Buttock Implant Revision

Q: Dr. Eppley, here are some pictures of my current buttock implants. They do not extend to my thighs and I can lift them off my butt by just putting my fingers under the implants. What are your recommendations for my buttock implant revision?

A: Thank you for sending your pictures. What you have are standard buttock implants placed in a subfascial or subcutaneous position. This is why they are so visible as the soft tissue have contracted around the implant perimeters, the rounded edges of the implants are visible and you can physically lift up the underside of the implant.

This is a difficult problem to improve as your options include the following:

1) Reposition implants into the deeper intramuscular place. While this is the best pocket for them as it will eliminate implant show, the implants would end up a lot smaller and there is the uncertainty as to what the overlying skin and subfascial pocket will do. (in other words would there be an overlying soft tissue sag?)

2) Keep the same pocket but have larger custom implants made that have feather edges and will cover a larger buttock area and go more to the sides. While this is a much better implant style to have in a superficial subfascial buttock pocket and will lessen implant show and give a better shape, what will happen long-term to the implants with such thin soft tissue over is unknown. (in other words will they drop over time, will they develop capsular contarcture)

Dr. Barry Eppley

Indianapolis, Indiana