How Can I Length My Short Thigh Muscles?

Q: Dr. Eppley,I am interested in a consultation on quad implants. I am specifically interested to hear about placement outside inner the muscle fascia. My quad muscle bellies are very short and I would like to hear if its possible to place an implant below the vastus lateralis muscle belly. The goal is not to thicken the existing muscle, but to thicken the area below the muscle.

A:Thank you for your inquiry and sending your picture. Your short quad muscle poses a treatment conundrum. The placement of all extremity based implants for muscle enhancement is underneath the muscle fascia. This provides the best implant coverage as well as stable positioning inside the contained fascia. It is not usually a good idea to place implants about the fascia in the subcutaneous space for a variety of reasons including increased risks of implant show, postoperative migration as well as chronic seromas.

To put that into context of what you want to achieve here is what I do know:

1) You definitely do not want to place an add on implant extending the appearance of the muscle in the subcutaneous space

2) You also probably do not want to place a long subcutaneous placed implant on top of the fascia of the short muscle to elongated its appearance towards the knee. Although this option is certainly better than #1.

3) Placing a longer implant in the subfascial plane of your existing muscle and then breaking through the fascia at the bottom of the muscle  to elongate it on top of the fascia below it is the third option. Whether this option is better than #2 can be debated. The problem with this option is that the existing muscle is already large enough and it doesn’t really need to be any bigger. Custom implant design and couldn’t get around that issue by making the implant thinner on the existing muscle and thicker below it.

As you can see your  thigh shape concerns are novel in my experience and I have yet to see a similar case. Therefore I cannot tell you definitively which option is truly better than the other or whether anty of these options could be effective.

Dr. Barry Eppley

Plastic Surgeon