ArticlePDF Available

Male Chest Enhancement: Pectoral Implants

February 2008
Aesthetic Plastic Surgery 32(1):101-4

DOI:10.1007/s00266-007-9018-5

Source
PubMed

Authors:

Jesus Benito-Ruiz

Antiaging Group Barcelona

Mauricio Raigosa

Hospital Clínic de Barcelona

Marisa Manzano

Hospital Sant Joan de Déu

Laura Salvador

antiaging group barcelona, Barcelona, Spain

The authors present their experience with the pectoral muscle implant for male chest enhancement in 21 patients. The markings and technique are thoroughly described. The implants used were manufactured and custom made. The candidates for implants comprised three groups: group 1 (18 patients seeking chest enhancement), group 2 (1 patient with muscular atrophy), and group 3 (2 patients with muscular injuries). Because of the satisfying results obtained, including significant enhancement of the chest contour and no major complications, this technique is used for an increasing number of male cosmetic surgeries.

Sport injury at the axillary aspect of the left muscle. A 180-ml manufactured implant was placed in an attempt to recreate the lateral contour of the muscle. A right implant was used, so that the thickest portion of the implant would be under the lateral edge of the muscle

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Measurements for choosing the implant: width at the infraclavicular (1) and caudal levels (2), height at the midportion of the muscle (3), and distance between the axilla and the chondroesternal angle (4)

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ORIGINAL ARTICLE

Male Chest Enhancement: Pectoral Implants

J. Benito-Ruiz Æ J. M. Raigosa Æ M. Manzano-Surroca Æ

L. Salvador

Received: 1 May 2007 / Accepted: 22 May 2007 / Published online: 5 August 2007

 Springer Science+Business Media, LLC 2007

Abstract The authors present their experience with the

pectoral muscle implant for male chest enhancement in 21

patients. The markings and technique are thoroughly

described. The implants used were manufactured and

custom made. The candidates for implants comprised three

groups: group 1 (18 patients seeking chest enhancement),

group 2 (1 patient with muscular atrophy), and group 3 (2

patients with muscular injuries). Because of the satisfying

results obtained, including signiﬁcant enhancement of the

chest contour and no major complications, this technique is

used for an increasing number of male cosmetic surgeries.

Keywords Male chest enhancement  Pectoral implant 

Silicone implants

Plastic surgeons have paid little attention to male chest

enhancement, as indicated by the very small number of

articles about this subject. Although chest enhancement is

not as common as other body implant operations, it has

become increasingly popular, and the demand for this

surgery is growing.

Many men strive to develop their pectoral muscles for a

look of bulk and projection. Some men work out exten-

sively and still are unable to develop the pectoral muscle

they hope to achieve. It is a fact that some body types do

not achieve chest muscle tone and deﬁnition as easily as

others. Genetically, some men are predisposed to building

fullness in the lower rather than the upper part of the chest.

This gives them an unbalanced, heavy look. Even those

men who work out frequently may gain strength in the

pectoral area without noticeable enlargement of the mus-

cle. In other instances, underdevelopment of the muscle in

the chest can be a result of a growth defect or injury.

An adequate chest wall is psychologically very impor-

tant for males. A well-developed chest denotes ﬁtness,

strength, and power. The exposure of the male body in

media advertising, especially the upper torso, which fea-

tures large and well-deﬁned pectoral muscles, makes the

latter highly desirable as an ideal standard [1].

In 1990, Horn and Aiache [3, 5] developed a pectoral

implant for male patients that contains a cohesive silicone

gel and a seven-layer capsule with volcanic texture [2]. The

implant is rectangular with oval-shaped borders. The shape

of the implant reproduces, as much as possible, the outlines

of the pectoral muscle. Polytech-Silimed Europe GmbH

(Dieburg, Germany) has three available sizes: 190 ml

(width, 14.4 cm; height, 2.4 cm), 230 ml (width, 15.8 cm;

height, 2.6 cm), and 300 ml (width, 16.5 cm; height, 2.9

cm).

