Hip augmentation is most commonly done using fat injections. Even for patients that do not have a lot of fat to harvest, enough can almost always be obtained to fill in indentations or divots on both sides of the hips. But when combined buttock and hip augmentations are needed or in a thin body type, fat harvest sites may be inadequate. In addition, not all fat injections to the hips are successful.
When fat injections is not option or has failed for hip augmentation, the only other option is the use of an implant. There is no standard or preformed hip implants. While some surgeons may try and use implants made for other parts of the body, the hip area requires a unique implant shape. This shape is more like that of a shaped buttock implant but with a lower profile at its peak projection.
Because the length of the hip and its indentation is different for each patient, custom hip implants are most ideally used. Using measurements taken from the patient, the length and width of the implant can be created. The higher projection of the implant is on its superior end and usually does not need to be greater than 3 to 3.5 cms. The implant tapers down to a fine edge on its inferior extent.
Hip implants are placed through a posterior incision placed at the upper-posterior margin of the implant pocket. It is usually no more than 4.5 cms in length. The pocket is dissected down on top of the TFL (tensor fascia lata, outer thigh muscle) along the outer implant markings. The iplants are inserted using a no-touch funnel technique. Their low durometer makes passing through the funnel possible. Drains are often used and stay in place for 3 to 5 days. An above the needle girdle or cross-buttock taping with Mefix serves as postoperative compression.
Custom hip implants provide a permanent augmentation to narrow or indented hips. They are an option when there is inadequate donor sites for fat injections or fat injections that have not persisted. When one has enough fat to do injections this should always be tried first as such injections improve the quality of the hip tissues even if its augmentation effect may turn out inadequate.
Dr. Barry Eppley