There are a few things to take into consideration. Most plastic surgeons in the United States don’t do gluteal augmentation with implants. there’s a reason for that. The procedure has a high complication and failure rate. It seems like those who are best at doing these are using an intramuscular approach for placing implants exclusively. When the implants are placed above the gluteus muscle between the fat layer and the muscle faster it creates its separation between those tissue layers. if the implants are then removed the skin and the fat layer is no longer attached to the muscle layer and the implant is not projecting the soft tissue above it. This can cause the skin and fat layer drop due to gravity into a new position that is undesirable. If that is the case sutures need to be placed to hold his skin and the fat layer in the anatomically correct position on the muscle layer. If not goodbye text create a droopy appearance. Removing large implants in the body is pretty straightforward but gluteal implants have the potential of causing deformity with their removal. There’s also the decision of if a drain should be placed or not. For this reason patience I probably best job finding the most experienced provider for removing the implant who can discuss all of the various issues that can be related to explantation. It sounds like you were happy with the outcome of your first procedure and the pictures look good so I would start by going to The surgeon to put in the implants. You should add a minimum at least consult with that provider and you can always choose to have a few other consultations to see if other providers have different thoughts views or opinions about anything together when it comes to removing your implant. Finally there are a lot of reasons people can have buttocks and thigh pain. It’s a common symptom and often happens and individuals who have lower spine pathology with pinched nerves from conditions like bulged disc. If you’re happy with the implants it would be important to confirm the implants are causing the pain and not some other underlying reason causing pain in that area which can definitely happen. Lower back pathology can get referred pain anywhere along your lower extremity. Who evaluate hip and thigh pain I suggest consultation with a back pain specialist or just a pain specialist. Good luck, Mats Hagstrom MD