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Procedure guide · Buttocks & Hip
Buttock Implant Removal and RevisionButtock implant removal and revision takes out, replaces or repositions a gluteal implant that has become infected, displaced, hardened or simply unwanted. Removal alone is a shorter operation than placement, through the same incision between the buttocks, and the buttock returns close to its previous shape. Where volume is still wanted, fat grafting is the usual replacement, generally at a second operation months later.
Buttock implant revision covers a range of operations that share one question: whether to put anything back. Removal alone, removal with the scar capsule, exchange for a different size, repositioning within a revised pocket, and conversion to fat grafting are all versions of it, and they differ enormously in length, difficulty and outcome.
Infection settles the question whenever it is present. An infected gluteal implant has to come out. Patients frequently ask for an exchange at the same operation so as not to lose the projection, and a surgeon who agrees is doing them no favour: replacing an implant in an infected field substantially raises the chance the infection returns, and the sound route is removal now with replacement several months later.
Where infection is not the issue, the honest framing is that revision surgery happens in tissue that has already been operated on. Scarring makes the planes less distinct, the blood supply is poorer than it was, and the anatomy is distorted. That is why revision demands a surgeon comfortable with revision specifically, and why outcomes are less predictable than a first-time augmentation.
Displacement is the commonest non-infective reason for revision, and understanding its cause determines whether the fix works. A pocket made slightly too large, constant muscle contraction and the pressure of sitting push the implant out of position over months. Simply repositioning the same implant into the same pocket invites the same drift, so the pocket itself has to be tightened or reshaped.
Capsulectomy, removing the scar capsule along with the implant, is not routine and should not be presented as though it were. A thin, soft capsule causing no trouble can be left alone. It is indicated where the capsule has thickened and is distorting the buttock, where it has calcified, or where it is infected, since leaving infected tissue behind is what allows the problem to recur. Asking which of those applies is reasonable, because capsulectomy adds bleeding, pain and operating time.
Simple removal is by a wide margin the shortest and safest operation in this group. The implant comes out through the original midline incision, the pocket is closed, and the buttock returns close to its shape before augmentation. Patients are frequently surprised that the buttock is not damaged by having held an implant, though a shallow dent or some looseness can remain where a large or long-standing implant sat.
Conversion to fat grafting is often the best plan for a patient who has had repeated trouble with gluteal implants. It ends the device-related problems permanently, gives a natural feel, and improves the waist at the same time. Most surgeons stage it rather than grafting at the moment of removal, because fat placed into a freshly emptied pocket sits in a space with disturbed blood supply and survives poorly.
For an international patient, staging means a second trip, and that is worth planning from the outset rather than discovering afterwards. It is also worth asking who would aspirate a fluid collection if one develops after you get home, since removing an implant leaves a space that fills with fluid and drains are frequently needed.
The last thing to say is that there is no medical need to remove a comfortable, well-positioned gluteal implant. Where the concern is appearance or firmness rather than infection or nerve symptoms, waiting until the original result has fully settled, usually 6 to 12 months, means the decision is made on a settled buttock rather than a swollen one. Where there is infection or pain radiating down the leg, that advice does not apply and assessment should be prompt.
Surgeons look for these points at the consultation.
Buttock implant removal and revision suits patients with an infected, displaced, rotated or hardened gluteal implant, with persistent pain or nerve symptoms, with a size or shape they are unhappy with, or who simply no longer want the implant, and who are well enough for a further general anaesthetic.
Reasons a good surgeon will ask you to wait or choose something else.
Elective buttock implant revision is deferred in smokers who will not stop, in poorly controlled diabetes, and in active infection where removal rather than exchange is the correct operation. Exchange is avoided where infection is present, and immediate fat grafting into a freshly emptied pocket is generally avoided.
Ask your surgeon which technique they recommend for you and why.
The implant is taken out through the original incision in the crease between the buttocks and the pocket is closed, with nothing put back.
The scar capsule around the implant is removed along with it, which is necessary where the capsule has thickened, calcified or is infected.
The implant is replaced with a different size or repositioned, and the pocket is tightened or reshaped so the new implant cannot drift the same way.
The implant is removed and volume is replaced with the patient’s own fat, usually at a second operation once the pocket has closed and settled.
Step by step, from arrival to discharge.
Buttock implant revision begins by distinguishing infection, displacement, capsular contracture and dissatisfaction, since each leads to a different operation.
Where infection is present nothing is replaced at the same operation, because exchanging an implant in an infected field substantially raises the risk of recurrence.
