September 30, 2026 | Body, Plastic Surgery
Muscle implants promise a shape the gym cannot give you. Calves, pecs, biceps, traps. Sometimes they deliver. When they are placed in the wrong layer, they do not.
A man came in for a four month follow-up after a facial procedure and raised something else. He had trapezius implants placed about ten years ago, elsewhere. Rather than write around it, here is the exchange from my consult dictation, identifiers removed.
“They Look Like Two Balls. I Don’t Know How They Moved.”
His full description: “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.”
I asked to see them, and asked whether the same surgeon had done his abdominal etching.
“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.”
The plane matters as much as the implant. Muscle is not passive tissue, and every shrug and every lift pushes on whatever is sitting in that pocket.
“So Would You Just Take Them Out?”
“I probably wouldn’t put in a new implant here. I would just take these out.”
He asked whether a bigger one was possible. My answer:
“I’ve never done it. You know, I’m very honest with you. I will start researching it.”
He worked out the shape problem himself, asking whether it would have to be almost like a triangle.
“Yeah, literally like that. It should go all the way to here.”
The trapezius runs from the base of the skull out to the shoulder and down the spine. A small round implant underneath a sheet of muscle that broad reads as a bump, not as anatomy.
“If You Take Them Out, Will I Just Be Flat?”
“What if the fat that I take out, I inject it into your traps, and I bulk them up?”
He asked what happens if he loses weight, then answered his own question: he usually maintains.
“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.”
“Can You Do the Back at the Same Time?”
“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.”
The liposuction does two jobs at once: it thins the upper and lower back, and it supplies the graft.
“It’s Like Your Body’s Angry Around Them.”
That was his phrase, not mine, and it is the second reason to remove implants like these.
“Exactly. They’re almost wanting to come out on their own. So that’s pretty simple.”
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.”
Why Choose Dr. Agullo?
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 turns on judgment in small decisions, and on being willing to say out loud when I have not done an operation before.
Ready to Talk?
Call my office at (915) 590-7900, text the consult line at 1-866-814-0038, or book a consultation at agulloplasticsurgery.com.
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