesthetic medicine practicioners to propose to their patients .
The techniques Endopeel consider each muscular unit like a viscoelastic elastomere which can be deformed in 3D applying vectors normal to the muscular plan and tensors parallel to the muscular plan choosing the direction and the sense of the movement to get a deformation.
Instead of using fillers to add volume to the butts, we have preferred to use a 3D isovolumetric repositioning of the muscles , by tightening the butts, lifting them and projecting them.The isovoumetric projection of the butts is logic at the difference of adding volume with fillers, regarding the laws of the gravitation in Physics ( adding volume lead to more weight which has tendence to fall down) .
All patients who desire a surgical or non-surgical gluteoplastycan 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.) Figure3
- Best indication is not fatty gluteal area, sagging down .
- Our criters of exclusion: pregnant women, subjects under 18 years, patients using recently steroid anabolisants, patients with severe allergy to arachides, patients with prosthesis placed too much superficial.Figure4
- Gluteal Projection Figure5
- Butts Tightening Figure6
- Gluteopexy or Butts Lift Figure7
- Hardening the gluteal area
- Gluteal Atrophy Figure7
- Gluteal Stretch Marks Figure8
- Correction post Lipoplasty Figure9
- Reshaping Sporty Butts for males Figure10 and females
- Fashion Butts Figure11
- Butts in case of inferior member asymetry
- Banana Fold Lift or Infragluteal Fold Lift
- Post Gluteal Prosthesis
Benefits and Advantages-Results
The gluteopexy effect is immediate and is perfectly visible 30 minutes after the end of the treatment with a maximum result 3 days after the procedure.
- The gluteopexy effect is early and will be relayed by the late peeling effect, specific to the techniques Endopeel.
- 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 proceduresbecause 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
- In the field of safety, so far and since 17 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 main complications are only transitory, like ecchymosis.
- The report/ratio benefit cost of the treatment is accepted in the large majority of the cases.
Material and Methods
The chemical patented mixture used for injection is made of carbolic acid and arachidonic acid.
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
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
Until now, the concept of Gluteoplasty was based only on volume augmentation concept, without taking care of the gluteopexy. With Endopeel techniques 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 which remain after tissue tension of the selected area. Indications of sutures will be too more restricted as they are not only painful but it is rare that a patient submits 2 times to sutures gluteal lift.
Finally chemical gluteopexy 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 dued to cellulitis ( which gets the, iron effect, with Endopeel ). Also the eventual stretch marks will only optically disappear, being as well redraped through the, iron effect, of Endopeel.
Keywords: endopeel,chemical myoplasty, chemical myopexy,retensado cutaneo,medical gluteoplasty,butts reshaping,gluteopexy,muscular repositioning.
Legend to Figures
Figure 1 : Endopeel is an isovolumetric medical myoplasty .On this 36 years old male, just the left butts has been treated and here is the result 30 minutes after procedure. It is easy to see the lifting effect ( myopexy), the tightening effect and the projection effect ( without any volume augmentation) .Endopeel techniques ( isovolumetric) is completely different of fillers ( adding volume)
Figure 2: The surgical look of prosthesis at contraction
Figure 3: Migration of PAAG Filler after 5 years
Figure 4: An implant placed too superficially is a contra indication for Endopeel
Figure 5: Indication : Gluteal Projection –Female Vietnamese Patient-Results after 3 days
Figure 6: Indication: Butts Tightening- Left Butt treated on a 30 years old male-Result after 15 minutes. The tightening effect measures 4 cm
Figure 7: Left Gluteopexy on a 45 years old male- Result after 30 minutes.
The gluteal muscles were atrophied after a long decubitus post accident which immobilizes the patient.
Figure 8: Endopeel improves the optical effect of gluteal stretch marks without treating the stretch marks .
Right Gluteus treated on a thai male patient 30 years old, who had lost 30 kg in 5 months after a diet
( initial weight was 100kg). Result after 30 minutes
Figure9: Correction post lipoplasty- Left Butt has been treated , 6 months after lipoplasty with fat grafting .
Result after 30 minutes on a 36 years old brazilian female.
Figure10: Left Butts treated on a male Brazilian soccer of 23 years old.
Soccers run so much that they increase quickly the gluteal mass and volume, too heavy for their well shaped defined body. That s why they are asking to reshape and lift their butts .Result after 30 minutes.
Figure11: Fashion Butts on a 18 years Cambodian male
Figure12 Vectors and Tensors
- Tenenbaum A (2009) La tecnica Endopeel- La medicina estetica-A.Redaelli, EEAFlorence.
- Dewandre L,Tenenbaum A (2011) The Chemistry of Peels (2nd edn), Saunders Elsevier.
- Tenenbaum A (2013) Medical Facelifts by Chemical Myoplasty, Myotension and Myopexy (Endopeel Techniques or Muscular SMAS Repositioning). Anaplastology 2: 116. doi: 10.4172/2161-1173.1000116