The original incision in the crease between the buttocks is used, so no new scar is created, and it is often excised and re-closed to improve a poor scar.
The implant is taken out, and the capsule is removed only where it is thickened, calcified or infected rather than as a routine step.
Where an implant is replaced, the pocket borders are tightened or reshaped so the new implant cannot drift the way the first one did.
Drains are frequently placed because removing an implant leaves a space that fills with fluid, and the wound is closed in layers to take tension off the skin.
Frequencies follow published guidance; your personal risk depends on your health and the surgeon.
The most important decision in buttock implant revision is whether to put anything back, and infection settles it. An infected implant has to come out, and exchanging it at the same operation, which patients often ask for so as not to lose the projection, substantially raises the chance of the infection returning. Surgeons who decline to do that are protecting you from a second failure, and replacement several months later once everything has settled is the sound route.
Where infection is not the issue, the honest point to make is that revision surgery happens in tissue that has already been operated on. Scarring makes the planes less clear, the blood supply is poorer, and an exchanged implant can drift the same way the first one did unless the pocket itself is revised. Simple removal is the shortest and safest of these operations by a wide margin, and for many patients who have had trouble with gluteal implants, taking them out and later grafting fat is a better plan than a third attempt at making an implant work.
Expected after buttock implant removal. The buttock returns close to its pre-augmentation shape, and patients who have had implants for years sometimes find this a bigger adjustment than they expected.
The midline incision is reopened in tissue that has already been operated on and is sat upon, so separation is at least as likely as after the original placement.
Fluid collecting in the empty pocket after buttock implant removal, which is why drains are frequently placed and why aspiration is sometimes needed afterwards.
A dent or looseness where the implant used to sit, particularly after a large implant or a long-standing one, which may need fat grafting to correct.
An exchanged implant drifting the same way as the first, which is why the pocket is revised rather than simply reused.
Infection returning after revision, which is more likely where an implant was exchanged rather than removed in the presence of infection.
More likely after capsulectomy than after simple removal, because the raw surface left behind is considerably larger.
Recovery from simple buttock implant removal is considerably easier than the original operation: the muscle is not split again, pain is moderate, and most patients are back at a desk within a fortnight. Where the capsule has been removed as well, it is more uncomfortable and drains are usual, because the raw surface left behind is much larger.
The restrictions are familiar from the first operation and exist for the same reason. Sitting is limited for the first weeks and done on a cushion, sleeping is face down or on the side, and the midline wound needs watching because it is being reopened in tissue that has already healed once. Flying is usually cleared at around 10 days. What surprises patients more than the recovery is the shape: the buttock looks flatter than they remember, and it takes some weeks before the tissue settles and that impression softens.
Days 1-3
Usually a night in hospital. Drains are common, particularly after capsulectomy. Lying face down or on the side, with sitting avoided.
Days 4-10
The midline incision is watched closely, since it is being reopened in scarred tissue. Sitting only on a cushion under the thighs. Flying usually cleared at around day 10.
Weeks 2-4
Desk work at around 2 weeks using a cushion. Walking is comfortable. No lower body exercise while the pocket closes down.
Weeks 6-8
Swelling resolves and the buttock takes its new shape. Where an implant was removed, the pocket is collapsing and any residual looseness becomes apparent.
Month 12
Tissue has settled fully. Any further work, such as fat grafting to replace lost volume or correct a contour dent, is planned from this point.
After removal the buttock returns close to its shape before augmentation, once swelling settles and the pocket closes down over some weeks.
Where an implant was exchanged with a revised pocket, symmetry and position are usually improved, though revision results are less predictable than a first operation.
Some looseness or a shallow dent can remain where a large or long-standing implant sat, and fat grafting at a later operation corrects what does not settle.
The tissue takes around 12 months to settle fully, and any further work is planned from that point rather than earlier.
Buttock implant revision is priced by what is actually being done. Simple removal is a short operation; removal with capsulectomy, or exchange with pocket revision, is considerably longer and involves more bleeding and more follow-up.
Where conversion to fat grafting is the plan, it is usually staged, so the realistic cost covers two operations and, for an international patient, two trips. Establishing that at the outset avoids an unwelcome discovery later.
Revision is a different skill from primary augmentation, and a surgeon who does it regularly is the part of this quotation worth paying for. Drains and follow-up are part of the operation rather than extras.
Why quotes for the same procedure differ, so you can compare packages fairly.
See the full buttock implant removal and revision price breakdown
Options to weigh before deciding, surgical and non-surgical.
