Asymmetrical Buttock Implants. How Can It Be Corrected?

Question

I had a buttock augmentation, implants to be precise, done about three months ago. I'm pretty much healed, but have noticed slight asymmetry between the right and left cheek. One side looks larger and rounder than the other. My doctor wants me to wait other three months before discussing corrective surgery.  Since I'm not really keen on going under the knife again, what other options do I have? My doctor and I discussed the fat transfer procedure, but I'm a little apprehensive. Can an injectable filler, such as or, be used instead?  I just want my butt to look symmetrical.

Nick Slenkovich, MD · Answer

This is a good question to put to your surgeon, as they will be most familiar with the specifics of your surgery. There are many variables that come into play, but some initial asymmetry is common after bilateral implant surgery (this applies to breast implants as well). Typically six weeks is a good initial healing period, after which we would normally expect symmetry to improve. 
Except for unusual circumstances, I would have a good idea about your ultimate result by four to six months after surgery.
What are your options for correction and when should they be considered? 
Again, I recommend maintaining a good rapport with your surgeon and seeking their input here. If a revision surgery is required to reposition an implant, this is arranged with your surgeon and is commonly performed several months after initial implant placement. 
Do you have non-surgical options?
Non-surgical options include efforts to massage the implant pocket or influence the implant position to improve symmetry. If the implant pockets are symmetric, then minor asymmetry generally improves as the months go by. However, if the pockets are not symmetric, surgical correction may be required.
Fat grafting or fat-transfer to the buttock are surgical procedures that use your own fat to sculpt and enhance the buttock contours. It is not uncommon to place 300-500cc of fat into each buttock in "non-implant" buttock contouring. Liposuction of the surrounding areas, particularly the small of the lower back, is an important adjunct to maximizing the buttock appearance. This combination of liposculpture and fat transfer is a powerful tool in my practice and while implants certainly have advantages, using your own body's tissue has the advantage of not having implant-related complications.

Shlomo Widder, MD · Answer

Dear anon,

	  It would have been very helpfull to subit your pictures - before and after. Sometimes an asymmetry that was present before surgery, gets more noticeable after surgery. 3 month after surgery is still early in the healing process and the asymmetry can improve with time. So your surgeon is correct by asking you to be patient for 3 more months. In the meantime you can massage the implants in order to loosen up the capsule ( scar around the implants ) and improve shape and symmetry.

	                 Best of luck,

	                                      Dr Widder

Jaime Perez, MD · Answer

Hello. It is hard to answer your question without seeing a picture or examination. I would highly recommend you follow the plan your surgeon has for you, as he is familiar with the surgery. Best of luck.

Steven H. Williams, MD · Answer

Thanks for the question -
Your doctor is correct to advise you to wait for a total of 6 months before considering corrective action.  It can take this much time for swelling and scar tissue to settle down.
Things that can be done to improve the situation if the asymmetry continues include changing the implants, changing the pockets around the implants.
In our San Francisco office we actually prefer to use autologous fat transfer (the Brazilian Butt Lift) to correct asymmetry or sagging buttocks.
Dr. Seinkovitch provides a good top level description but we would consider this a surgical intervention (meaning that you'd have to "go under the knife" even though the incisions involved with this procedure are very small.)
Non-surgical techniques like massage after 6 months are unlikely to provide large improvements.  
Injectables for this problem are not a great solution.  The first reason is injectables are temporary meaning that you'd have to have them done over and over again.  In addition, buttock asymmetry typically requires significant amounts of volume which most of the time can't be done in a cost effective or safe manner.
In addition - in your case injections of dermal fillers put your implants at risk for infection - so be particularly cautious.

Douglas M. Senderoff, MD, FACS · Answer

To ensure the success of your procedure, Be sure to choose a board certified plastic surgeon with extensive experience and high success rates with buttock implants.

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