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Archive for the ‘bicep implants’ Category

Bicep Implants – Five Things to Know

Wednesday, February 22nd, 2017

 

Muscle enhancement of the body with implants has a far shorter surgical history than that of facial augmentation. Pectoral and calf implants are the most recognizable body implants to enhance muscular size and definition in men. But other body muscles can be synthetically augmented but because they are done in such few numbers, the public is largely unaware of them.

One type of body implant for upper extremity augmentation is that of bicep implants. Bicep implants are used for a variety of upper arm concerns such as aesthetic muscle enhancement or in the correction of congenital deformities such as Poland’s syndrome caused by underdevelopment or from muscle atrophy effects due to a bicep muscle tear or surgery. They have a very successful history of favorable patient outcomes with a low risk of complications. Here are five of the most important concepts to know about bicep implant surgery.

A Bicep Implant Is Not The Same As A Breast Implant. A breast implant is a two part medical device that has an outer silicone shell (bag) which contains either saline or a silicone gel. They have a limited span and will not last forever in any patient. One day the bag will develop a tear and the failed implant will need replaced. Conversely, bicep implants are made of a solid but very soft silicone material that can not fail, rupture or break apart. They are permanent medical devices from the perspective that they will never need to be replaced due to loss of implant integrity.

Bicep Implants Incision Markings Dr Barry Eppley IndianapolisA Bicep Implant Is A Muscle Implant. What is unique about most body implants is that they are designed to make the natural muscle bigger and are thus ‘muscle implants.’ They are usually shaped like the muscle they are designed to enhance. Although they are solid implants they are very soft and flexible and will essentially feel similar to the muscle they are designed to enhance. They are made of a very spongy solid silicone material which allows for tremendous flexibility without tearing or fracturing the implant.

Bicep Implants Are Not Just For Body Builders. Many people have the misconception that a man gets bicep implants because they want to look like a body builder. While that may be true in some cases, it is actually not the most common reason. They are far more frequently used in men who can not adequately develop sufficient upper arm size through exercise or who have arm deficiences/asymmetries due to a congenital or developmental anomaly. In other words they are used for men who are seeking to look more normal and fit but not necessarily ‘supernormal’.

Custom vs Standard Bicep Implants Dr Barry Eppley IndianapolisBicep Implants Come In Standard or Custom Made Sizes, Since the shape and size of male arms are different, it is no surprise that bicep implants are not just ‘one size fits all’. The shape of a bicep implant is more cylindrical (technically half of cylinder in length) whose length is critical. They should be no longer in length than the length of the muscle bulge when the arm is flexed at 90 degrees. Three standard size bicep implants exist as well as they can be custom made for each patient based on preoperative measurements

Right Bicep Implant result intraop Dr Barry Eppley IndianapolisBicep Implants Are Placed Through High Axillary Incisions. As part of a successful bicep implant surgery, the incision to place the implant should be hidden. The best place to insert a pectoral implant is through an incision way up inside the armpit. Others have advocated a mid-incision so the implant could be placed beneath the biceps muscle, this risks motor nerve injury. A subfascial implant location (on top of the muscle) works well in my experience. Incisions in the armpit usually heal very well and are hidden up under the lateral border of the pectoral muscle.

Dr. Barry Eppley

Indianapolis, Indiana

Combined Pectoral and Bicep Implants in Men

Monday, October 3rd, 2016

 

Pectoral implants for male chest enhancement can be a very effective method for a visible change in the size and shape of the pectoralis muscle. Inserted in a completely submuscular position, they push outward on the entire muscle in a largely even distribution of volume. The implants are inserted through a high axillary incision which provides good access for submuscular dissection.

The axillary incision can also provide the opportunity for biceps augmentation as well. Bicep implants are far less commonly performed than pectoral implants. This is due to a general lack of awareness that the procedure exists and that there are no standard styles of bicep implants commercially available.

