Buttock Implant Revision

Q: Dr. Eppley, I am interested in a buttock implant revision. About ten years ago I got tear drop shaped buttock implants.  I had very little fat on my butt, so it was a bit disappointing after surgery.  I did have some augmentation, but my rear looked kind of pointed in the center.  I went back for some fat grafting towards the bottom to blend them in a bit, and it did help, but it was a so so result.  I figured it was better than having a completely flat butt, so lived with them for the next five years.  I had occasional soreness after exercise and sitting for long periods of time, but nothing unbearable. 

About three years ago I noticed the upper right side of my left buttock seemed sore pretty frequently.  I also wanted to investigate a different type of implant, so I found a doctor that preferred round implants.  He inserted a fairly large round implant that aesthetically was more pleasing and natural looking.  I’ve found that I have much more soreness with this pair. After exercise, after sitting for long periods of time, even laying flat in bed for a long time (if I’m sick) can cause discomfort for days afterwards even weeks.  It seems to be more around the “edges” of the implants or the implant pockets, but they are generally sore all over.  Especially that upper right corner again. Occasionally, it seems to radiate down the back of my legs, but this is rare. It seems to be getting progressively worse. 

They actually look pretty good.  There is nothing that unusual or unnatural looking about them. I don’t think the average person would ever know..so that part is not the issue..it’s the discomfort about 50% of the time. 

I’m really tempted to just remove them, but I’m afraid of being disfigured without them. It would be some period of time (6 mo’s- year) before I could do some fat grafting or anything else to remedy the issue.

Any thoughts on what’s going on and what I should do?

A: In answer to your buttock implant quandary, there are some critical pieces of information missing in your description. Are the implants in the subfascial or intramuscular position? What is the volume size of the implants? Who is the manufacturer and what is their durometer? (durometer = degree of firmness of a silicone material)

That information aside I can make the following general comments:

1) I think you would feel deformed if they were removed. It is no different than having breast implants and then taking them out…the resultant appearance will not be like what it was before they were put in.

2) It is hard to justify doing a buttock implant revision with an implant result that looks good even with some discomfort symptoms. The only reason to do so is if the buttock implant you have could be improved by new buttock implants that have much lower durometer. (much softer)

Dr. Barry Eppley

Indianapolis, Indiana