Aesthetic surgery journal · 2026
XCREST II: The X-factor in Iliac Crest Remodeling for Advanced Waist-to-hip Definition.
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Manzaneda Cipriani Raúl M, Salazar Jose David, Duran Héctor, Adrianzen Gerardo A, Flores Emmanuel, Ben Moussa Hassan, García Santana Carlos H, Romero Algara Enrique, Monar Goyes Maribel C, Fernandez Rodriguez Margiory
Аннотация
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.
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.