Most aesthetic body contouring surgeries manipulate soft tissues for augmentative or reductive changes. Very few aesthetic procedures, unlike the face, change the bony structures to exert its effects. Such body procedures include limb lengthening, shoulder narrowing and lengthening and lower ribcage reductions for waistline/torso narrowing. But a new structural body procedure has emerged for aesthetic augmentation known as pelvic plasty.
Pelvic plasty, as it is known today, involves augmentation of the pelvic rim or iliac crest. The iliac crest is the superior wing of the ilium and the most superior and lateral margin of the pelvis. It is the area of bone at the upper hips which everyone can feel. It has a long convex curved shape although it is not uniform in thickness from its most anterior point (anterior superior iliac spine) to its most posterior point. (posterior superior iliac spine) Its aesthetic significance is that its width has a role in establishing the waist-to-hip ratio (WHR)
WHR for female attractiveness is within the range of 0.6 to 0.7. While good WHR can usually be achieved by conventional surgical methods, some patients have anatomic limitations due to their pelvic bone size/girth. Augmenting the iliac crest of the pelvis presents a novel skeletal approach aimed at genuinely increasing pelvic bone width to attain the desired WHR.
Iliac crest implants now exist that are capable of increasing pelvic width. Placed through a small incision just below the anterior superior iliac spine. They are a plate design in which the working end of the implant is its central portion where the width is created. They are available in various widths of 15, 20, 35, 40 and 50mms. The 35 and 40mm widths are the most commonly used.
To obtain optimal width benefit from the implant it must be properly positioned on the iliac crest. The edge of the iliac crest has an angulation to it of about 45 degrees which is how the plate its designed to fit. Screw fixation is required to keep it at this angle even though the plate sits well on the angulated crestal shaped platform.
Dr. Barry Eppley
World-Renowned Plastic Surgeon