Muscle implants are a quiet corner of plastic surgery. Calves, pecs, biceps, traps. A man came in for a four month facial follow-up and brought up something else entirely: trapezius implants placed about ten years ago, somewhere else. What follows is that part of the consult, identifiers removed.
Him: “About ten years ago I got trap implants, but now they look like two balls. I don’t know how they moved. They’re just not in their place.”
Me: “Let’s take a look.”
Him: “They made an incision right here. The pain wasn’t anything.”
Me: “Was it the same surgeon that did your abdominal etching?”
Him: “The second time, yes. They found them, but they were in the wrong place. They were under the muscle. They’re supposed to put them on top, and they were under. So of course they were never going to show, especially if I gain weight. And they were folded like a taco.”
Me: “I probably wouldn’t put in a new implant here. I would just take these out.”
Him: “No?”
Me: “I’ve never done it. You know, I’m very honest with you. I will start researching it.”
Him: “Because it would have to be almost like a triangle here, right?”
Me: “Yeah, literally like that. It should go all the way to here.”
He worked out the shape problem himself. The trapezius is a big triangle. A small round implant under it looks like a lump, not like the muscle.
Using His Own Fat Instead of a Second Implant
Me: “What if the fat that I take out, I inject it into your traps, and I bulk them up?”
Him: “You could do that, but if I lose weight? Well, you don’t think so? I usually maintain.”
Me: “If you usually stay the same, that will make them bulk up and it’s going to look natural. I do that with the biceps a lot.”
Him: “And then, the back?”
Me: “No pieces, no scars. Just a little bit. It would make it thinner. But we have to use the J-Plasma to tighten the skin. We could do the whole thing, and use the J-Plasma, that way you get a little bit more fat, and then we’ll put it here, and I think it’ll give you a nice result. It’s going to look better than this.”
Him: “I think eventually these will give me problems in the future.”
Me: “Yeah, and we just need to get them out.”
Him: “It’s like your body’s angry around them.”
Me: “Exactly. They’re almost wanting to come out on their own. So that’s pretty simple.”
The Takeaway
Grafted fat is your own tissue, so it goes up and down with you. Stable weight, stable result. His answer of “I usually maintain” mattered more here than anything I measured.
My exam note from that day: “This patient has two trapezius implants, which are very small, and they look like two bumps on the trapezius area. He has some excess adipose tissue in the upper back and lower back with some excess skin.”
I am a double board-certified plastic surgeon, a Mayo Clinic fellowship alum, and I teach plastic surgery as a Clinical Associate Professor at Texas Tech University Health Sciences Center. Revision work is less about technique than about saying plainly which operations I have done and which I have not.
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If an old implant has shifted, hardened, or never looked right, let’s take a look together. Call the office at (915) 590-7900, text us at 1-866-814-0038, or book a consultation at drworldwide.com.
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