300cc each side, butt implants dropped - please help (Photos)

Question

So I had Butt implants. They wanted to put in bigger ones but couldnt.Ihave 300cc each side. They looked fine at first and now 6 months later I really dont Like how they look. All the projection is at the bottom where i dont want it, none,,on top“. My butt still looks flat like a cutting board. My surgeon also Said they have dropped but said nothing Could be done in revision, just that putting a bigger implant might add volume on top. My whole butt looks like its sagging- please help.

Ryan A. Stanton, MD · Answer

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.

Based purely upon your photos, the problem may be that your implants are not within a total intramuscular pocket but rather on top of the muscle (a.k.a. subfascial or subcutaneous). The classic scenario is that subcutaneous/subfascial buttock implants look good at first but then become saggy/droopy over the next 6+ month’s postoperatively. If this is in fact the case, revision surgery is indeed possible. The current implants can be removed, a brand new total intramuscular pocket created, then new implants placed into this new pocket. Final note, because an extremely few number of board certified plastic surgeons specialize in buttock implants, you may have to travel far and away from your local area to seek consultation with this particular type of surgeon.  Glad to help.

Dev Vibhakar, DO, FACS · Answer

Hello,The implants have stretched the pocket and subsequently dropped. Putting a larger implant will only make this worse. I suggest removing your implant and letting your skin and muscle heal/settle. You can then consider adding fat to the layer above the muscle (NOT THE MUSCLE) in order to enhance the upper buttock region. You will find yourself in the same position with implant exchanges or increasing the size. Hope this helps!Dr. Dev

Miguel Mota, MD · Answer

Thank you for posting. So sorry you are going through this. The good news is that if they went any bigger they would of dropped faster and they would look much worse. It seems to me like the issue here is implant placement. Butt Implants need to go inside the muscle. The muscle holds them in place.
If you still want implants I suggest a revision. They need to placed inside the muscle.

Best of luck,
Dr. Miguel Mota

Zoran Potparic, MD · Answer

It is very difficult to give you meaningful opinion without in person evaluation. Sometime a combination of liposuction of lower waist/above the buttock areas combined with fat grafting of the central and upper buttock can create desired shape and projection. Second opinion consult with a board certified plastic surgeon experienced in this area is recommended.

Mats Hagstrom, MD (license on probation) · Answer

Unlike breast implants, gluteal implants simply don’t work well.You are outcome is actually better than average.There is a good reason why most plastic surgeons don’t offer this procedure.The operation has high complication rates and secondary issues rates with low, long-term patient satisfaction.Your outcome is actually a good one.It seems that the providers who have the best results tend to follow a few principles.The first is to keep the implant intramuscular as much as possible. The second is to use implants that are not larger than what can fit in the inside that space.using larger implants tends to create more complications and more problems.The implants also don’t give fullness in the hips and so they don’t argument or form an ideal S-curve, a.k.a. hourglass, a.k.a. Coke bottle figure.If you feel the implants are an overall positive, then keep them. If you think the negatives outweigh the positive, then consider having them removed.Removing implants can involve some undesirable consequences as well.Placing the implants creates a tissue separation that can mis-align when the implant is removed. removing the implant can cause the subcutaneous surface to drop a bit.Sometimes the two surfaces need to be secured with sutures closing the space when removing the implants.Gluteal implant augmentation simply isn’t a great procedure.This is why most plastic surgeons don’t offer it.The procedure gains traction with a handful of individuals who see it as a reasonable procedure. Those who offer the procedure often get more cases, since there is less competition.Best,Mats Hagstrom, MD

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