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Shaping of the waistline and buttocks has taken on great popularity in the past decade. With the widespread use of various buttock augmentation procedures as well as liposuction, changing the outer  shape of the pelvic region can be done. While most commonly done by fat injections (aka the BBL procedure) and the less frequently by implants, the posterior portion of the pelvic region can be satisfactorily increased in volume.

Often buttock enlargement is desired to be accompanied by hip augmentation for a more complete overall and proportionate body reshaping effect. While the area referred as the hips is open to interpretation, it is anywhere from the iliac crest down to the trochanteric indentation. Provided one has enough fat the hips can be enlarged by fat injections either alone or in conjunction with buttock augmentation.

But if one does not have enough fat to harvest for injection or previously injected fat has failed to survive or persist, the options for hip augmentation are very limited. Using implants is the only other augmentation option but there are no standard or preformed hip implants unlike that of buttock implants.

Custom hip implants can be fabricated based on height and width measurements based on the patient’s desired area of hip augmentation. The thickness of the implant and its shape is open to individual patient preference although most designs will have greater fullness on its superior pole and is thinner at its inferior end. Maximum height projections can also be done in the central region or even at the lower pole but these are less common aesthetic hip shapes.

The custom hip implants are made of an ultrasoft (very low durometer) solid silicone material. With implanted underneath soft tissues they will always feel more firm when in place then when squeezed in one’s hand outside of the body. Their feel will be equivalent to that of buttock implants placed in the subfascial location.

Hip implants are inserted from a 4.5 cm curved incision placed at the superolateral location of the marked hip augmentation perimeter. The implant pocket is made underneath the superficial fascia layer and on top of the muscle fascia.  The pocket is made within a limited dissection that goes just to the edge of the overlying marked implant pocket. The implants are inserted with the proper orientation and a three layer closure is done. No drains are used.

Custom hip implants have an aesthetic role to play as a stand alone procedure or in conjunction with buttock augmentation. For the make to female transgender patient they offer a possibility to achieve a more feminizing body shape.

Dr. Barry Eppley

Indianapolis, Indiana

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