Hip Implants vs Hip Augmentation by Fat Injections

Q: Dr. Eppley, Most transwomen need a quite a bit of width at the hips to be able to balance their shoulders – we are looking at 2.5 -3 cm added projection on each of the sides. This means a very substantial amount of fat needs to be transferred. I do have ample, (un)fortunately!

I understand the vast majority of people are happy with what stays in their butt after fat transfer but I honestly dont know a single person who had enough left at the hip one year after surgery! 

What percentage of patients do you think can retain an inch of extra fat on each of the hips permanently? Won’t quote you on this! If the odds are not great, I would much rather consider implants. I understand they need “maintenance” – how often do you see displacement? I would assume they are at high risk because of the range of motions our hips go through! 

A: I would not disagree with you on the hips and the lack of fat retention, It is a very different recipient fat site than that of the buttocks. My general statement is that if you have enough fat you always give that a go first as, even if much of the fat is lost, you are making the hips a better recipient site for implant placement later.

But in the long run a 2.5cm to 3 cms increase is only going to be obtained by hip implants.

With custom made hip implants I haven’t see any worse issues that what occurs in buttock implants.

Dr. Barry Eppley

Indianapolis, Indiana