Q: Dr. Eppley, I am interested in getting deltoid implants. The look that I am going for is aimed at the appearance of wider shoulders to improve my waist-hip ratio, rather than increasing the overall mass of the deltoid muscle. So I have two questions with respect to that:
1) If a custom implant is used, what is the limit to how wide the shoulders can be made?
2) Is the width created by the implant independent from the width potentially created by muscle hypertrophy? In other words, if I achieve lateral deltoid hypertrophy through weight training after having the implant placed, will my ‘new width’ be the implant size + any new muscle size I have gained?
3) If a subfascial implant is used, will it a) show up unnaturally if I drop down to 8% body fat or so, and b) obscure any potential aesthetic definition (such as muscle striations) that I might otherwise obtain with low body-fat?
4) From an aesthetic standpoint, do you think that there can be too much shoulder width?
5) Another concern is that the implant may make the shoulder muscles look too big; so I think I am asking whether there any techniques that can be used to maximize the perceived width of the shoulders while minimizing the perceived size of the deltoid heads themselves, i.e. I want the width but not the unnatural and disproportionate deltoid size.
A: Almost all deltoid implants have to be made in a custom fashion since there are no true preformed deltoid implants available. When placing deltoid implants the limitation of its size is based on how much the overlying fascia can stretch as well as the length of the incision used to insert them. Any muscle hypertrophy added after the implants are placed will create a cumulative effect.
The deltoid area has a fairly thin subcutaneous layer so low levels of body fat may expose the outline of the implants.
I cam certain there is a limit to how much shoulder width is aesthetically pleasing. But the more important issue is having an implant that blends in well to the surrounding tissues regardless of its size.
I think when you are trying to create a distinction between muscle size and shoulder width you are trying to make a critical difference which does not exist. Deltoid implants, or any body implant for that matter, just isn’t that specific. Deltoid implants create a indistinct mass effect.
Dr. Barry Eppley