Cairo Plastic Clinic 

Biceps and /or Pectoral augmentation were initially used by surgeons to help in the reconstruction of soft tissue defects of the upper extremity and/or chest, left by significant trauma or after cancer removal. 

For cosmetic purposes, they have been used since 2004 for bodybuilders. While it doesn’t add to the patient’s use of the arm, the use of a silastic implant does provide “gratifying cosmetic results” that are durable, and provide bulk to the arm and/or Chest regions, with aesthetically pleasing outcmes.

 How is the Surgery Performed?

Dr Wilson makes a cut in the armpit region and the fascia overlying the biceps and / or pectoralis muscle is identified. Next, a cut is made in this fascia to gain access to the muscle. Using blunt dissection, a pocket is created just below the biceps and/or pectoralis muscle on top of the long bone of the upper arm.

The implant is then placed in this pocket. The muscle lining is sutured with absorbable sutures and subcuticular sutures are used to close the skin. Over time, the implant becomes surrounded by a scar tissue pocket, where it stays for the rest of the person’s life.

 Placing the implant above the fascia or under the muscle causes a lot of complications, and Dr Wilson routinely places the implants under the fascia.

LIMITATIONS

In any initial biceps augmentation, patients are instructed on the fact that they can achieve an augmentation of approximately 1 inch in vertical height. Because the silicon implants come in preset sizes, there is a limitation on amount of enlargement.

Larger augmentations may require a second operation with larger, custom implants. Also, patients are instructed that while biceps and triceps augmentations can be performed, it is safer to separate this into two separate surgeries to avoid the risk of compartment syndrome in the upper extremity. 

After care

On leaving the hospital on the day of surgery, the patients have their arms wrapped in elastic compression sleeves to diminish the amount of swelling and potential for seroma formation. These sleeves are removed on the first day postop and a compression garment is applied that is to be worn at all times for a period of 4 weeks. Patients may remove the sleeves to shower and to wash the sleeves as needed. Patients may begin showering the day after surgery, taking care to dry the elastic tape over their incisions with a hair dryer on a low heat setting. The patient is instructed post-operatively to limit the use of the upper extremities and to avoid exertion or any heavy lifting. Patients may begin to use their arms as tolerated immediately after surgery but are restricted from heavy lifting or vigorous activity for 4-6 weeks post-operatively.



Revision Biceps Implants in a 28 year Old Patient:

This patient had biceps arm implants placed in India and were put over the fascia leading to disfigurement, pain and visible edges. Dr Wilson replaced them with different silicon implants placed under the fascia, and gave a more aesthetically pleasing harmonious result. Note the excellent contour achieved by the correctly placed implants with smaller size.

 And Implants that were removed:

 And after placing the new implants under the Fascia:

Arm Biceps Implants in a 38 year Old Patient:

This body builder had small weak arms that affected his career.  Dr Wilson inserted silicon implants under the fascia, giving a more aesthetically pleasing harmonious result. Note the excellent contour achieved by the correctly placed implants and natural appearance.