The shortest and safest option, and the correct one where there is infection. The buttock returns close to its previous shape.
Replacing implant volume with your own fat at a later operation, which ends the device-related problems permanently where there is donor fat.
Keeps projection and corrects displacement or size, provided the pocket itself is tightened rather than simply reused.
Worth stating plainly. There is no medical need to remove a comfortable, well-positioned gluteal implant, and revision carries its own risks.
Ask the same questions at every consultation so you can compare answers.
Where the reason for revision is size, position or a hardened capsule, yes: buttock implant exchange with a revised pocket is a standard operation and keeps the projection rather than losing it.
Where the implant is infected, no, and a surgeon who offers it anyway is doing you no favour. Exchanging an implant in an infected field substantially raises the chance the infection returns, and the sound route is removal now and replacement several months later once everything has settled.
Close to their shape before the augmentation, once swelling has settled. The buttock is not damaged by having held an implant, and the pocket collapses down over the weeks after removal.
The adjustment can still be larger than patients expect, particularly after a large implant or one that has been in place for years, where some looseness or a shallow dent can remain where it sat. Those settle over months, and fat grafting at a later operation corrects what does not.
Not routinely. A thin, soft capsule causing no trouble can be left, and removing it adds operating time, bleeding and pain for no benefit.
Capsulectomy is indicated where the capsule has thickened and is distorting the buttock, where it has calcified, or where it is infected, because leaving infected tissue behind is what allows the problem to recur. Ask the surgeon to say which of those applies to you rather than accepting it as standard.
Converting a buttock implant to fat is a common and generally good plan, especially for patients who have had repeated trouble with gluteal implants. It ends the implant-related problems permanently and gives a natural feel, provided there is donor fat to harvest.
Most surgeons stage it rather than grafting at the time of removal, because fat placed into a freshly emptied pocket sits in a space with disturbed blood supply and survives poorly. That usually means a second operation, and for an international patient a second trip, which is worth planning for from the outset.
Spreading redness, increasing rather than decreasing pain, fever, and any discharge from the midline wound are the signs of buttock implant infection, and they warrant contact the same day rather than at the next appointment.
Infection around gluteal implants can also appear later and more quietly, as a low-grade discomfort with intermittent discharge. Because the location carries a high bacterial load, any persistent discharge from that incision should be assumed to involve the implant until proven otherwise.
A pocket that was made slightly too large, muscle contraction over time and the pressure of sitting all push a buttock implant out of position, most often outward or downward. It is one of the leading reasons these implants are revised.
Correcting it means reopening the pocket and tightening its borders so the implant cannot drift the same way, rather than simply putting the same implant back. A surgeon who describes how they will revise the pocket has understood the problem; one who proposes only to reposition it has not.
Sitting after buttock implant revision is limited for the first 2 weeks and then done on a cushion supporting the thighs for several weeks, exactly as with the original operation. The midline incision is being reopened in tissue that has already healed once, so it is no more robust.
Flying is usually cleared at around day 10 for simple removal, later where capsulectomy or exchange has been done. Take a cushion for the journey and stand up regularly, which relieves pressure and reduces clot risk at the same time.
Simple buttock implant removal is easier and shorter. Anything else is harder, because revision happens in tissue that has already been operated on: the planes are less clear, scarring distorts the anatomy and the blood supply is poorer than it was the first time.
That is why exchange requires a surgeon comfortable with revision work specifically, and why results are less predictable than a first-time augmentation. It is also an argument for conversion to fat rather than a third attempt at an implant, where a patient has already had two that failed.
Drains are frequently used after buttock implant removal, particularly where the capsule was taken as well, because removing an implant leaves a space that fills with fluid. A drain for a few days reduces seroma, which is otherwise common after this operation.
For anyone travelling, drains determine when you can fly, since travelling with them in place is not possible. Ask how long they are expected to stay, and who would aspirate a fluid collection if one develops after you get home.
Where a buttock implant is infected or causing nerve symptoms, do not wait: those need assessing promptly. Where the concern is appearance, firmness or position, surgeons generally ask patients to wait at least 6 to 12 months after the original operation so the decision is made on a settled result.
Beyond that, there is no deadline and no medical need to remove a comfortable, well-positioned gluteal implant. It is a preference rather than a treatment, and it is reasonable to take time over it.
Almost always, yes. Both gluteal implants are placed through a single incision in the crease between the buttocks, and removal uses the same route, so no new scar is created.
