Treatment of the High Iliac Crest With Iliac Crest Reduction (XCREST)

The iliac crest is defined as the superior border of the ilium or iliac bone and serves as an insertion point for various muscles, ligaments, and fasciae. The iliac crest should be prioritized if a more harmonious body is sought. Performing a fat transfer above the gluteus medius muscle area results in the gluteus medius being volumized, creating a high and large buttock, which is not always aesthetically desirable.

The aim of this study was to describe a safe, crest-treating technique (XCREST) designed to decrease the iliac crest, thereby achieving a more harmonious transition from waist to hip.

The sample consisted of 200 female patients. Measurements were taken of the waist, the distance between the iliac crest and the trochanter, and the distance between the last palpable rib and the iliac crest. Measurements were recorded in the preoperative stage, in the immediate postoperative stage, and 6 months later.

A reduction in the mean waist measurement was found, from 83.11 cm preoperatively, to 72.31 cm in the immediate postoperative period, and to 72.06 cm 6 months after the operation. The average distance between the last palpable rib and the iliac crest increased by 3.8 cm. Ten percent of the patients presented complications related to pain for less than 2 months, which were duly treated.

The XCREST technique effectively reduces the waist diameter and improves the aesthetic appearance at the sixth postoperative month, evidencing a better transition between the waist, hip, and buttocks.