Morphological Analysis of the Buttocks and Thighs and Liposuction
What does a beautiful buttock look like?
The photo below shows a Brazilian woman who was chosen as having the most beautiful buttocks at a "World's Most Beautiful Buttocks" contest hosted by an underwear company last year. In a way, she looks like she has what Koreans call a "duck butt." The curve of the lower spine makes the buttocks protrude, the buttocks do not sag, and they are round from top to bottom and side to side — this seems to be what people find beautiful. There is also a balanced harmony between the thighs, buttocks, and waist.

In the picture below, B stands for buttock, ILB for inferior lateral buttock, BN for banana fold, T for thigh, and H for hip. People often use "hip" to mean the buttocks, but strictly speaking, the "hip" is the bulge above the pelvis on each side, and the "buttock" is the part that touches the chair when you sit. So surgery that lifts the buttocks should really be called a "buttock lift" rather than a "hip lift."
The figure next to it shows the anatomy. An important structure is the ligamentous support of the buttock: Luschke's ligament at the lower buttock is attached to the underlying fascia so that the buttock does not sag downward, and the banana fold is also attached, in the form of a ligament, to the muscle fascia below the buttock, supporting the buttock while preventing the back of the thigh from sagging.

If Luschke's ligament is damaged, fat from the buttock can slip down toward the thigh, or the crease under the buttock can droop downward, which is cosmetically unattractive.

Also, as in the photo below, damage to the ligament at the banana fold can create a double crease.

Therefore, for liposuction to create a beautiful harmony between the buttocks and thighs:
First, it must be a three-dimensional operation that understands the round curves of the female body while bringing the flanks (the hips), buttocks, and thighs into harmony with one another. Dr. Klein, who developed tumescent liposuction, emphasizes that the hips, buttocks, and thighs should be regarded as a single cosmetic unit, must be treated together, and should be shaped so that they look harmonious with one another.
The photo below shows a bulge at the hips, relatively less projection of the buttocks, and a bulge on the outer thighs (saddlebags), giving the pelvic area a square shape. By removing the bulges at the hips on the flanks above the pelvis and at the outer thighs below, the outer silhouette of the pelvic area was changed from a square shape into a round, feminine curve, and fat grafting to the upper part of the buttocks increased buttock volume, resulting in a soft, three-dimensional, beautiful feminine buttock shape.
In the end, harmony of the cosmetic unit was created, and a buttock lift was achieved.

Second is the outer thigh. The bulge on the outer thigh that is characteristic of women is sometimes called the "saddlebag," and this is also the area where women's bodies accumulate the most fat. Dr. Gasparotti of Italy, well known for superficial liposuction, classified the various shapes of saddlebags and stated that surgical techniques should differ accordingly.
Because fat accumulates here under the influence of female hormones, this area also responds poorly to diet or exercise.

In the photo below, the outer thighs project more than the buttocks, making the legs look shorter. By Gasparotti's classification, this is type C. By removing more fat from the outer thighs than from the buttocks, the size and shape of the thighs and buttocks were brought into harmony.
In other words, the buttocks gained a sense of volume, the transition from buttock to thigh became natural, the buttocks look lifted, and the legs look longer. A buttock lift was achieved.

In the photo below, by reducing the size of the buttocks rather than the outer thighs, harmony between the thighs and buttocks was achieved. In addition, by removing the ILB (inferior lateral buttock) shown in the figure above — the lower outer part of the buttocks — we removed the fat bulging outward on both sides at the panty line, gathering the buttocks toward the center.
When buttock volume decreases, the buttocks naturally become lighter and the position of the crease that supports them rises, so a buttock lift was also achieved.
The third area that needs attention is the crease that serves as the support of the buttocks. In some people this crease is congenitally weak or absent altogether, and in others it droops downward. In such cases, deepening the crease to clearly separate the buttock from the thigh, and shaping the crease into a slightly upward curve, will create a beautiful buttock.


Fourth and finally, when there is congenital asymmetry between the two buttocks or a depressed area, correction is needed. The photo below shows a depression at the left pelvic area; by filling it with fat grafting and removing different amounts of fat from each buttock, the buttocks and thighs were changed to look fairly similar on both sides.

In conclusion, thigh and buttock liposuction should be performed together to obtain a harmonious shape of the hips, buttocks, and thighs, and it should be an operation that brings out beautiful, soft feminine beauty — three-dimensional in form and emphasizing curves rather than straight lines.
Because Venus Clinic pursues overall harmony and an adequate amount of fat removal, in most cases we perform liposuction all at once on the entire thigh in a 360-degree circumferential manner — outer, inner, front, and back — together with the knees, buttocks, and the hips below the flanks. We recommend this cosmetic-unit approach because fat is removed evenly, so the shape is less likely to change even if you gain weight later.
This approach has the advantage of creating a well-balanced lower body, because it allows us to work on several lines at once: narrowing the outer line from the hips to the knees and both sides of the buttocks, a buttock lift that gives an upward effect, the back line of the buttocks, the front thigh line from the groin to the knee, and the inner line running from the inner thigh past the knee to the calf.
References
Venus-style liposuctionLiposuction information by body areaButtock volume enhancementPrecautions by surgical area
[Dr. Jung, Director, Venus Clinic]