Initially developed for surgical repair of deficiencies, such as congenital pectoral aplasia, pectoral implants can be used to improve the appearance of patients with an undeveloped or disproportionate chest. Over the past decade there has been increased interest is sculpting the ideal male form, as exemplified by provocative ads of men showing off defined abdomens and muscular pectoral regions. An adequate chest wall is psychologically very important for males, denoting fitness, strength, and power. For all of these reasons above, pectoral augmentation has become more prevalent amongst men seeking cosmetic surgery as they continue to further define their physique. Men want to be able to show their chests proudly rather than cowering when confronted with events that reveal the upper torso, such as physical activity (i.e. sports) or simply relaxing at the beach. Using pre-formed silicone pectoral prostheses, the aesthetic surgeon is able not only to correct volume deficits but provide reliable augmentation of the pectoral region, giving men a more defined and muscular appearance.
HISTORY OF THE PROCEDURE
Since the 70’s, reconstructive surgeons have used solid silicone prostheses to reconstruct chest wall defects as a result of Poland’s Syndrome.
In 1999, Dr. Nikolas Chugay published his work on pectoral augmentation in 16 patients for purely aesthetic purposes. Describing his experience with 16 patients served as one of the largest early evaluations of pectoral augmentation along with its risks and benefits.
An incision is made in the axillary region and blunt dissection is used to create a pocket beneath the pectoralis major muscle.
The implant is then placed in the pocket below the pectoralis major muscle. The muscle lining is sutured with absorbable sutures and subcuticular sutures are used to close the skin. Over time, the implant becomes surrounded by a scar tissue pocket, where it stays for the rest of the person’s life.
Initially, pectoral augmentation was introduced as a means to treating asymmetries in the pectoral region left due to congenital anomalies (e.g. Poland’s syndrome and pectus excavatum) and in those patients who suffered volume deficits secondary to trauma or post oncologic surgery. Pectoral augmentation, for purely aesthetic reasons, is indicated for the patient who has hypoplasia in the area of the chest muscle and is unable to achieve the desired projection despite vigorous exercise or muscle building. The last group of patients that may benefit from pectoral augmentation are those that have suffered some injury to the pectoral region, leaving them with an asymmetry and defect in the anterior chest.