Yes — buttock implant removal and a Brazilian Butt Lift can be performed in the same operation, and for many patients it’s the most sensible approach. Removing implants alone leaves the buttocks deflated; combining removal with fat transfer restores volume and contour using the patient’s own tissue, in a single recovery rather than two.
This article covers when the combined approach works, when a staged procedure is safer, and what to expect during recovery.
Why patients have implants removed
The most common reasons for buttock implant removal are capsular contracture (where the scar tissue around the implant tightens and distorts shape), implant displacement, chronic discomfort, infection, and a change of mind about the look of synthetic implants over time.
Buttock implants sit deep within the gluteal muscle or beneath the gluteal fascia, in an area that bears significant weight and movement. Long-term complication rates are higher than for breast implants — published series report capsular contracture rates between 5–30% depending on the technique used and follow-up duration.
Removal involves reopening the original incision (usually intergluteal), extracting the implant, and excising scar tissue from around the implant capsule. The pocket is then irrigated and closed.
Why combine removal with a BBL?
Removing buttock implants without restoring volume produces a flat, sometimes hollowed appearance — particularly if the implants have been in place long enough to stretch the surrounding tissue.
A Brazilian Butt Lift (BBL) uses fat harvested via liposuction from the abdomen, flanks, or thighs, processed and reinjected into the buttocks. Combining it with implant removal:
- Restores buttock volume immediately rather than leaving the patient deflated for months
- Uses the same anaesthetic and recovery period for both procedures
- Contours the donor sites at the same time, since liposuction is the harvest method
- Avoids re-implanting synthetic material in tissue that has already had a complication
The trade-off is that combined surgery takes longer under anaesthesia and carries the cumulative risk of two procedures rather than one. For most healthy patients, that’s an acceptable trade.
RELATED: Different Types of Brazilian Butt Lift
When a staged approach is safer
Combined surgery isn’t always appropriate. The implant pocket is reshaped or removed during the first procedure, and the surrounding tissue has been stretched and inflamed for years. Injecting fat into that environment immediately can compromise fat survival.
A staged approach — implant removal first, then BBL three to six months later once the tissue has healed — is recommended when:
- The implant has been in place a long time and the pocket is large or scarred
- There is active or recent infection
- Skin quality is significantly compromised by previous surgery
- The patient needs significant weight loss before BBL to optimise fat-grafting volumes
The decision is made at consultation based on examination findings, imaging where appropriate, and the patient’s overall health.
Suitability for the combined procedure
The most important practical consideration is whether the patient has enough donor fat to produce a meaningful volume increase. Very lean patients may not — in which case the BBL is delayed until weight is gained, or the patient accepts a more modest volume.
Other suitability requirements:
- Stable weight for at least three months
- Non-smoker, or willing to stop for six weeks before and after
- No untreated medical conditions that increase surgical risk
- Realistic understanding that 30–40% of transferred fat is reabsorbed in the first three to six months
The procedure step by step
Combined surgery is performed under general anaesthesia at our Baker Street day surgery facility, typically taking three to four hours.
The implant is removed first through the original incision, with the surrounding capsule excised where appropriate. The pocket is irrigated to reduce infection risk and seroma formation.
Power-assisted liposuction is then used to harvest fat from the agreed donor sites — most commonly the abdomen, flanks, and lower back. The harvested fat is processed to separate viable adipocytes from blood, oil, and tumescent fluid.
The processed fat is injected above the gluteal muscle layer using ultrasound guidance. This is the safest current technique — keeping fat placement above the muscle avoids the deep gluteal venous plexus, where fat embolism has historically been the cause of BBL deaths.
Compression garments are fitted before the patient leaves the operating theatre.
Recovery
The first 48 hours are the most uncomfortable. Patients are advised to sleep on their stomach or side, and to avoid sitting directly on the buttocks for two to three weeks. A BBL pillow distributes pressure to the thighs when sitting is necessary.
A compression garment is worn 24 hours a day for the first six weeks, removed only for showering. Most patients return to office work at two to three weeks; strenuous exercise is delayed until six to eight weeks.
Final results are visible at three to six months, once the surviving fat has stabilised and swelling has fully resolved.
RELATED: Recovery After BBL — Top Tips
Risks specific to this combined procedure
In addition to the standard risks of BBL and implant removal individually, the combined operation carries some specific considerations:
Reduced fat survival. Tissue that has held an implant has altered vascularity. Fat grafted into this environment may have a lower survival rate than fat grafted into an untouched buttock — meaning a second touch-up procedure is more often needed.
Skin laxity. Long-term implants stretch the overlying skin. Once the implant is removed, the skin may not contract back fully even with fat replacement. In that case, a buttock lift to remove excess skin can be added — either at the same time or later.
Asymmetry. Existing capsule asymmetry can affect the symmetry of the fat-grafted result. Patients are counselled that perfect symmetry is rarely achievable in revision surgery.
Cost
The combined procedure is priced based on the implant removal complexity, the volume of liposuction required, and the volume of fat to be transferred. Detailed pricing is given at consultation. Finance options including 0% APR are available through Chrysalis Finance.
Frequently asked questions
Will the result last?
The fat that survives the first six months becomes permanent — it behaves like any other fat in the body and is affected by weight changes. Significant weight loss after a BBL will reduce volume; significant weight gain will increase it.
What if I don’t have enough fat?
The most common solutions are to gain a modest amount of weight before surgery, accept a more conservative volume increase, or stage the procedure with implant removal first and BBL later once weight is gained.
What about the scar from the implant?
The original implant incision is reopened during removal, so no new scar is created in that area. The scar can be revised at the same time if it has healed badly.
How soon can I return to work?
Office-based work: two to three weeks. Physical work: six to eight weeks. Driving: typically two weeks, once you can sit comfortably.
Can the fat move after surgery?
Fat that has established a blood supply (around six weeks post-op) is permanent. Before that point, fat survival is sensitive to pressure on the buttocks — which is why sitting and sleeping position matter during early recovery.
Booking a consultation
For a buttock implant removal and BBL consultation at our Baker Street clinic, call 0207 993 4849 or email contact@centreforsurgery.com.
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