Background: Aesthetic body implants, excluding breast implants, strive to achieve muscular enhancements. The most common body implants are placed in the chest (for men), buttocks and calfs and because of their level of patient requests exist in standard shapes and sizes. Other muscles of the body can be augmented but with less frequent requests are done by custom implant designs for each patient.
One such uncommon but effective body muscle augmentation is that of the thighs. The anterior thigh is composed of four muscles but the largest and most visible is the bicep femoris and vastus lateralis muscles. While these are separate muscles they often share a similar fascial lining. As a result they can be augmented by an implant placed in the subfascial location. The entrance incision is either in or close to the groin crease.
Once thigh implants have been successfully placed a postoperative question is whether larger implants can be done secondarily. That answer is yes….but one is changeable (implant volume/projection) and the other not so much. (implant footprint)
Case Study: This male had a prior history of multiple body contouring implants including buttock, lateral thigh, hip dip and anterior thigh implants. A 3D scan showed the multiple implant locations, an incredible testament as to the body’s tolerance of so much implant material in one concentrated area. He now desired to have larger more extended anterior thigh implants.
Under general anesthesia and in the supine position his existing groin incisions were used to access the existing thigh implant pockets. The existing implant pockets were extended more inferiorly towards the knee with blind capsulotomies with long dissecting instruments. His new thigh implants were eventually placed but not without some modifications to their projection and width, particularly at the top end where they lie the closest to the lateral thigh implants.
Incisional closure was not a problem after a three layer deeper tissue closure. Drains were not used for the replacement implants.
His immediate intraoperative results showed longer and fuller thighs with improved symmetry between them.
Body muscle implants are uniquely different from many other type of implants, particularly breast implants. Because the implant is long and is placed through a proximal incision at one end of the implant, much of the implant pocket is done using blind instrument dissection. Once the implant is placed and the capsule forms and heals around it the pocket becomes fixed. It is very difficult to ever change the shape of the healed This is particularly relevant when it comes to implant replacement. While the first implant acts as a tissue expander permitting some volume increase the implant’s footprint or pocket extender is not so easily done. In this case it was possible to make it vertically longer but width changes could not be safely done.
Case Highlights:
1) Thigh implants augment the bicep femoris and vastus lateralis muscles of the anterior upper leg.
2) Thigh and lateral hip implants reside very closely and their pockets may merge.
3) Custom thigh implants replacements can increase volume but footprint change are primarily limited to their vertical length.
Dr. Barry Eppley
World-Renowned Plastic Surgeon