Article published in: Cosmetic Surgery Times September Issue
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Early experience with this procedure is producing positive results.

A novel triceps augmentation procedure using specially designed silicone implants is becoming increasingly popular in the cosmetic surgery arena, allowing patients to realize their desired aesthetic muscle contour quickly and safely.

According to one pioneer in the field, the triceps augmentation procedure is easy to perform and can help achieve an increased muscle mass and aesthetic muscle contouring in those patients who fail to reach their desired aesthetic goals from traditional muscle building exercises.

“The triceps augmentation procedure is a natural extension of other already-established bodycontouring augmentation techniques readily being used for biceps, deltoid, pectoral and buttock augmentation. Patients can now realize the muscle mass that they desire in the triceps region with this very easy-to-perform implant procedure, adding a fullness and definition to the triceps region,” says Nikolas V. Chugay, D.O., of the Chugay Cosmetic Surgery Medical Clinic, Long Beach, California.

Initial indications Implant augmentation procedures were originally designed for the aesthetic reconstruction of the underarm after trauma or cancer surgery or for the correction of genetic anatomic anomalies. The indication for body implants has now expanded in cosmetic surgery and is becoming increasingly popular in body builders and those patients who simply are not satisfied with the level or contour of muscle mass they are able to build up in that region.

Falling back on his decades of experience using implants for biceps, deltoid, pectoral, calf and buttock augmentation, Dr. Chugay is now performing a parallel technique to augment the triceps. He says he developed the patented Chugay triceps implants (AART , Las Vegas) and has used the body implants in 10 patients to date, achieving exceptional cosmetic results. The triceps prosthesis is made of a soft solid silicone and, according to Dr. Chugay, the implant feels very real to touch and is also aesthetically and visually true to real body muscle mass. “Social pressures and trends regarding the ‘ideal’ body appearance have given birth to non-invasive body sculpting techniques, as well as surgical procedures such as body implants.

Patients who come to me for muscle augmentation implant surgery often will typically begin with biceps and pectoral implants, and triceps augmentation is usually the next logical step in their quest for achieving their desired aesthetic image,” Dr. Chugay explains.

Procedure details Performed under IV sedation, the procedure takes approximately one hour to complete for both arms. The technique follows an incision in the patient’s axilla. After the triceps muscle is localized through the incision, the fascia is identified and a cut is made in the muscle. Using blunt dissection, Dr. Chugay proceeds to create a pocket just below the fascia of the long head of the triceps muscle. The silicone implant is placed in this pocket and fixated with a distal suture to prohibit movement and migration of the implant.

The muscle lining is then closed with absorbable sutures, and subcuticular sutures are used to close the skin. Dr. Chugay says that over time, a fibrous capsule will form around the silicone implant that further ensures its stability within the pocket created.

According to Dr. Chugay, the blunt dissection of the tissues is one of the keys to a safe procedure. The advantages here include less risk of injury to tendons, nerves, blood vessels and other surrounding tissues, much less bleeding with subsequently less hemostasis needed, less risk of hematoma and seroma formation and a faster healing time for the patient and surgical site.

“Each patient is treated individually, as each implant is custom-made for each case. After carefully assessing body type, symmetry, proportions as well as the desired aesthetic outcome, we create unique implant designs in order to ensure maximal satisfaction for the patient,” Dr. Chugay says.

Implant safety The silicone implants and gels used for breast augmentation in the past typically consisted of liquid silicone encapsulated in a hard shell. However, controversy arose when this liquid silicone leaked out of its shell and dispersed itself systemically around the body, causing potentially serious health issues in the unfortunate patient.

According to Dr. Chugay, the specially designed soft solid silicone implants do not share the same dangers, as there is no risk of leakage and systemic dissemination of the silicone.

“The triceps implant is made out of a soft solid silicone, a biologically inert material, the same material which is also readily used in facial implant surgery to enhance the chin, cheek and jaw. Therefore, there are no issues of biocompatibility, making the procedure a safe procedure, in the long term,” Dr.Chugay says.

Body implants for other anatomic sites have become well established in muscle contouring surgery, and though the triceps augmentation procedure is still in its infancy, Dr. Chugay says that the simplicity of the surgical procedure, its safety record and the immediate aesthetic results achieved will likely propel body implants to be the contouring cosmetic procedure of the future.