{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:53:37Z","timestamp":1791899617308,"version":"4.3.4"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Modern body contouring has evolved toward structural reshaping, with the waist\u2013hip-gluteal unit as a key determinant of body contour aesthetics. The iliac crest is a critical landmark for lower waist contour.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the aesthetic outcomes, safety, and anatomical contribution of XCREST II, a combined bony and myofascial technique for lower waist contouring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four hundred eighty patients were included. Baseline characteristics were comparable, except for longer operative time in combined procedures (p &amp;lt; 0.001). At 12 months, all anthropometric measures improved significantly from baseline across groups (p &amp;lt; 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 &amp;lt; 0.001), differing only in body image (p = 0.019) and scar assessment (p &amp;lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/asj\/sjag226","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T11:47:01Z","timestamp":1791632821000},"source":"Crossref","is-referenced-by-count":0,"title":["XCREST II: The X-factor in Iliac Crest Remodeling for Advanced Waist-to-hip Definition"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1359-2298","authenticated-orcid":false,"given":"Ra\u00fal M","family":"Manzaneda Cipriani","sequence":"first","affiliation":[{"name":"Plastic and reconstructive surgeon in private practice in Lima , Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose David","family":"Salazar","sequence":"additional","affiliation":[{"name":"Plastic and reconstructive surgeon in private practice in Medellin , Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3399-6302","authenticated-orcid":false,"given":"H\u00e9ctor","family":"Duran","sequence":"additional","affiliation":[{"name":"Plastic and reconstructive surgeon in private practice in Merida Yucat\u00e1n ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerardo A","family":"Adrianzen","sequence":"additional","affiliation":[{"name":"Private practice in Lima , Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Flores","sequence":"additional","affiliation":[{"name":"Plastic and reconstructive surgeon in private practice in M\u00e9xico city ,","place":["M\u00e9xico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Ben Moussa","sequence":"additional","affiliation":[{"name":"Plastic and reconstructive surgeon in private practice in Marrakesh , Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos H","family":"Garc\u00eda Santana","sequence":"additional","affiliation":[{"name":"Plastic and reconstructive surgeon in private practice in Jalisco ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Romero Algara","sequence":"additional","affiliation":[{"name":"Plastic and reconstructive surgeon, Puerta de Hierro Andares Hospital , Guadalajara, Jalisco ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maribel C","family":"Monar Goyes","sequence":"additional","affiliation":[{"name":"Plastic and reconstructive resident, Pontifical Catholic University of Ecuador , Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margiory","family":"Fernandez Rodriguez","sequence":"additional","affiliation":[{"name":"Private practice in Lima , Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,13]]},"container-title":["Aesthetic Surgery Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/asj\/advance-article-pdf\/doi\/10.1093\/asj\/sjag226\/71908244\/sjag226.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/asj\/advance-article-pdf\/doi\/10.1093\/asj\/sjag226\/71908244\/sjag226.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:19:58Z","timestamp":1791897598000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/asj\/advance-article\/doi\/10.1093\/asj\/sjag226\/8914390"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,13]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/asj\/sjag226","relation":{},"ISSN":["1090-820X","1527-330X"],"issn-type":[{"value":"1090-820X","type":"print"},{"value":"1527-330X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,13]]},"article-number":"sjag226"}}