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Hip augmentation remains a challenging body contouring procedure. An autologous approach with fat injections are the most logical approach but the survival of fat in the hip area is generally poor particularly if a deep trochanteric depression exists. Hip implants offer assured volume retention but have a significant complication rate due to the lack of a good tissue pocket in which they can be placed. The subcutaneous pocket for a vertically oriented implant on the side of the leg is not ideal.

In uncommon cases there is one autologous fat approach to hip augmentation that can provide satisfactory hip reshaping for the trochanetric depression area. If the patients needs a tummy tuck the tissue discard provides an autologous dermal-fat graft for transfer. The epithelium or skin can be removed from the excisional area on each side. By keeping a lateral attachment onto the upper hip area the dermal-fat graft becomes a pedicled fat flap.

A subcutaneous pocket is developed over the trochanteric area into which the fat flap will fit. It is then rotated into the hip pocket and the communication between the hip and abdominal cavities closed off by sutures. The tummy tuck is closed in the usual multi layer method.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

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