Hip Implants and a Natural Look

Q: Dr. Eppley, Papers on buttock augmentation strongly recommend placing the implants between the muscle to avoid implant palpability and displacement.  I understand this is not possible with hips and the implant has to be placed below fascia. I found the following piece of information regarding hip implants. What do you think?

“Hip implants are problematic in several ways.  There is not much tissue to hide the implant so they can look fake.  Also, there’s significant risk that the implant may migrate because there is no natural pocket to constrain it in place.  It also has to be placed over the femur (leg bone) so that it is not subject to flexure when sitting.”

A: I find that commentary on hip implants erroneous on every level:

1) The way to avoid a hip implant from looking fake is to actually have a custom hip implant made that is designed specifically for that area. Since there is no such thing as a standard hip implants surgeons use body implants made for something else, like a buttock implant on the hips. No wonder it ends up not looking natural.

2) With a custom implant design that favors tissue ingrowth and a well made pocket for it, migration is not an issue.

3) Custom hip implants are commonly placed over the femur and its superior trochanteric extension. This does not interfere with flexion when sitting, standing or any other bodily movement.

Such comments are made based on an historic or a complete lack of a contemporary approach to hip implant augmentation.

Dr. Barry Eppley

Indianapolis Indiana