Custom Hip Implants – Current State of the Art

Aesthetic hip implants are silicone implants placed over the outer pelvis/hip region to increase hip width, roundness, and curve, enhancing the waist-to-hip ratio.They are most often used to:

• Correct hip dips
• Create a more hourglass silhouette
• Complement previous BBL results when fat alone isn’t enough
• Done with rib removal waist reshaping surgery for a more feminine body contouring effect.

Implant type

• Solid silicone elastomer (similar concept to buttock implants, but thinner longer and more contoured)
• There are no off-the shelf hip implants
• Custom implants designs are needed. The optimal implant design is not yet known. But ‘smaller’ implant designs are more successful than larger ones.

Surgical placement

• Can only be placed on top of the TFL fascia (deep subcutaneous plane), subfascial or submuscular are not options over the lateral pelvis/hip area
• Incisions are ;placed must below the iliac crest 5 to 7cms in length.
• Need for prolonged drain use in the early recovery period.
• Can be combined with many other body contouring procedures:
  • Liposuction
  • Fat grafting
  • Buttock augmentation
  • Rib removal waist/torso

Typical candidates

• Lean patients with minimal fat for BBL
• Persistent hip dips despite fat grafting
• Patients seeking predictable, permanent volume
• Those wanting lateral width rather than posterior projection

Pros

• Immediate, stable volume
• Not dependent on fat survival
• Strong control over shape and symmetry

Cons & risks

• Higher complication rates than any other aesthetic body implant
• Seroma formation
• Implant edge visibility, occurs most commonly in lean patients (who often need them the most)
• Infection,  implant removal
• Asymmetry
• Longer recovery than BBL-only approaches

Because of these risks, most surgeons avoid hip implants or have no to limited experience with them and prefer:

• Strategic fat grafting
• High-definition liposculpture
• Hybrid approaches (very small implant + fat camouflage)

Bottom line

Aesthetic hip implants can work, but they’re not first-line for most patients. They’re best for:

• Very lean bodies where fat isn’t available or has failed
• Revision cases
• Structural deficiencies fat can’t fix

Should be avoided in patients seeking large hip augmentation results as the complication risks get more significant the larger surface area coverage the implant has.

The optimal hip implant design is not yet known that works well in all patients. But the most effective designs that have the lowest risk of complications stay within the hip dip area. The more lean a patient is the more limited the implant surface area should be with lower projection profiles.

Custom hip implants are differetiated from the Pelvic Plasty  procedure which is a skeletally based hip augmentation concept more commonly used in transfemales with congenitally narrow pelvic widths.

Dr. Barry Eppley

World Renowned Plastic Surgeon