Buttock Implant Removal

Q: Dr. Eppley, Two questions about buttock implant removal:

1.Do you remove the capsule? I would like to try fat grafting in the future to try to achieve a more normal appearance.  I understand if the capsule is not removed or if it does not close completely the injected fat can die if it is injected into an empty pocket. Would you agree? Or is it better to leave the pocket for some “padding”?

2. Can fat grafting lift up a sagging buttock after implant removal or do you need something more solid like an implant? 


A: In answer to your buttock implant removal questions:

1) It is not necessary to completely remove the capsule and in trying to do so can be source of postoperative hematoma and would mandate the use of drains. The capsule will naturally undergo a lot of resorption once the implant is removed since there is no purpose for it any longer. It is not true that if fat is injected into it, it will die. In fact some surgeon espouse the opposite….injecting fat into a capsular space enhances its survival. But this is is really an irrelevant discussion sine the you might be injecting fat will be long after most of the capsule is gone.

2) Fat grafting will not lift up a sagging buttock. It takes a strong push from a solid implant to have that effect unless one injects a tremendous amount of fat…which you don’t have to harvest.

Dr. Barry Eppley

Indianapolis, Indiana