Can Forearm Implants Make My Wrists Appear Less Narrow?

Q: Dr. Eppley, I am interested in forearm implants. I previously had a fat transfer to my wrist areas that did not work.

A:While fat grafting to the wrist (technically the distal forearm) was reasonable to initially try I have never seen it work there as there is little subcutaneous fat to help it survive. Technically you are referring to wrist (distal forearm)and not proximal forearm implants. That is more than a semantic difference. Proximal forearm implants are in the upper 2/3s of the forearm and are muscle type implants that are under somewhat thicker tissues and are not exposed to wrist join movements. Distal forearm or wrist implants are subcutaneous implants placed right under the skin, the tissue cover is very thin and they are exposed to flexion and extension movements of the wrists and hands. The point being is the proximal forearm is a better implant location in terms of potential postoperative problems than the distal forearm closer to the wrist. That being said distal forearm implants can be done with the understanding that they can come up to but not cross the bony bump closer to the wrist which are the ends of the ulna laterally and the radius bones medially. (see attached image, red arrows) Whether one or both sides need to be done (in green) is up for discussion. Such implants are made using a moulage or measurement technique to create their computer designs.

Dr. Barry Eppley

World-Renowned Plastic Surgeon