Understanding the structures that shape the buttock.
From deep muscular architecture to visible surface contour. A clinical reading of layers, landmarks and movement—before procedural planning.
Explore the anatomy
ANATOMICAL ILLUSTRATION
Read the buttock as a layered anatomical system. The skeleton establishes the framework; muscles provide bulk and movement; fascia and fibrous septa connect tissues; subcutaneous fat and skin determine the visible envelope.
A surface hollow does not identify a single deep structure. Assess several layers before attributing a contour to muscle, fat or tethering.
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The iliac crest frames the upper region. The sacrum and coccyx form the central posterior axis. The posterior superior iliac spines (PSIS), greater trochanters and ischial tuberosities provide important orientation landmarks.
Pelvic tilt and stance change apparent projection. Palpation and examination establish individual landmarks; a photograph alone cannot locate deep structures reliably.
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Gluteus maximus is the large superficial muscle. Gluteus medius lies mainly lateral and superior, partly covered by maximus; gluteus minimus lies deep to medius. The deeper short external rotators have distinct relationships to the hip and neurovascular structures.
Maximus primarily extends and externally rotates the hip. Medius and minimus contribute to abduction and pelvic stability during single-leg support; actions vary with fibre position and joint angle.
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The broad origin includes the posterior ilium, dorsal sacrum and coccyx, sacrotuberous ligament and associated fascia. Fibres pass inferolaterally to the iliotibial tract and gluteal tuberosity of the femur.
Its size and architecture contribute strongly to posterior fullness. Visible projection also depends on fat distribution, pelvic orientation and the soft-tissue envelope; maximus alone does not determine shape.
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Gluteal fascia, the gluteal aponeurosis and continuity with the fascia lata support the region. Subcutaneous fibrous septa connect the skin and deeper tissues, influencing local mobility and transitions.
Attachments are not interchangeable with wrinkles or muscle borders. A crease may reflect tethering, loading and envelope geometry rather than the edge of a muscle.
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The subcutaneous layer contains adipose tissue organized by connective-tissue septa. Its thickness and distribution vary across the buttock and between individuals. Skin elasticity and tissue laxity further influence drape.
Distinguish muscle bulk, adipose fullness, skin laxity and focal tethering. Similar surface contours can arise from different combinations of these tissues.
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Examine the iliac crest, sacral midline, PSIS region, lateral trochanteric transition, intergluteal cleft and infragluteal folds together. Compare both sides using consistent stance and lighting.
Surface landmarks orient examination. They are not a substitute for knowledge of depth, anatomical variation or procedure-specific safety assessment.
ANATOMICAL ILLUSTRATION
In this contour atlas, “presacral triangle” describes the posterior surface region over the sacrum between the upper buttocks. It is a descriptive visual reference, not a discrete muscle or a universally standardized anatomical compartment.
Do not confuse this posterior surface descriptor with the internal presacral space anterior to the sacrum. Visibility varies with posture, adiposity and individual attachments.
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“Infragluteal diamond” is used here as a descriptive contour region at the medial buttock–upper-thigh transition. Its appearance relates to the lower cleft, paired folds and the position of the thighs.
There are no universal anatomical borders or mandatory ideal proportions for this descriptor. Record observed transitions rather than inferring an isolated deep structure.
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The lateral depression is a common variation at the transition between the pelvic region and greater trochanter. Pelvic geometry, muscle contours, fascial attachments and regional fat distribution all contribute to its appearance.
A hip dip is not inherently a defect or disease. Its depth cannot be explained by a single insertion, and anatomy alone does not predict a treatment response.
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A region to examine—not just a crease to trace.
The infra gluteal area is the transition beneath the lower buttock into the proximal posterior thigh. In this atlas, it is assessed as a region with surface extent and tissue depth; the infragluteal fold is one visible landmark within this broader reading.
The superficial contour reflects skin, subcutaneous fat and fibrous septa, together with continuity of the fascial envelope toward the posterior thigh. Deeper relationships include the ischial tuberosity and proximal hamstring origins, with gluteus maximus overlying part of this transition. The appearance of the region does not reveal these structures or their depth directly.
Assess subgluteal fullness, the buttock-to-thigh transition, skin laxity and symmetry separately from the crease. A localized fat roll below the fold, descent of buttock tissue and a pronounced fold are different observations; one does not establish the cause of another.
Compare relaxed standing with controlled contraction using matched posture and lighting. The sciatic nerve and posterior femoral cutaneous nerve and its branches are relevant deep relationships; the visible region is not a safe treatment zone.
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The infragluteal fold marks a buttock–posterior-thigh transition supported by connective-tissue anchoring and the arrangement of the soft-tissue envelope. It does not simply trace the inferior border of gluteus maximus.
“Banana fold” is a colloquial term and may also refer to adjacent subgluteal fullness. Distinguish the crease from the fat roll below it and from true tissue descent.
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The intergluteal or natal cleft is the midline groove separating the buttocks over the sacrococcygeal region. Its visible depth and length depend on adjacent volume, skin attachments and position.
Inspect the skin as well as the contour. Inflammation, drainage, pain or a suspected pilonidal condition calls for medical assessment before aesthetic planning.
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Supragluteal dimples are often seen near the PSIS region, where local soft-tissue attachments influence the surface. A V-shaped crease may be visible at the upper cleft, with variable expression.
Neither feature is obligatory. A fixed crease length, universal ratio or single causal muscle insertion should not be inferred from surface appearance.
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The superior gluteal neurovascular bundle typically leaves the pelvis above piriformis. The inferior gluteal bundle and sciatic nerve usually pass below it. Important vessels and nerves lie deep to gluteus maximus; branching and course vary.
No visible triangle, quadrant or crease guarantees safety. Deep venous injury is a major concern in gluteal fat grafting; its safety guidance must not be generalized to other procedures. This atlas provides no injection sites, depths or dosing.
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Muscle activation changes local firmness and contour; hip position and pelvic tilt alter what is seen. Compare relaxed standing with controlled contraction and, when relevant, movement or single-leg stance.
Use matched views and lighting. A change in contour during contraction does not by itself demonstrate treatment efficacy or establish which tissue should be treated.
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Average sex-related differences in pelvic geometry, muscle mass and fat distribution may influence contour. Individual overlap is substantial, and age, training, body composition and posture also matter.
Assess the person, not a stereotype. No universal male, female or ethnicity-based ideal can replace individual anatomy and patient-defined objectives.
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Anatomical assessment identifies the tissues contributing to a contour and their functional relationships. In this clinical vocabulary, Myomodulation® is the technique and concept; Endopeel® is a specific formulation used for myomodulation, not a generic product category.
This page establishes anatomical context. Fundamental Basics addresses the 3D/isovolumetric deformation model; Step by Step addresses treatment execution. Anatomy is not evidence of efficacy or a guarantee of safety.
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Document posture, pelvic orientation, palpable bony landmarks, symmetry, regional fullness, skin quality, creases and the response to contraction. Review previous surgery, scars, implants and relevant symptoms.
Integrate clinical history, examination and appropriate imaging when indicated. Map what is observed, identify uncertainty and keep contour assessment separate from procedural execution.
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