How Can I Improve A Mobile Implant After Downsizing My Buttock Implants?

Q: Dr. Eppley, I am contacting you because I am in very great pain. To redo the chronology of what happened to me, it turns out that I had a buttock implant placed 4 years ago by a surgeon who did not know how to advise me on the right volume. (remember) Following this, I found myself with 530 cc which literally made my buttocks fall with a crease under the buttocks, banana under the buttocks and a disgrace due to the excessive weight of the implant. Following this, I ended up having the implant removed in favor of a smaller one (370 cc) but in the meantime the buttocks had been enlarged and the new implant was moving inside. I have therefore undergone many procedures in recent months. (A Bodytite under general anesthesia) no results. A first butt lift -12 cm (no result). And a second butt lift 2 weeks ago, again -12 cm (again no results.) the skin is flaccid and the implant wanders around in the completely enlarged buttock pocket

What can we do? Thank you in advance for your response. 

A:To your buttock implant dilemma I can make the following comments:

1) When you downsize  a buttock implant in volume the diameter or footprint of the implant also gets smaller. With an established pocket size the smaller implant no longer ‘fits’ and it will slide around in the now larger pocket…this is exactly what can be predicted to happen. The pocket does not shrink down contrary to what most surgeons think and there is no practical way to surgically reduce pocket size. This is why when do go for a smaller implant volume make sure the implant footprint stays the same and only the projection gets smaller (custom implant), thus keeping the implant ‘locked’ into place. Or you will end up with what you have now.

2) In the correction of buttock ptosis (bottoming out, banana roll deformity, inferior migration of infragluteal crease) the only effective treatment is a lower buttock lift/tuck. Trying to pull it up from above is a conceptually flawed approach that never works. (as you have now proven x 2) The force of the pull/lift is to far away from the problem to be effective. In short you can lift away a distant problem, it has to be treated by direct excision.

Dr. Barry Eppley

World-Renowned Plastic Surgeon