Q: Dr. Eppley, I’m largely familiar with the constellation of procedures that comprise Facial Feminization Surgery and Sexual Reassignment Surgery. Procedures that ‘balance’ the lower-body to ensure it’s proportional to the upper body are much less clear. Would you please take a moment to help me understand your thigh and buttock augmentation procedures?
1. What is the vertical & circumferential extend of implants used for lateral augmentation of the thigh (in the region of the greater trochanter)?
2. What are the vertical & lateral dimensions of the buttock implants? My concern here is to understand how these implants, in conjunction with lateral thigh implants, will create a natural curved profile in the waist-to-thigh area (instead of being “localized” augmentation).
3. I have a ‘flat’ area just below the iliac crest. Since this is above the greater trochanter and will likely not change with lateral thigh augmentation, do you have a method (or implant) to fill-in this area for to create an more uniform curvature from waist-to-thigh?
4. How are implants in this area ‘secured’ in their desired location so there will be no dislocation over time?
5. Where are the incision(s) for lateral thigh augmentation?
A: Thank you for your questions. In answer to them:
- There are no standard off the shelf thigh implants. They almost all have to be custom made so their dimensions can be largely what one chooses based on measurements of the patient. But one should not think of them as circumferential, they are lateral implants and that is the extent that they cover.
- Even when put together at the same time in the same patient, buttock and thigh implants will be localized augmentations. They do not connect nor can they. Their implant pockets are separate.
- The trochanteric drop area is best treated by fat injections if possible since it is a flexion area for which implants are not best used.
- All forms of body implants are secured only by the pocket that is made for them. They stabilize because the body forms a layer of scar around them (the capsule) this locking them into place.
- Lateral thigh implants are placed through a small (4 to 5 cm) incision over the upper thigh.
Dr. Barry Eppley