Chest, Calf and Other Implants

Risks and limits of surgery
How do I choose the right size for me?

Choosing the right size is an important decision that I will help you to make. The important thing is for you to have an idea of your aims. If you use any external prostheses / implants, pleaes bring these with you. You should also consider your work and lifestyle; and how your new size would impact on these. It is often very helpful to bring a close friend or trusted family member with you for this.

How do I help prepare for my surgery?

Always disclose everything when asked about your medical history including anything you take whether prescribed or not.

Do not take any medications that might increase the risk of bleeding, for example non-steroidal painkillers (eg. Ibuprofen). Some herbal and vitamin supplements may also have an effect and should be avoided completely, a balanced diet will more than suffice.

If you smoke you must stop before your procedure – the longer the better.

Silicone safety and breast implant brands

Implants have been used since the 1960’s and the evidence suggests that properly made implants manufactured to medical specifications are safe. I only use implants from reputable, established manufactures and will discuss all aspects of safety with you at consultation.

This section of my website is for those of you seeking an increase in volume of a given area other than the breast or face. This may be simply for aesthetic reasons or as a result of underdevelopment or trauma and various medical conditions.

Patients come to see me because they desire more bulk and definition in a given area. In men the most common area is the chest which is typically enlarged using silicone pectoral implants. Other patients seek more shape to their calves and again silicone implants can be used for this. Less frequently other areas such as the triceps can be enhanced.

Underdevelopment, trauma and medical conditions:

This includes developmental conditions such as chest wall disorders including pectus excavatum and Poland syndrome. In the latter the pectoral muscle does not develop and an elegant solution for this is to take the latissimus dorsi muscle from the back and transfer it to the front of the chest to reconstruct the area, but custome designed implants may also be used.
Sometimes childhood disease can affect growth. Polio is an example in which there is underdevelopment of the calf (and other) muscles. In these situations there may also be underdevelopment of the skin and tissue planes. This is addressed by using tissue expanders first to enlarge the soft tissue envelop before a second stage of putting an implant into position ie a multistage process.

When only a moderate increase in size is needed this may be achieved by using a person’s own fat if this available and fat transfer is another alternative.
This type of surgery is highly specialised and individualised and the management is very much dependant on the characteristics of the problem in a given individual. This is something that I would go through in a detailed consultation.

As a general principle, single stage implant procedures typically take between 90 minutes and two hours.

The general principle is that an implant is placed into a plane that sufficiently covers and hides the implant and provides robust protection. In the case of calf implants, this is usually on top of the calf muscles but under the soft tissue sheath that encases the muscles. In the case of pectoral implants to increase chest size in men, the implants usually are almost always placed under the existing chest muscle.

Most of these procedures are carried out under general anaesthetic and I routinely keep my patients in for one night for the single stage procedures. More complex procedures that involve moving a muscle may involve a longer hospital stay and longer procedures.

In some situations, the defect to be filled requires a bespoke implant and on these occasions a mould is made of the defect using a moulage (plaster cast) kit in outpatients. This is then sent to the implant manufacturers who will make a custom designed implant to fit that space.

When fat transfer is used the procedure typically takes 1-2 hours and is carried out as a daycare. Often this can also be done under local anaesthetic. Please also refer to fat transfer.

The recovery period is light activities of two weeks and depending on where the implant is, a return to normal activities around three to four weeks. For more rigorous activities my recommendation is typically three months.

The goal of surgery is to carry out the procedure that is right for you. This requires careful thought and planning.There are a number of aspects to this.

Once we have established a surgical plan for you, I will go through all aspects of the procedure itself, recovery time for healing, return to work, childcare and exercise. I will also go through potential complications and risks specific to you if you have any medical conditions.

If you decide to go ahead with surgery we will arrange a date for this and you will receive confirmation by letter, with detailed instructions about what you should and should not do before surgery.

On the day of surgery, I will meet you on the ward and go through the surgical plan with you again. At this point I will also mark up the area in preparation for your operation. The anaesthetist will also see you and will also go over your medical history and make a plan to ensure that your anaesthetic is smooth and discomfort minimised.

Your operation will usually take between 90 minutes and 2 hours and you will wake up gently in the recovery room where my anaesthetist and I will see you to ensure that you are comfortable post-operatively.

After a short while you will be transferred back to the ward. Once you are fully awake you will be encouraged to get up, initially with help, and to mobilise gently.

The following day I will come and see you again and check everything in preparation for discharge from hospital. You will be provided with medication that includes strong painkillers for your first week. On discharge I will go over what you should do at home in detail with you and give you a written guide. I will also arrange to see you in a week to check on your progress.

Each patient will have a recovery plan tailored to their situation, but as a general guide:

  • You will be in hospital until the day after surgery
  • You should be able to carry out light work after 1 -2 weeks
  • You may drive short distances after 1 week – this will be 2-3 weeks for calf implants.
  • I recommend that you restrict exercise to walking in the first 3-4 weeks. Thereafter you may carry out general light exercises but refrain from full exercise until 3 months.