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Enlargement of the male chest is most commonly done through exercise and subsequent muscle hypertrophy. Strenuous physical exertion and protein supplements can build muscle, often times very impressively. Under ordinary circumstances, most people can create mild to moderate pectoral enlargement that they will find satisfactory. For those seeking substantial chest definition, chest enlargement in the shortest period of time, or if one suffers from developmental pectoral or sternal deformities, exercise alone will not produce a desired result.

Significant pectoral enlargement and definition can most rapidly and assuredly be achieved through an implant. While breast implants in women are far more commonly performed, pectoral implants for men are an equally satisfying procedure. Being essentially the same operation as that of breast augmentation (albeit with a different implant shape and texture), a well placed implant can create a subtle to dramatic change in one’s pectoral outline.

Pectoral implants are placed through an armpit (transaxillary) incision. Made larger than that used for a saline breast implant, the incision is usually about 6 to 8 cms long in the highest skin crease in the armpit. The incision needs to be longer than that for saline breast augmentation because the implant is inserted at its full size (this can not be altered) while a breast implant is deflated and inserted at a fraction of its functional size. The scars, while red for a time after surgery, usually heal quite well and are ultimately hidden within the armpit hair.

A pectoral implant is inserted under the pectoralis major muscle but above the smaller pectoralis minor muscle. This is a natural plane that is easily developed. The dissection should not be lower than the bottom edge of the muscle unlike the pocket that is developed for female breast implants. The goal is to increase the projection and definition of the existing pectoral muscle, not create a new outline or position for it. (in some developmental chest wall deformities this may be needed)

The pectoral implant itself is a solid silicone elastomer that is soft and flexible. Its flexibility is demonstrated but it being able to be folded unto itself to be inserted through the armpit incision. Its feels very much like a ‘gummy bear’ candy. Pectoral implants comes in several different styles (and different sizes within each style), an oval and a more rectangular shape. Which one is best can be determined by taking measurements of one’s pectoral muscle and an artistic sense of the patient’s final goal. As a general rule, rectangular implant is going to give more bulk and definition as there is more implant volume per size. But, like breast implants, the exiting size and shape of one’s chest has a major impact on how any style or size will look.

Because it is muscular manipulation, pectoral implant surgery will be sore after and it takes time to feel comfortable again. I do not use drains after surgery but some plastic surgeons do as this is perfectly fine. Fluid collections or seromas after surgery are not only possible but do occur. So limiting strenuous activity for 3 weeks after surgery is important. But I do want patients to be doing arm range of motion exercises within days after surgery, but just no weights.

Pectoral implants offer a rapid and reliable method for enhancing the male chest. Good results come from a limited intraoperative pocket dissection, good implant style and size selection, and refraining from strenuous physical activity for several weeks after surgery.

Dr. Barry Eppley

Indianapolis, Indiana

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