Q: Dr. Eppley, I am interested in thigh implants. I wish to increase the volume of the thighs, the front and the back, I am aware that there are limitations and that everything is not possible at once. The front of the thighs, so that they grow wider would be desirable. I understand that it is probably not possible to do both the front and the back of the thighs at the same time.
A:Thank you for sending your pictures and detailing your thigh implants augmentation objectives. You have now have thigh-calf disproportion after your calf implants. Augmenting the calfs is a very successful procedure because there is one defined muscle belly and the implant-muscle ratio is fairly high. (a lot of implant for the size of the muscle) Thigh augmentation, while it can be successfully done, is not as easy to get such a good result as calf augmentation because there is not one muscle that makes up the thigh and any implant-muscle ratio is going to be much much lower than that of the calfs.
That being said, there are two fundamental approaches to thigh augmentation. The most biologic approach, although not one that produces the most augmentation, is to place the implant under muscle fascia. (which is always preferred in implants if possible) This largely leaves the rectus femoris muscle on the anterolateral thigh which is the largest muscle belly. The other approach is to ignore subfascial placement and place it on top of the muscle fascia. In this way a larger augmentation can be done as it does not have to stay within the defined underlying muscle fascial borders. It has a slightly higher risk of infection and implant show although the latter can be overcome by implant design.
Dr. Barry Eppley