How Can My Pelvic Plasty Problem Be Fixed?

Q: Dr. Eppley, I wound up getting pelvic plasty with the Korean yonsei baro chuk group that does it  as well. I went for a first surgery 6 months ago and then an attempted revision to fix the plastic portion again 1 month ago. Unfortunately neither helped at all, and now I am even worse off than before I got pelvic plasty.

Since my primary issue is the plastic implants sticking out exactly like before, I was wondering if you could help me with this issue? My old pocket is very big and likely needs to be adjusted to look normal. When I asked recently yonsei stated they did not alter the pocket because it was too deep to be sutured. I don’t know if I need new implants, or none at all plus fat transfer, or just a new pocket, but I was hoping to find that in a consult too. And to clarify I’m fine with my metal, my only issue is with the lower bulge. I have attached photos below.

Could I please get your opinion on this matter and what you would recommend? And how much you would charge roughly? Regarding a consult I’d prefer just an online one but if an in person evaluation is needed please just let me know

A:As can be seen in your 2-D CT scan there is excellent placement of the titanium crest implants as well as good adaptation of the silicone hip implant to the titanium crest one. But in looking at the external contour it is quite clear that the implant protrudes too far outward.  Whilethe implant pocket is clearly bigger than the implant, particularly on the right side, you can never adjust the actual implant pocket. That is simply too difficult or impossible to do. But I don’t think the implant pocket is the real issue. In my opinion it is the shape and size of the silicone implant that is the problem. Because the hooked design of the implant attaches to do the titanium crest implant, which is ideal, this also appears to be holding it out or pushing out the silicone implant and not allowing it to fall inward which creates the visible external contour deformity.

This is certainly a new pelvic plasty problem that I have not seen before and I don’t really have an obvious solution to it. Since you can’t adjust the implant pocket to pull the implant inward this suggests that either a different length and shape of the silicone implant is needed or, maybe it is best to have the silicone implant removed and let it heal and then see what it looks like. For all we know maybe you have an implant size that is really bigger than what you need or maybe you really don’t need the silicone hip implant at all. Given that you have had one effort at silicone implants adjustment with no resolution I would favor the latter as opposed to the former approach.

Dr. Barry Eppley

World-Renowned Plastic Surgeon