Bicep implants can be placed either in the intramuscular or the subfascial location. Sitting under the biceps muscle is the coracobrachialis and the brachialis muscle. The implant can be placed directly under the biceps muscle and on top of these two muscles. However, the musculocutaneous nerve from the lateral cord of the brachial plexus runs right through this area and is at risk from compression or a stretch injury. This may lead to loss of muscle strength in the forearm as well as numbness on the radial side of the forearm. For this reason the subfascial location on top of the biceps muscle is preferred.

transaxillary-incision-for-pectoral-and-bicep-implants-dr-barry-eppley-indianapolisUnlike the intramuscular location which requires an incision on the inner aspect of the arm, the subfascial location can be done through the axillary incision. This incision provides equal access to the subpectoral plane medially and the bicep subfascial plane laterally. As the pectoral muscle crosses over the upper border of the bicep muscle the axillary incision provides dual access with equal ease.

custom-pectoral-and-bicep-implants-result-front-view-dr-barry-eppley-indianapoloisBecause of the incisional access, a combined pectoral and bicep implant augmentations can be done during the same surgery. This has the aesthetic benefit of augmenting the two body muscles in men that are most commonly associated with a perception of strength. Despite the same incision this will prolong recovery to some degree as it affects both chest and arm movements across the moveable shoulder joint. But with early physical therapy and range of motion, one should be back to full activities within three to four weeks after surgery.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Custom Bicep Implants

Tuesday, September 20th, 2016

 

Background: Most body implants are done for muscular enhancement. The only exception is that of the female breast implant. In augmenting the muscle size, it is usually most effective if the implant is placed on top of the muscle under its fascial lining. This is certainly true for muscular augmentations that are on the extremities such as the arms and legs. The gliding nature of the muscle inside the fascial sheath allows for a good dissection plane into which the implant can be inserted.

Bicep implants are one of the most uncommon body implants done. While men often seek out larger arm muscles, the appeal of a bicep implant remains limited. This is undoubtably due to the few surgeons that do them and the lack of a good implant which together offers limited public awareness and demand for the procedure. The shape of the bicep muscle is not unlike that of the calfs so the overall implant shape is largely cylindrical.

While there are no true marketed bicep implants, the most common form of them are known as contoured carving blocks. (Implantech) These solid implants come in half cylindrical shapes that go up to 2 cms in length and 6.5 cms wide. The maximal projections are around 2 cms. These implant dimensions will work for most. but not all, patients who seek upper arm augmentation.

custom-vs-standard-bicep-implants-dr-barry-eppley-indianapolisCase Study: This 45 year-old male was to undergo multiple body contouring surgeries, one of which was bicep implants. He was a larger man in stature so even the largest contoured carving blocks were inadequate. Custom bicep implants were made of dimenions 18 cm long, 8 cms wide and 3.5 cm in projection. The attached picture shows the difference between a preformed large bicep implant and that of the custom designed one.

right-biceps-implant-result-intraop-dr-barry-eppley-indianapolisUnder general anesthesia, the custom bicep implants were placed on top of the bicep muscle under the fascia through a high axillary incision.

custom-bicep-implants-result-dr-barry-eppley-indianapolisHis results at two months after surgery show good muscular augmentation with symmetrical implant positioning. The axillary incisions were well healed. He had no restriction of arm flexion or extension. He had just begun back to working out again.

While most bicep implants can be using conventional preformed shapes and sizes, larger men or those that seek more significant arm muscle size may need to consider the custom implant approach.

Highlights:

1) Bicep implants are soft solid implants that are placed in the subfascial location on top of the muscle through an axillary incision.

2) Bicep implants comes in several different sizes but larger dimensions requite a custom implant approach.

3) Custom bicep implants are made based on measurements of the patient arms in the partially flexed position.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Custom Pectoral and Bicep Implants

Wednesday, September 14th, 2016

 

Background: Augmentation of the male chest can be done by either fat injections or pectoral implants. Fat injections, however, can be unpredictable and often only creates a fuller and rounder chest appearance. Implants produce a much more natural and guaranteed pectoral muscle enhancement effect since they are placed directly under the muscle. By being under the muscle they create a maximal push effect on the entire surface area of the chest portion of the pectoralis major muscle.

Pectoral implants come in several different styles and a variety of sizes that will meet the aesthetic demands of most men who seek chest enhancement. But some patients,  particularly men of bigger statures, may find even the largest of the standard sizes to be aesthetically inadequate. They may need more surface, projection and volume of the implant than is available in preformed implants. Custom implants can be made in almost any size to meet the need for ‘extra large pectoral implants’.

A good complement to pectoral implants is that of bicep implants.  The two muscles are not only adjacent to each other but their augmentations can be done through the same axillary incisions. Bicep implants may be particularly useful when custom pectoral implants are being placed to maintain some proportion to the upper body. Bicep implants are available in either standard or custom implant sizes.

