How would a butt implant replacement go? (Photo)

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

First you should know, fat transfer BBL will NOT correct your problem, period.

Secondly, If all you have had done to your buttock is implants, it is highly unusual to have such a deflation type asymmetry such as you have. It is more likely that your buttock implants were made of silicone gel and not silicone rubber and the right side has ruptured and deflated.

Unlike breast implants, silicone gel buttock implants are not FDA approved and thus not legal for buttock implantation in the USA. I actually see about one patient a week that had gel implants done in another country and, although they looked and felt great at first, they are now seeking revision because the implants are either visible on top of the muscle and/or grossly deformed by flipping over, rotating, scar contracture and/or the implant has ruptured several years after placement leaving behind hardened scar tissue my migration of silicone liquid. The soft semi-solid silicone rubber implants used in the USA are much more form-stable and thus much less likely to have these problems if placed correctly within the gluteus muscle AND are considered permanent implants because they cannot rupture and leak like silicone gel implants. In 2015 I created and recently patented a new "Stanton Anatomic" shaped implant that avoids the unnatural effects of round implants, whether silicone gel or rubber . The benefit of this is the fact that ~95% of patients have much more of an oval shaped buttock cheek not round, thus a true oval implant (i.e. Stanton Anatomic implant) creates a much more natural and harmonious buttock contour. This is especially true when the patients bends over, does squats, or pokes their butt out while striking a pose or dancing. Many avid weightlifters, fitness competitors, and athletes from various sports have had these implants without problem of movement, visibility, or drooping. Glad to be of help.

The majority of plastic surgeons in the United States do not offer gluteal implants. There’s a really good reason why most of us don’t do the procedure.
It’s a procedure that has a very high complication rate and undesirable side effect or outcome profile.
In other words most patients and up having issues with the implants and I’m not happy with the long-term results.
For that reason I recommend patients avoid gluteal augmentation using implants but if that is the procedure someone is going to have then they have to find one of a handful of plastic surgeons in the United States or other countries who have mastered the procedure. to get consistent quality implants requires first having a plastic surgeon who has done thousands or close to it of the same procedure and does it on a regular basis. The implant needs to be the correct size and that means it needs to be no bigger than what can fit inside the gluteus muscle. The implant needs to be placed intramuscularly. Placing the implant on top of the gluteus muscle allows it to migrate especially when you sit on the implant which is going to put lateral pressure forcing it out to the side or down on your thigh.
If you want to revise your procedure then you’ll need to find one of the surgeons who has the skill to do the procedure correctly. This means intramuscular placement with appropriate size implants with a long-standing track record of successful outcomes long-term.
There are a few who answer questions on the form and maybe one of them will respond to your question.
You should recognize that removing the implants will not put your bottom back the way it was before your augmentation. Each time someone has surgery things get distorted and subsequent operations become more difficult.
Generally it’s better not to go with the implant route but if you do it has to be with the right provider. There are not very many plastic surgeons who know how to do gluteal implants correctly. You’ll have to try to find one of them.
Best,
Mats Hagstrom MD