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Dr. Barry Eppley

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Posts Tagged ‘hip augmentation’

Plastic Surgery Case Study – Fat Injection Hip Augmentation

Saturday, March 14th, 2015


Background: The hips are an important part of a female’s body and their shape is often very gender specific…women’s are curved while men are straight. To be specific, the hips refer to the anatomic region overlying the hip or femur-pelvic joint. It is located to the sides of the buttocks but below the iliac crest of the pelvic bone. Since the greater trochanter of the femur is the most lateral part of the bony hip region, the shape of the hips can be seen to be influenced by its prominence but not exclusively so. The natural amount of fat in the subcutaneous layer also helps determine the outer hip contour.

Hip Augmentation Dr Barry Eppley IndianapolisThe aesthetic shape of the hips is almost an exclusively female concern. While too wide of hips is a more common aesthetic problem, there are females whose hips are too narrow or feel like they have ‘boy hips’. Hip augmentation is a way for those women to potentially enhance and widen their hips to create a more of an outer convex contour. Options for hip augmentation include fat grafting or hip implants.

Fat grafting through injection is the most common method today and is often part of many buttock augmentations as well. Through a liposuction harvest fat is collected and processed for injection. Through blunt cannulas the fat is injected to build out the hip contours. A side benefit is the body contouring that comes from the liposuction harvest. The downsides to the procedure are in how well does the fat survive after transfer and how much fat does one have to harvest. But if one has enough fat this is the best hip augmentation procedure despite the unpredictability of volume retention.

Since the fat comes from the patient’s own body, fat transfer is not ideal for patients with very little body fat. In these cases only silicone hip implants can be used. While their volume retention is assured, they come with all of the potential downsides that any other body implant has.

Case Study: This 36 year-old female wanted to fill out her hip depressions (trochanteric indentations) and get rid of her flanks. (love handles) She also had abdominal and waistline areas she wanted reduced although they were not an extensive amount of fat.

Fat Injections for Hip Augmentation Technique Dr Barry Eppley IndianapolisUnder general anesthesia, liposuction was performed on her full abdomen, flanks and outer thighs. A total of 875cc of liposuction aspirate was obtained. This was processed down to 270cc of concentrated fat. Each hip indentation was injected with 135cc of fat through  three separate angles in a linear fashion.

Fat Injection Hip Augmentation Indianapolis Dr Barry EppleyWhile she did lose some of the initial fat injected, she remained with an improved hip contour at six months after the procedure. The very obvious indentations were gone and the outer hip contour had been changed into more of a convexity than a concavity. The combination of flank liposuction and hip augmentation made for a more pleasing shape.

Case Highlights:

1) Hip augmentation is most commonly performed for trochanteric depressions over the mid-hip area or to create a more rounded contour of flat hips.

2) Fat injections are the natural method of hip augmentation and require some fat to harvest.

3) Fat injections in the hips can be expected to retain 50% to 75% of the injected volume.

Dr. Barry Eppley

Indianapolis, Indiana

Aesthetic Augmentation to the Hips/Upper Outer Thighs

Thursday, May 16th, 2013


The use of implants for body augmentation has been around for over fifty years. Breast implants are the most well known and account for the majority of all body contouring implants placed. But there are a variety of other body site implants that are recognized by most even if they occupy a small number of all body implantations performed. Implants exist for the chest, buttocks, arms and calfs. The numbers of these implant sites is increasing along with the array of implant options that are available for them.

One would think that just about every body site that could be augmented or implanted has been…but this is not true. One new area for body augmentation is that of the hips or thighs. Depending upon how you define this location, the goal is to have more curvature to the upper outer thigh. This seems ironic since most plastic surgery efforts are spent trying to reduce fullness in this area by liposuction. But there are women (and transgender females) that want a more curvaceous look to their outer thighs which is naturally very straight.

Upper thigh or hip augmentation can be done with a very soft silicone implant placed beneath the fascia overlying the outer thigh muscles. The surgical approach for the implant’s insertion is a 3 to 3.5cm horizontally oriented incision over the trochanteric region. The underlying fascia identified over the vastus lateralius muscle and opened where a blunt instrument is used to make the pocket. The implant itself is unique as no standard hip implant exists due to the newness of the application and the rarity of its request. I modify other existing body implants, most commonly contoured silicone carving blocks of sizes about 16 cms. long, 9 cms wide and 2 cms thick to fit into the pocket. Since they lie under the fascia and on top of the muscle, their contours are not seen on the overlying skin.

Other than some tightness of the outer thighs and the potential for infection or seroma (fluid collection), the risk of complications is fairly lower. The anatomy in this area has no major blood vessels or nerves. The muscle is not entered or violated so this hastens recovery. The only nerve of consequence is the lateral femoral cutaous nerve which supplies feeling to the lateral thigh, but its course is above and in from of the location of the incision. Recovery is fairly short in terms of returning to normal activities but strenuous activity and exercise requires waiting a full month after surgery.

The hip or upper thigh implant provides a curve or fullness to the upper outer thigh. These relatively thin slightly convex silicone implants are placed subfascially on top of the muscle to augment an otherwise straight leg line. For those women who have little fat to give for fat injection hip augmentation, an actual preformed implant is an alternative body contouring option.


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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