Butt reconstruction and tissue expander: will I gain the muscle back after the tissue expansion is done?

Very sorry to hear of your misfortune. More information is needed in order to better understand the current condition of your gluteus muscles. If your muscles too have been damaged by the infection it may be very difficult to gain muscle mass back. Typically in this situation, the most reliable and permanent option is to undergo buttock implants surgery to best restore projection and shape of the buttock contour. On other hand, BBL fat transfer tends to survive very poorly in a previous infected bed of scar tissue. Please keep in mind that an extremely few number of board-certified plastic surgeons specialize in buttock implants so be sure to consult with one that is reputable and experienced. Unfortunately you may have to travel long and far away from home to find this particular surgeon. Glad to help.

Muscle does not grow back. If it’s been lost from trauma, infection or other reasons than it’s gone forever.

Tissue expanders are a way of making adjacent skin thin and stretched out to help cover scar tissue or other circumstances. Free flaps are other procedures that can possibly cover or replace damaged or missing tissue. When I was a resident we had a patient who lost her buttocks down to muscle due to infection. I initially covered the muscle with a skin graft. My long term plan was to attempt two free TRAM or DIEP flaps to reconstruct the defect. That would have added quality skin and a nice layer of fat to the patients gluteus muscle. These are very complicated procedures that are more commonly used to reconstruct breasts after a mastectomy. I’m sorry this happened to you. Good luck with your procedures.

Mats Hagstrom, MD