How Can My Hip Implants Be Revised?

Q: Dr. Eppley, I was hoping to receive some information about getting a revision surgery for my hip augmentation and also potentially getting my current buttock implants replaced with a larger size. I received both hip and buttock augmentation last year using custom implants for my buttocks and custom implants for my hips as well. While the intramuscular buttock surgery went well, the subfascial hip implants have been a huge problem for me. They seemed to be fine at first, but over time they’ve dropped lower on my leg, and are now protruding unnaturally and moving around. Attached are some photos of my protruding hip implants, for reference.

I did some research and saw that you’re an expert at revision surgery and custom implants, so I figured you were the right person to ask about my very specific situation. Are these revisions something that you would be willing to perform, and if so, do you have any other advice or information you could provide (pricing, recovery, etc)? Please let me know, and thanks in advance for your help.

A:Thank you for your inquiry and sending your picture and detailing your surgical history to which I can say the following:

1) Hip implants are very different than buttock implants in terms of pocket location. Buttock implants are locked into place by the intramuscular location. Hip implants, however, can not have an intra- or submuscular location and must be placed above the muscle or technically on top of the TFL fascia. As a result, there is the risk of inferior migration as they heal.

2) With this inferior migration comes an elongated pocket. Since the silicone surface does not adhere to the overlying tissues what you have now is an implant that is too ‘small’ for the pocket and thus can freely slide up and down. (pocket is vertically longer than the implant)

3) The most predictable approach is to work with the existing size of the implant pocket as making hip implant pockets smaller by trying to raise it and stay raised is prone to failure. (not to mention that it also requires a new incision at the bottom end of the pocket to do so)

4) Thus making a new longer implant to fit the length of the pocket width with an improved side profile would be the approach. Your existing hip implant is a version of the CCB7 implant design which has the maximum projection in the upper third of the implant. You would likely be better served by having a mid-implant projection point. (see attachments which shows the basic design file of the implants you currently have in place….although the exact dimensions I do not yet know.

Dr. Barry Eppley

Indianapolis, Indiana