Background: There are many upper body muscles that men strive to build by exercise. These include the arm (bicep and tricep) and chest (pectoral) muscles for which aesthetic implant augmentations can be done to assist or replace the need for strenuous exercise. But one upper body muscle that is often developed by weight training is that of the trapezius muscle. Implant augmentation of it has rarely been reported.
The trapezius is a large upper back muscle that extends from the occipital skull and spine in the midline and down out and up to attach to the scapula. By its shape and attachments it should technically be called the spinotrapezius muscle. It provides support to the upper arm and movement to the scapula. It has three parts of which its upper third is the only part of the muscle that is visible when viewed from the front and helps support the weight of the arm.
Case Study: This middle-aged male was in excellent shape (actually remarkable for his age) and had good upper body muscle definition of all major muscle groups by weight training. But he desired further muscle augmentation of which the trapezius muscle was one of them.
Under general anesthesia and in the prone position a 3 cm oblique skin incision is made in the low lateral neck. Dissection is carried to the underlying fascia. The fascia is incised and subfascial dissection is carried out laterally along the lines of the skin marks. In some patients the fascia may be very adherent and difficult to elevate. In these cases the pocket is created on top of the fascial in the deep subcutaneous layer. The chosen soft silicone implant is chosen and shaped and then inserted. Closure is done in multiple layers.
At three year followup the improved trapezius shape could be see in both front and back views.
The fine line scars were well healed and minimally perceptible.
Unlike some other aesthetic body implants, there is no specific off-the-shelf trapezius implants. A small calf implant can be modified and used or a custom trapezius implant can be made. Either way trapezius augmentation can be done as successfully as any other body muscle augmentation site.,
Highlights:
1) The trapezius muscle is an upper back muscle that creates a visible contour between the neck and the shoulders.
2) Implants can be used to augment the trapezius muscle through low lateral neck incision.
3) The fascia over the trapezius muscle is tightly adherent so implant augmentation may need to be done in a deep subcutaneous level on top of the fascia.
Dr. Barry Eppley
Indianapolis, Indiana