XCREST II: The X-factor in Iliac Crest Remodeling for Advanced Waist-to-hip Definition

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ID: 332259
2026
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Abstract
Abstract Background Modern body contouring has evolved toward structural reshaping, with the waist–hip-gluteal unit as a key determinant of body contour aesthetics. The iliac crest is a critical landmark for lower waist contour. Objectives To evaluate the aesthetic outcomes, safety, and anatomical contribution of XCREST II, a combined bony and myofascial technique for lower waist contouring. Methods A multicenter retrospective cohort study included 480 patients who underwent XCREST II between 2024 and 2026. Patients were categorized into four groups: XCREST II alone (n = 180), XCREST II + gluteal fat grafting (n = 84), XCREST II + RibXcar (n = 132), and XCREST II + RibXcar + gluteal fat grafting (n = 84). All underwent ultrasound-guided iliac crest remodeling with partial gluteus medius detachment. Anthropometric and BODY-Q outcomes were assessed preoperatively and at 12 months. Results Four hundred eighty patients were included. Baseline characteristics were comparable, except for longer operative time in combined procedures (p < 0.001). At 12 months, all anthropometric measures improved significantly from baseline across groups (p < 0.001), without intergroup differences. Complications were low; prolonged postoperative pain and iliac crest pain were more frequent in groups including RibXCar (p = 0.020 and p = 0.017, respectively), without chronic pain. BODY-Q scores improved significantly across all domains (p < 0.001), differing only in body image (p = 0.019) and scar assessment (p < 0.001). Conclusions XCREST II, a refinement of XCREST incorporating partial gluteus medius detachment, demonstrated favorable 12-month waist contour improvement and high patient satisfaction, with a low complication rate. Outcomes were consistent across subgroups.
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Authors Raúl Manzaneda Cipriani, José David Salazar, Héctor César Durán-Vega, Gerardo A Adrianzen, Emmanuel Flores, Hassan Ben Moussa, Carlos H García Santana, Enrique Romero Algara, Maribel Carolina Monar Goyes, Margiory Fernandez Rodriguez
Journal Aesthetic surgery journal
Year 2026
DOI
10.1093/asj/sjag226
URL
https://doi.org/10.1093/asj/sjag226
Keywords Keywords not found

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