The sizes and shapes of bodies should absolutely not be a trend, but we can all agree that over the past 20 years, having a larger and more shapely booty has become more desirable than ever before. Beyond focusing on glute workouts and hoping for the best, there are multiple procedures that deliver a curvier derriere. These days, the most popular one is the Brazilian butt lift, but the OG is butt implant surgery.
While the Brazilian butt lift is recognized as being one of the riskier plastic surgery procedures out there, influencing many to pursue butt implants instead, keep in mind that no surgery is without risk. It’s critical to be aware of the potential dangers of a treatment before booking so you can go in with eyes wide open and do everything you can to minimize those risks. Here, four board-certified plastic surgeons break down exactly what complications could occur from butt implant surgery, including shifting implants, infection, and an abnormal-looking outcome.
Before we dive in, there’s an important thing to note: many people seeking out implants, including butt implants, are concerned about their “life span.” According to Dr. David Shafer, a board-certified plastic surgeon in New York City, “if there is no problem, there is no reason to remove them. It’s not like they’re tires that have to be replaced every 10,000 miles.”
Keep reading to learn more about the potential risks associated with butt implant surgery.
Butt implant risk #1: malposition
If you’ve watched Botched, you’ve likely seen this nightmare fuel—an implant that a patient can “flip” within their own buttocks. “Displacement is a dramatic complication that’s led to some interesting YouTube videos,” agrees Dr. Shafer. Luckily, all the providers we interviewed for this article confirmed that this complication, a form of malposition, is extremely rare. “Usually this occurs because the implant pocket is too big for the implant itself,” explains Dr. Johnny Franco, a board-certified plastic surgeon in Austin, Texas. If the pocket is made too large initially or if the pocket stretches over time, this quite literally gives the butt implant wiggle room, allowing it to flip over either when moving the gluteus muscle or when manipulating the implant itself. (This can happen with breast implants too, by the way.)
While being able to flip an implant inside your body is very uncommon, malposition overall is not. In fact, it’s the most common risk of getting butt implants, says Dr. John Paul Tutela, a board-certified plastic surgeon in Livingston, New Jersey. “The implant slides into an incorrect position, making an unnatural shape,” he says. Using an inexperienced provider will increase this risk, but you may still encounter this issue even when treated by a skilled plastic surgeon. “It is very difficult to place the implants in a position that creates the round dome of the buttock without having shifting at some point,” explains Dr. Michele Koo, a board-certified plastic surgeon in St. Louis. “That’s due to the gluteus maximus and minimus muscles being relied upon for all our daily activities of sitting, standing, running, and walking.”
Failure to comply with your provider’s recovery guidelines can cause your implants to shift, among other post-procedure risks. “Buttock implant recovery can be difficult, as we have patients avoid sitting [without a surgery pillow] for six weeks,” says Dr. Franco. “We never realize how much we sit until we can’t. It is important to give your butt implant surgery time to heal so that you can minimize the risk of complications.”
Butt implant risk #2: implant rupture
Butt implants are generally pretty sturdy, as far as implants go. You may never want or need to replace them, but if you do, it will likely be due to a change in how you perceive them. “Implants may not last forever in terms of aesthetic desire,” explains Dr. Franco. “It’s unlikely that you’re going to have a buttock implant surgery and never need a second surgery, because your aesthetic goals change or your body itself changes over time.”
Still, butt implants can wear and weaken with time. “A change in
shape, feel, or comfort is a sign that a change may be necessary,” says Dr. Koo. In very rare cases, they can rupture or break within the body. “Most of the updated implants are semisolid, so there is no liquid in them—but depending where you go to get them done, the [provider] might not be using the most updated devices, and they could leak if filled with liquid,” says Dr. Tutela. For the most part, though, true leaks are unlikely. Usually, butt implants are made with either a gel within a shell, like newer breast implants—in which case, any gel that escapes will stay localized to the implant—or a semi-solid silicone, which could conceivably fracture and break.
Butt implant risk #3: healing issues
Infection is undoubtedly the most common risk of any procedure. “Every surgery has a small risk of swelling and bruising and possible infection,” says Dr. Shafer. “Butt implants have a higher risk of infection due to an area of the body that is easily contaminated during healing.” That makes sense—while some surgeons place butt implants via incisions at the upper outer buttocks, many make their incisions in the gluteal crease (where your butt cheek meets your thigh) or between the cheeks. Good hygiene is of paramount importance during recovery.
Another reason to take extra care with your incisions is because wound dehiscence (when your incision splits) is possible, especially with a procedure like butt implant surgery. “The flat, firm implant placed in a rounded contour with pressure against the incision and constant pressure from sitting and activity leads to increased risk of wound dehiscence,” says Dr. Koo. There’s a reason providers want you to wait so long before you start putting your new butt to good use: all that movement of a large muscle can put way too much strain on a fresh incision.
Another fairly common risk of plastic surgery is a seroma, which is fluid that’s collected underneath the skin. “Seroma is possible when any surgery is performed but especially when a foreign body, such as a butt implant, is inserted,” says Dr. Shafer. Seromas generally aren’t dangerous so much as they are annoying, and they often resolve on their own.
Butt implant risk #4: nerve pain
Nerve damage or pain is a possibility from most plastic surgery, but butt implant surgery is unique in that it puts you at potential risk of sciatica. This refers to pain of the sciatic nerve, which travels from your lower back, through your hips and buttocks, and down each leg. “The gluteal implant is placed, typically, under the fascia or the muscle itself and can partially be in both planes,” warns Dr. Koo. “This deep dissection near the sciatic nerve increases the risks of nerve irritation.” The risk is low, especially when the procedure is performed by an experienced plastic surgeon, because this nerve is very deep. However, the larger the implant, the more pressure that could be placed on the sciatic nerve, increasing your risk of discomfort.
Butt implant risk #5: unnatural look
Malposition can certainly create an abnormal-looking booty, but the limitations of a butt implant procedure can play a large role too. Unlike a breast implant, which is form-forgiving and flexible, butt implants don’t truly mimic the real thing. “Butts are dynamic and move and are soft,” says Dr. Shafer. “Implants are static and stiff.” Dr. Koo notes that while butt implants have become softer and more natural over the years, they’re still firm. “They’re a solid, flat implant over a curved muscle and bony structure, which makes the fit and contour not ideal for stability,” she says. This is likely a reason that Brazilian butt lifts, which use fat to build out a derriere, have become more popular than implants—fat tends to be the deciding factor in what makes a butt look real.
Butt implant options are also quite limited, says Dr. Franco, with very few size options as compared to those available for breast implants. “Butts come in all shapes and sizes, so it’s really difficult to design an implant that is one size or one shape fits all,” says Dr. Shafer. The combination of natural asymmetry plus limited options for implants can result in an aesthetically displeasing outcome when performed by an inexperienced provider. “If possible, performing a fat transfer with implantation aids in the overall symmetry and appearance of the buttock,” says Dr. Franco.
Lastly, and perhaps obviously, the size of the implant you get will affect your outcome—if you get an implant that doesn’t “match” you well, it’ll be noticeable as well as lead to issues during recovery. “We want the implant to fit your body so that it minimizes the risk of complications and gives you an amazing result,” says Dr. Franco.