Case Study: This 45 year-old male wanted to dramatically improve the appearance of his upper body. He wanted a very large chest augmentation result as well as that of his upper arms. Custom pectoral implants were designed to have a projection of 5cms with a volume of 896ccs. Custom bicep implants were designed to have a projection of 3.5 cms in height and 235cc in volume.

Under general anesthesia his extra large custom pectoral implants were placed in the completely submuscular position through a high axillary incision of 7 cm. Through the same incision the custom bicep implants were placed in the subfascial plane over the biceps muscle.

extra-large-pectoral-implants-result-fronty-view-dr-barry-eppley-indianapoliscustom-pectoral-and-biceps-implants-result-front-view-dr-barry-eppley-indianapolisHis result shows the dramatic effect that can be obtained with larger pectoral and bicep implants that are custom made. The ultrasoft solid silicone gel material allows very large implants to be inserted through relatively small incisions. The soft gel will initially feel firm due to swelling but will soften over the first few months after surgery.

Highlights:

1) Pectoral and bicep implants done together can create a dramatic upper body augmentation result.

2) Pectoral and bicep implants are placed through the same high axillary incision.

3) Pectoral and bicep implants come in standard sizes or can be custom made to best achieve the patient’a aesthetic needs.

Dr. Barry Eppley

Indianapolis, Indiana

Case Study – Custom Bicep Implants

Wednesday, July 20th, 2016

 

bicep muscleBackground: The bicep muscle is the most recognized muscle of the entire arm as evidenced by someone flexing their arm to show its presence. It is a two-headed muscle that runs between the shoulder and the elbow. It has two distinct heads, known as the short and long heads, which emanate from the scapula of the shoulder. The two heads come together into a single muscle mass by the mid-portion of the upper arm. From there the muscle extends across the elbow and attaches to the radius of the forearm.

Augmentation of the bicep muscle can be done by fat injections or an implant. While both treatment methods can be effective, a biceps implant offers a reliable and permanent muscular enhancement method. These implants can inserted either under the muscle (intramuscular) or on top of it just under the fascia. Because of potential injury to the musculocutaneous motor nerve, it is preferable to opt for the subfascial placement on top of the muscle. This also creates the most visible muscle enhancement effect.

Bicep Implants Dr Barry Eppley IndianapolisThere are no formal silicone bicep implants per se. Most commonly used are either silicone calf implants or contoured carving blocks. (Implantech) Their long cylindrical shapes matches the longitudinal shape of the arm muscle. Such performed implants can achieve a 2 cm increase in muscle profile. For larger bicep implants, a custom design process must be used.

CCB3 Custom 18x 8 x 4 3D-R02-1Case Study: This middle-aged male wanted a significant biceps muscle enhancement. Given his large body frame (over 6’ 4” tall) and weight, all standard sized bicep implants were inadequate to make surgery worthwhile… or least not enough to meet the patient’s aesthetic goals. A pair of custom bicep implants were designed and made to exceed the dimensions of standard sized implants used for the biceps. These custom implants were different largely in thickness and width, the length stays the same as other implants.

Bicep Muscle Shortening Dr Barry Eppley IndianapolisWhen doing the preoperative markings for a bicep implants or in the design of custom bicep implants, it is important to appreciate how the muscle belly shortens as the arm flexes. The maximum implant length should not exceed the proximal-distal length of the muscle when in flexion. (hand bend back to the shoulder)

Bicep Implant placement technique Dr Barry Eppley IndianapolisUnder general anesthesia a 4 cm axillary incision was made in the anterior axillary skin crease. Deeper dissection led to the biceps fascia which was opened and a subfascial pocket developed. The custom bicep implants were inserted and positioned directly on top of the muscle. The fascia was closed over them as well as multiple layers beneath the skin.

Bicep Implant immediate result Dr Barry Eppley IndianapolisRight Biceps Implant result intraop Dr Barry Eppley IndianapolisThe change in arm size was immediately apparent as would be expected. Due to the soft durometer of the implants they felt fairly similar to muscle.

Custom bicep implants can be used when a bigger size is needed than what standard implants provide. In men with larger body frames a higher profile (projection) and width may be needed to create an adequate muscle enhancement effect.

Highlights:

1) Biceps implants are placed on top of the existing muscle for an enhanced upper arm profile.

2) Placed through an axillary incision, the implant is placed under the overlying fascia of the biceps muscle.

3) Custom bicep implants are bigger than standard sized implants but are placed the same way.

Dr. Barry Eppley

Indianapolis, Indiana


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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