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The Cadogan Clinic is currently offering a reduced service in light of the government's January lockdown guidelines.

All of our services will be delivered in line with the UK government's social distancing measures and fully compliant with all PPE guidance from Public Health England and NHS England.

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Saddle bags are localised fat pads overlying the greater trochanters of the hips. The greater trochanter is sharp angle of the femur (thigh bone) where it angles into the hip. Being sharp, it needs padding and is where bed-ridden patients tend to develop pressure sores.

The saddlebags, fat pads only develop at puberty as a response to the boost in circulating oestrogen. They are thus secondary sexual characteristics and normal. The size is the issue. In some cultures, they are a sign of fertility and bigger hips are highly valued, appearing as fertility figures in central American sculptures. This shape is so out of fashion that we call this figure the condition of Trochanteric Lipodystrophy.

Fat over the hips is usually accompanied by deposits of the buttocks, inner thighs and inner knees. Currently, the athletic toned female has slim, boyish hips, which suit elegant clothing. Your body shape is inherited and often racial. No diet or exercise will change it. The athletic African female has slim hips but a highly prized pert bottom, due to another fat pad over the gluteal muscles.

The recent display of the Kardashian style hips and buttocks has renewed the recognition of the sexual attraction of these Columbian figurines. There is huge scope for body sculpting, taking fat from one area and grafting it elsewhere.

The common treatment is liposuction of the hips/saddlebags through a stab incision hidden under the buttocks. There is 10% skin retraction, which usually enough to prevent sagging. Older people and those that need  a considerable reduction may benefit from skin excision.

Those patients with a hanging bottom, where the buttock folds over the lower buttock (inferior gluteal) fold, benefit from a buttock reduction, removing the overhang and tightening the buttock skin. This well worth the extra scar, which is mostly hidden in the inferior gluteal fold.

There is a place for non surgical fat reduction, if you will be happier with a smaller reduction or do not want even the minor invasion of liposuction with general anaesthesia. We use TIVA which avoids the nausea of the usual anaesthetic gases.

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Of course, we use the very latest technology. But our real skill is in knowing how and when to use it to suit each individual patient.


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