The majority of plastic surgeons in the United States, do not offer gluteal implants. Most plastic surgeons tend to offer almost all cosmetic surgical procedures, even once they rarely perform. The single exception is gluteal implants. There’s a good reason why plastic surgeons generally don’t offer the procedure. The complication rate is very high, the rate of undesirable outcomes, and need for revision surgery is even higher. The number of patients who get gluteal implants with quality long-term outcomes without having to have the implants removed or revised is really low. I simply don’t recommend the procedure. most patients, in fact, eventually fail, gluteal, augmentation and end up having the implants removed. There are a handful of plastic surgeons in the United States, who do implants full-time, or at least gluteal implants represents a very large segment of their practice. Sometimes they answer questions on this website. Generally speaking Demar revisions, patients have had the less likely it is that they’re going to get a quality outcome. If the procedure wasn’t done well, the first time around the chance of quality outcome goes down from there. it seems that those who seem to get the best outcomes follow a few principles. One is to use small to modest size implants that fit in the anatomic space. The second is the implants are placed intramuscularly. Converting implants position becomes extremely difficult, because the space has been created from the primary procedure. Gluteal implants are completely different than breast implants and any thoughts of what can be done with breast implants is not applicable to gluteal implants in regards to position and its involvement with surrounding muscles. Undesirable outcomes is very common after this procedure. You are hardly alone being disappointed after having gluteal implants. Ultimately, each surgeon is responsible for the outcome of the procedures they perform. Patients are responsible for provider selection.To begin to make any kind of assessment regarding the outcome, we generally need to see a complete set of proper before, and after pictures. If patience have had more than one procedure, then they should include before and after pictures of each of the previous procedures. If you don’t have before, and after pictures and ask your surgeon to forward, the pictures they took. Best, Mats Hagstrom, MD