The existing scar is often excised and re-closed at the same time, which can improve its appearance where it healed poorly or separated after the first operation. That is worth asking about specifically, since it costs nothing extra in scarring and many patients have a wide scar from the original surgery.
Ask specifically how many buttock implant revisions they perform, not how many implants they place. Revision is a different skill, it happens in scarred tissue, and a surgeon who mainly does primary augmentation may not be the right choice.
Then ask what they would do in your specific situation and why, particularly whether they would put anything back and when. A surgeon who declines to exchange an infected implant, or who proposes staging fat grafting rather than doing it immediately, is giving you the safer answer rather than the more appealing one.
Fat grafting follows buttock implant removal by at least 3 to 6 months, so the pocket has closed down and the blood supply has recovered. Fat grafted into a recently emptied pocket sits in a space with poor circulation and survives badly.
Where the implant was removed for infection, the wait is longer and depends on the infection being fully cleared. For an international patient this means a second trip, which is worth planning from the outset rather than discovering afterwards.
Buttock implant removal sometimes leaves a dent, particularly after a large implant or one in place for years, where the muscle and overlying tissue have been stretched and thinned around it. A shallow depression or some looseness can remain.
Much of it settles over the first months as the pocket closes and the tissue redistributes. What does not settle is corrected by fat grafting at a later operation, which fills the depression with your own tissue.
Removing one buttock implant alone is possible and occasionally the right answer, where only one side is infected or displaced. The obvious difficulty is that it leaves you asymmetric, sometimes markedly so.
Most surgeons remove both and replace neither, or remove both and replace both, for that reason. Where one side has a problem, discussing what the asymmetry would look like, and whether fat grafting could balance it later, is worth doing before deciding.
Buttock implant removal hurts considerably less than placement, because it does not split the muscle again, so the deep soreness that dominates the first operation is largely absent, and most patients are back at a desk within a fortnight.
Removal with capsulectomy is more uncomfortable, because the raw surface left behind is much larger and drains are usual. Exchange with pocket revision sits between the two, since the pocket is being reworked rather than simply emptied.
The original incision in the crease between the buttocks is almost always reused, so buttock implant revision creates no new scar. Both implants are reached through it, as they were originally.
The existing scar is frequently excised and re-closed at the same time, which can improve its appearance where it healed poorly or separated after the first operation. That is worth asking about specifically, since many patients have a wide scar from the original surgery and it costs nothing extra in scarring.
Hardening usually means capsular contracture, where the scar capsule around the implant thickens and tightens, firming the buttock and sometimes distorting its shape. It is less common here than in breast surgery but does occur.
Treatment is removal of the capsule along with the implant, since leaving a thickened capsule behind means the problem persists. Whether an implant goes back afterwards is a separate decision, and for a patient whose first implant contracted, converting to fat is often the more durable answer.
Yes, and it is the shortest and safest version of this surgery by a wide margin. The implant comes out, the pocket is closed, and the buttock returns close to its shape before augmentation.
Patients sometimes feel that removing without replacing is a defeat, particularly having paid for the original operation. It is not: for someone who has had infection, displacement or persistent discomfort, stopping is frequently the best outcome available, and fat grafting later remains an option.
Flying home after buttock implant revision takes around 10 days for simple removal, longer where the capsule was taken or an implant exchanged. Drains, where used, set the earliest date, since flying with them in place is not possible.
Take a cushion for the journey and stand up regularly, which relieves pressure on the wound and reduces clot risk at the same time. Establish before you travel who can review the wound or aspirate a fluid collection once you are home.
Where there is infection, worsening pain, or pain radiating down the leg, yes: those need prompt assessment rather than waiting for a scheduled review.
Where the concern is size, firmness or appearance, there is no medical urgency at all. Surgeons generally prefer patients to wait until the original result has fully settled, usually 6 to 12 months, so the decision is made on a settled buttock rather than a swollen one.
Buttock implant removal is sometimes funded, where there is a documented complication such as infection, capsular contracture causing pain, or nerve symptoms, since treating a complication is medical rather than cosmetic.
Removal because a patient no longer wants the implant is generally treated as cosmetic. Where the original surgery was abroad, some systems are reluctant to take on complications from elsewhere, which is worth establishing with your own doctor rather than assuming either way.
Not immediately. Removal loses the projection the implant provided, and the buttock returns close to its shape before augmentation once swelling settles and the pocket closes down.
Fat grafting at a later operation restores volume using your own tissue, which for many patients is a better long-term answer than another implant. It needs a donor supply and it is usually staged 3 to 6 months after removal, so it means a second operation rather than a swap.
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