Can I have a butt lift done at that same time as the removal to take care of any sag or mis-shapeness?

The big question is, why are you removing your implants? If it because they are easily visible, palpable, and/or droopy then the problem lies within the fact that they are on top of the muscle. If this is the case, you may want to consider removing them and replacing them to the intramuscular tissue plane (aka within the gluteus muscles) so that these issues will most be likely be resolved. If you are otherwise happy with your current implants on top of the muscle and you just want to remove them for a smaller buttock, then I recommend removing them and waiting at least six months to a year for the tissues to settle into their final place then any necessary buttock lift or tuck can be more accurately and precisely performed at that time. Glad to be of help.

Yes you up can, and it will be the best way to proceed, remove the implants and there the extra skin also

With the implants being above the muscle and being of large size you are an increased risk for the skin and fat layer to drop down with the removal of the implant. Prior to augmentation you had a dense Netwerk of connective tissue that anchor the skin to the underlying muscle facia throughout the buttocks. Prior to augmentation you had a dense Netwerk of connective tissue that anchor the skin to the underlying muscle facia throughout the buttocks. All of that connective tissue was cut in order to make room for the implants. with the implant removed there’s nothing holding the skin surface in contact with the muscle surface and gravity will allow the skin side to drop down.To avoid this the two surfaces need to be sutured together in the correct anatomic position. This is easier said than done because the procedure will be done with you laying on your abdomen and that may put the two surfaces that need to be attached in a different natural position than when you were standing. in other words making it look right on the table laying on your abdomen may have a different appearance later when you’re standing up.The key with this procedure as with almost every plastic surgery procedure it’s just stick the most talented and experienced surgeon who has done this procedure successfully numerous times and can prove it by having a collection of before and after pictures that reads like a telephone book. in your case you looking for before and after pictures of implant removal results.The majority of plastic surgeons don’t do gluteal implants. Some of those may be willing to remove implants but you probably want to stick with those who do the procedure on a regular basis and have a very solid track record for doing quality gluteal augmentation.The first and most obvious choice if you’re happy with the outcome is to go back to the surgeon who did your initial procedure.Regardless I would start the process by having multiple in person consultations with plastic surgeons who have a long history of performing gluteal augmentation with implants and asked to review their entire portfolio or before and after pictures of implant removal outcomes.Gluteal implants is one of those things that ideally people should not change your mind on unless there’s a problem.It’s probably better to leave the implant in place if it’s doing its job properly. Ask yourself if risk of having your skin hanging off the buttocks is a better option than what you currently have with the implant.Best,Mats Hagstrom MD