Typically, three groups of patients seek this procedure.

The most common group includes men who are unable to

develop their pectoral muscles even with a regular exercise

regimen and those who are not willing to make the effort to

improve their body image. The second group comprises

men who have a congenital absence of the pectoralis

muscle on the one side (Poland syndrome) or denervation.

The third group consists of men with injuries to the muscle

due to excessive training (sport injury).

Materials and Methods

Pectoral implantation was performed for 21 men, ages 25

to 56 years, who wished to enhance the bulk and projection

J. Benito-Ruiz (&)  J. M. Raigosa  M. Manzano-Surroca 

L. Salvador

Antiaging Group Barcelona, Institut Dexeus, C/ Sabino de

Arana, 5-19, 08028 Barcelona, Spain

e-mail: drbenito@cirugia-estetica.com

123

Aesth Plast Surg (2008) 32:101–104

DOI 10.1007/s00266-007-9018-5

of their pectoral muscles. For 16 of these patients, we used

manufactured anatomic pectoral implants (Polytech-Si-

limed Europe GmbH, Dieburg, Germany). For two

additional men, we used oval buttock implants (Polytech-

Silimed Europe GmbH), and for the remaining three men,

we used custom-made implants.

Choosing the Implant

The pectoral muscle is measured at the following different

levels (Fig. 1):

• Width at the infraclavicular level (level 1) and at the

lower border of the muscle (level 2)

• Height at the midportion of the muscle between the

clavicle and the lower border (level 3)

• Distance between the axilla and the chondroesternal

angle (level 4).

The real pocket usually is about 2 cm smaller than the

measurements we have taken on the skin. In cases of

unilateral reconstruction, the normal muscle is measured,

and the implant is chosen to match the normal side. For

custom-made implants, a cast is made with the desired ﬁnal

result. In these cases, projection of the muscle and the

curve of the chest are outlined in the model.

Surgical Technique

Markings are made following the outlines of the pectoral

muscle with the patient in a standing position, and the

procedure is performed with the patient under general

anesthesia. The patient is comfortably placed in the

supine position with the arms abducted 90. A solution

containing adrenaline 1/100000 is used to inﬁltrate the

area. The incision made in the axilla is transverse for the

manufactured pectoral implants and longitudinal

following the posterior aspect of the border of the pec-

toralis muscle for the custom-made implants. The mean

length of the incision is 4 cm. The lateral border of the

muscle is identiﬁed, and the pocket is created behind the

muscle, initially with scissors and then with a blunt

dissector. It is very important to stop the dissection about

1 to 2 cm below the areola without detaching the costal

and sternal insertions of the pectoralis muscle. Otherwise,

the implant will be positioned too low, resulting in a

female appearance [2]. Laterally, we perform a blunt

dissection to make room for the implant, stretching out

the fascia. Meticulous hemostasis is performed, and the

implant is placed.

The orientation of the implant depends on the desired

result and the shape of the muscle. The implant can be

placed in a transverse or more oblique position. In some

cases, we have rotated the implant to use its thickest part to

reconstruct an injured portion of the muscle. Closure is

performed in layers, and a light compressive bandage is

placed on the chest.

Results

We performed 21 surgeries between 2003 and 2006. The 18

men in group 1 were unable to develop their pectoral

muscles even with a regular exercise regimen or were not

willing to make the effort to improve their body image. One

of these men underwent a reoperation to exchange the

implant due to a capsular contracture secondary to a

hematoma. We used custom-made implants for two patients

(Fig. 2), oval buttock implants for two patients (both 240-

ml implants), and available implants manufactured by

Polytech-Silimed for the remaining patients (Fig. 3). Six

these patients received 230-ml implants; three received

300-ml implants; and ﬁve received 180-ml implants.

The one patient in group 2 had pectoralis muscle atro-

phy (Poland syndrome, denervation) (Fig. 4). This patient

had a brachial plexus injury with denervation of the pec-

toralis muscle as well as the radial, median, and ulnar

nerves. We placed a custom-made implant to recreate the

pectoralis muscle and a Glicenstein calf implant (Polytech-

Silimed Europe GmbH, Dieburg, Germany) for the triceps

muscle.

