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Fascia glutealis as mediator of musculocutaneous dynamics in the buttocks region

Die Fascia glutealis als Mittler der muskulokutanen Dynamik der Gesäßregion

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Journal für Ästhetische Chirurgie Aims and scope

Abstract

Cellulite is a change of the skin and subcutaneous tissue that develops mainly in the thighs and gluteal region of almost all women. Many concepts in the pathological physiology of cellulite are to some extent contradictory and inconclusive; however, some studies point to structural changes in the dermis and subcutaneous tissue. A correlation of cellulite with focal hypertrophic subcutaneous connective tissue strands and lower density of connective tissue septa in subcutaneous tissue also point to changes in the related gluteal fascia and thus in the closely interlaced gluteal muscles. A rapid degenerative development of the muscle dynamics that were originally gained over generations unquestionably occurs in the Caucasian race and its related urbanization. The gender-specific dimorphism in the subcutaneous area must also be investigated further, since almost exclusively women are affected. For this reason we have anatomically examined male and female gluteal zones and demonstrated significant genderspecific changes. In particular, a weakening of the muscle-tendon and muscle-fascia dynamics of the gluteal muscles appears to be responsible for the round, superficially visible dermal changes. The entire embryonic unit of the muscle-fascia-skin structures in the buttocks and thigh area is involved in female cellulite. A transformation of these degenerative changes through regenerative measures, such as active movement and shock wave therapy is, therefore, appropriate and necessary.

Zusammenfassung

Cellulite ist eine sich bevorzugt an den Oberschenkeln und Glutealregion beinahe bei fast allen Frauen entwickelnde Veränderung von Haut und Subkutangewebe. Viele Konzepte zur Pathophysiologie der Cellulite sind teilweise widersprüchlich und unschlüssig. Einige Studien weisen jedoch auf strukturelle Veränderungen an Dermis und Subkutangewebe hin. Eine Korrelation von Cellulite mit fokalen hypertrophen subkutanen Bindegewebssträngen und verringerter Dichte der Bindegewebssepten im Subkutangewebe weist auch auf Veränderungen der damit verbundenen Fascia glutealis und mit der dabei eng verwobenen Glutealmuskulatur hin. Fraglos besteht bei der kaukasischen Rasse und der mit ihr verbundenen Urbanisierung eine rapide degenerative Entwicklung der ursprünglich über Generationen erworbenen Muskeldynamik. Auch ist der geschlechtsspezifische Dimorphismus im subkutanen Bereich genauer zu untersuchen, zumal fast ausschließlich Frauen betroffen sind. Aus diesem Grund haben wir männliche und weibliche Gesäßzonen anatomisch untersucht und hierbei deutliche geschlechtsspezifische Veränderungen aufzeigen können. Vor allem eine Abschwächung der myotendinösen und myofaszialen Dynamik der Glutealmuskulatur scheint für die runden, oberflächlich sichtbaren dermalen Veränderungen verantwortlich zu sein. Die embryologische Einheit der muskulofasziokutanen Strukturen im Gesäß und Oberschenkelbereich ist als Gesamtes bei der weiblichen Cellulite involviert. Daher ist eine Transformation dieser degenerativen Veränderungen durch regenerative Maßnahmen wie aktive Bewegung und Stoßwelle sinnvoll und notwendig.

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Acknowledgments

I would like to thank Dr. Martin Barsch for working on the English text version and for his scientific cooperation in the preparation of the article.

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Authors and Affiliations

  1. Zentrum für Venen, Lipödem, Laser, Haut, Praxis Dr. Matthias Sandhofer/Dr. Martin Barsch, MBA, Starhembergstr.12/3, 4020, Linz, Austria

    M. Sandhofer

  2. http://www.hautarzt-passau.com

    P. Schauer

  3. Harrachstr. 21, 8010, Graz, Austria

    U. Pilsl &  F. Anderhuber

Authors
  1. M. Sandhofer
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  2. P. Schauer
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  3. U. Pilsl
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  4. F. Anderhuber
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Correspondence to M. Sandhofer.

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M. Sandhofer, P. Schauer, U. Pilsl and F. Anderhuber declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

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Sandhofer, M., Schauer, P., Pilsl, U. et al. Fascia glutealis as mediator of musculocutaneous dynamics in the buttocks region. J Ästhet Chir 12 (Suppl 1), 6–13 (2019). https://doi.org/10.1007/s12631-018-0132-9

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