Will Larger Pectoral Implants Improve The Appearance of Muscle Asymmetry?

Q: Dr. Eppley, I’m interested in speaking with the Doctor about having pectoral implants done, both to increase size and correct a structural asymmetry. I previously had implants surgically inserted. Unknown to me at the time, the Doctor had detached the muscle (which wasn’t noticed due to the general healing from the surgery with the drains to remove any bleeding and edema from that trauma, as well). Secondarily I had the sternal head of the left pectoral muscle repaired using an allograft. Since that time, however, it feels like the muscle has either detached from the sternum itself or some other structural changes have occurred as I can now feel the bone and part of the ribs on the left side. Given that I have started avidly bodybuilding since, I am ultimately looking for new implants that will both correct the appearance and possibly go with something slightly larger than my current physique would typically warrant. I plan on continue adding muscle and would rather go with an XL size that won’t end up looking disproportionate yet again in another 2 to 3 years. 

After conducting extensive research about options within the field, I feel like Dr. Eppley and his approach to custom implants designed based on 3D CT scans would be the most promising solution for my situation long term

A: In answer to your pectoral implant questions:

1) With indwelling pectoral implants and the desire for a larger augmentation, the use of 3D CT implant design is the superior method to do so. You can clearly see your pectoral implants on a 3D CT scan and that allows the ability to make a precise larger implant design with that information.

2) By your description you may be referring to disinsertion of some of the pectoral muscle attachments along their sternal origins. This is most likely to occur at the lower edge of these attachments…which is actually commonly done in breast implant augmentation but not with pectoral implants. Once that muscle area is detached there is no way to reattach it. Attempts can be made to camouflage it (fil in the contour deformity) and that sounds like what was attempted with the allograft. Larger pectoral implants will not correct that soft tissue contour issue and may even make it more apparent. This is also what can occur with pectoral muscle enlargement which may be why it is more apparent now than previously. Secondary management can be done with pectoral implant replacements and the only question there is what soft tissue augmentation would work the best.

Dr. Barry Eppley

World-Renowned Plastic Surgeon