How Can My Malpositioned Flipped Buttock Implants Be Fixed?

Q: Dr. Eppley, I had a BBL with buttock implant five years ago. My buttock Implant are malpositioned, flipped and sagging and they split out of the muscle. What can be done now?

A:Thank you for sending your pictures. Based upon your description of concerns your buttock implants would have to be outside of the muscle as this would be the only reason they would flip and/or sag. Intramuscular placement about it implants is not associated with implant flipping or sagging.

I obviously have no information as to what the specifics of your buttock implant surgery as to how they were initially placed. It would be most helpful, if possible, to see the operative note from your surgeon from that surgery.

That being said, knowing that they were 455cc implants, in my experience those would be very difficult to get complete muscular coverage even if they tried to place them on an intra-muscular basis. Even if they got complete muscular coverage over them the size of implants would ultimately split the muscular closure due to pressure and they would have ended up either completely or partially outside of the muscle. Once outside the muscle then they can flip and sag. It would be easy to confirm this diagnosis with a CT scan if there is any doubt about the current implant location. However, a physical exam would likely provide verification of my explanation.

To solve this problem implants would need to be repositioned into the intramuscular space. It would be prudent to downsize the implants to the 350 to 400 mL range to successfully do so.

Dr. Barry Eppley

World-Renowned Plastic Surgeon