Hip Implants When One Does Not Have Enough Fat For Hip Augmentation

Q: Dr. Eppley,  I have been to a couple of consultations but most plastic surgeons told me that I do not have enough fat to transfer into my hip area. I would like to know if you do hip implants. I am not happy with my shoulder to hip ratio.  I have broad shoulders and its making my lower body look even smaller. I am pretty fit and even with a fat transfer as much cardio as I do that will be disappear within a couple years. Please let know after talking to the doctor if he can possibly do something ? I have photoshopped the pictures below so you can get an idea of how I want my hips to look like.Thank you in advance for your time. 

A: You are correct in that you do not have enough fat to do hip augmentation with it and any fat transferred would not stay in a vey active person which your pictures demonstrate that you are. Based on this reality, here are your considerations for permanent hip augmentation:

1) Hip implants are your only option and they are good option if you can accept the 4 cm incision on each side to place them.

2) All hip implants are custom made based on measurements of the patient’s hip areas. So not only would their size be correct but that they will have feather edges which is critical to not have visible implant outlines showing through the skin.

3) Given your desired area of hip augmentation (trochanteric depression) they would have to be placed on top of the TFL fascia, a location where feather edging of the implant is critical.

4) Given that the #1 ‘complication of suprafascial hip implants is a fluid collection (seroma), it is of critical importance that one does not return to working out for 3 weeks after surgery to lower this potential postoperative problem risk.

Dr. Barry Eppley

Indianapolis, Indiana