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Revisional Buttock Implant Surgery

 

Like implants placed anywhere on the body, buttock implants can also have complications. When one compares the two methods of buttock augmentation, fat injection vs implants, it is no surprise that the placement of an implant is associated with a higher rate of potential complications. But for those women and men who have inadequate fat harvest sites, buttocks implants are their only buttock augmentation option.

As overall buttock augmentation surgery has become more prevalent, the number of buttock implants being placed has also increased. As a result the number of implant complications has expectantly risen as well. Buttock implant complications include medical problems of wound dehiscence, infection, hematomas an seromas as well as aesthetic concerns of  size and shape. How well patients do with buttock implant revisions and their outcomes has not been previously studied or published.

In the February 2017 issue of the journal Plastic and Reconstructive Surgery, the first paper on this topic was published entitled ‘Revision Buttock Augmentation: Indications, Procedures, and Recommendations’.  In this paper the author reviews his twelve year experience in 43 patients who had revisional buttock implant replacement. The indications for buttock implant replacment were prior loss of implant (42%), asymmetry (37%) and size change. (21%) Revision buttock implantation procedures done were implant removal (24), implant replacement (19), implant exchange (18), capsulotomy (6), size change (5) and capsulorraphy. (1) Complications after the 24 buttock implant removals included contour irregularities that required fat grafting (2) but no infections o wound dehiscences were seen. Of great interest is what happened in the 19 buttock implant replacement patients. Infections occurred in 25% of them. Complications after buttock implant exchange was hematoma. (5%)

In primary buttock implant surgery the most dreaded complication is that of infection. Once it is diagnosed the recommendation is to remove the implant immediately and wait at least 6 months until it is replaced. Trying to replace the implant too early (just months after its removal) is associated with a higher rate of recurrent infection.

Implant asymmetry was seen equally in both subfascial and intramuscular locations. Its resolution requires either capsulotomies to expand the space or implant shape change.

Aesthetic buttock implant exchange for size and shape requires a good understanding of postoperative expectations. Oval shaped implants are good when the buttocks is long and lacks lower pole fullness. Oval implant rotation is treated by a round implant replacement. The typical implant size increase was 100cc with an additional cm in implant width.

The need for revisional buttock implant surgery is always a potential sequelae of primary implant augmentation and includes management strategies for the timing of primary implant removal and secondary implant replacement due to infection and seromas. Aesthetic implant revision must be tempered with balancing the potential risks vs how much buttock size and shape change will result.

Dr. Barry Eppley

Indianapolis, Indiana


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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