Q: Dr. Eppley, I was looking into your procedure for fat grafting for Coccydynia. I have pain around my coccyx and sitting down is painful for me. I’m looking for a pain relief alternative to having the coccyx removed. I wanted to know exactly how the procedure is done.
A: There are two methods fat grafting to cover the coccyx with the intent of providing increased padding over the bone. The first method is dermal-fat grafting. There is where a strip of skin and fat is taken (usually from the abdomen) and implanted over the coccygeal bone through a small incision. (dermal-fat grafting) The second method is injectable fat grafting where fat is harvested by liposuction, processed and then injected into and around the ccocygeal bone. The success of both methods would be based on how well the fat survives. I have done both numerous times and there are advantages and disadvantages with each method. Dermal-fat grafts usually survive better but require a harvest site and an open incision to place. Injectable fat grafting is incision-free but its survival over the pressure point of the coccygeal bone, which is also frequently sit on, is less.
Dr. Barry Eppley