The two patients in group 3 had injuries to the muscle

caused by excessive training (sport injury) (Fig. 5). One

patient lacked deﬁnition of the muscle in the tendon area,

and the other patient lacked deﬁnition of the caudal edge of

the muscle. In both cases, a manufactured implant was

used.

There were no complications such as hematoma, sero-

ma, or capsular contracture. All the patients resumed

exercise and a normal life after 5 weeks.

Fig. 1 Measurements for choosing the implant: width at the infrac-

lavicular (1) and caudal levels (2), height at the midportion of the

muscle (3), and distance between the axilla and the chondroesternal

angle (4)

102 Aesth Plast Surg (2008) 32:101–104

123

Fig. 2 Chest enhancement with

custom-made implants. This

type of implant is best when the

patient wants a squared muscle,

well deﬁned in all its boundaries

Fig. 3 Two 230-ml pectoral

implants. The implants were

oriented obliquely to follow the

triangular shape of the muscle

Fig. 4 Left pectoral atrophy

after a brachial plexus injury. A

custom-made implant was

placed to match the

contralateral side. Another 90-

ml calf implant was placed

under the triceps muscle

Aesth Plast Surg (2008) 32:101–104 103

123

Discussion

Clinicians can expect pectoral augmentation to be among

the surgical procedures included in the increasing number

of procedures used in male cosmetic surgery. Few works

on the pectoral implant procedure can be found in the

medical literature [2–6].

For most patients, pectoral implantation is not a tech-

nically demanding procedure, especially if the surgeon has

experience with the axillary approach. The best implants

are those designed by Aiach and manufactured by Poly-

tech-Silimed Europe GmbH (Dieburg, Germany) because

they provide a good contour and are made of cohesive

silicone that allows for any type of exercise and muscular

workout after the surgery. Custom-made implants are more

rigid, and although they provide a good contour, the patient

may experience some discomfort when exercising because

the implant is not as pliable.

If the manufactured implants are not available, buttock

implants are a good option, although they do not ﬁll the

most cranial area of the pectoral muscle (upper third). Male

pectoral implants are designed to deﬁne and shape the chest

area. For men unable to achieve the desired results through

exercise, the surgery can give the existing muscles a toned,

enhanced look. For patients with congenital defects or loss

of muscle from an accident or injury, the pectoral implant

procedure often can reproduce a natural, even a symmetric,

chest area.

Pectoral implants can help build self-conﬁdence for

individuals who once were embarrassed by their appear-

ance. The result is the athletic, natural appearance of a

well-proportioned torso.

References

1. Benito-Ruiz J (2003) Buttock implants for male chest enhance-

ment. Plast Reconstr Surg 112:1951

2. Aiache AE (1991) Male chest correction: Pectoral implants and

gynecomastia. Clin Plast Surg 18:823–828

3. Aiache AE, Carlsen LL, Amezcua H, et al. (2003) Calf, buttock,

and pectoral implants. Aesth Surg J 23:410–413

4. Hodgkinson DJ (1997) Chest wall implants: Their use for pectus

excavatum, pectoralis muscle tears, Poland’s syndrome, and

muscular insufﬁciency. Aesth Plast Surg 21:7–15

5. Horn G (2002) A new concept in male chest reshaping: Anatom-

ical pectoral implants and liposculpture. Aesth Plast Surg 26:23–

6. Pereira LH, Sabatovich O, Santana KP, et al. (2006) Pectoral

muscle implant: Approach and procedure. Aesth Plast Surg

30:412

Fig. 5 Sport injury at the

axillary aspect of the left

muscle. A 180-ml manufactured

implant was placed in an

attempt to recreate the lateral

contour of the muscle. A right

implant was used, so that the

thickest portion of the implant

would be under the lateral edge

of the muscle

104 Aesth Plast Surg (2008) 32:101–104

123

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