Pecs Appeal : When Working Out Fails to Chisel Your Chest, Surgery Can Redefine It

TIME WAS WHEN a 98-pound weakling would send away to Charles Atlas for exercise equipment guaranteed to give him a rugged physique. But now a man who wants his chest to look more developed can seek out a qualified physician and, after relatively minor surgery and a few weeks of recovery, dazzle others with his new upper-body definition. The surgery is known as pectoral implants.

This is no joke. Pectoral implants may well be the fastest-growing segment of plastic surgery practice right now. Dr. Mel Bircoll, the Beverly Hills plastic surgeon who devised the procedure, says that it all started about three years ago, when he began performing calf implants on bodybuilders. The muscles in the calf, he explains, are difficult for some people to develop, even with rigorous exercise. By making a small incision behind the knee, he was able to position a chunk of flexible, molded silicone into the patient’s calf-muscle compartment. The result brought these men’s lower legs into proportion with the rest of their bulked-out frames.

Then, one day in 1988, Bircoll recalls, a patient asked whether he could do something similar for a man’s chest--and the pectoral implant was born. The operation--which Bircoll usually performs in his office and with a general anesthetic--begins with a 1 1/2-inch-long cut in the armpit. Through that opening, Bircoll inserts three tapered pieces of silicone, each about six inches long, under the existing chest muscle, and then he fans them out to simulate the natural contours.

Because a man’s own tissue encapsulates the implants and holds them in place, Bircoll says, there’s no danger of their winding up as love handles later. And, he says, “they feel natural--like three hard ribs.” The entire procedure takes about an hour and a half. The cost? About $6,500.

Despite that price tag, Bircoll estimates that he has performed 50 implants in the past year and a half, the majority for amateur bodybuilders. (Implants would disqualify any professional bodybuilder from competition, just as the use of steroids would--although Bircoll says some of his patients have been professionals who have escaped detection and gone on to compete successfully.)

Bircoll is not the only local surgeon who offers such implants. The first colleague who watched Bircoll perform this surgery was a former associate, Dr. Brian Novack of Beverly Hills, who has generated widespread publicity for it. Media coverage included Novack’s appearance on “Entertainment Tonight” in October. Since then, he says, he has been performing about one operation a week.

His patients, Novack says, are “men who had hoped for such an operation for years and years. They say, ‘I knew something would be available eventually if I waited long enough, and now it is.’ ”

Christopher Vicari, for example, is a 34-year-old New Jersey resident who suffered from scoliosis, or a severe curvature of the spine, until he had a rod implanted in his back several years ago. But that prevented him from working out, so when he saw Novack on “E. T.,” he immediately called for a consultation and then flew out to have the operation within a couple of weeks.

His reaction to his new look? “Completely ecstatic,” says Vicari. “People have noticed that I have a chest. ‘Have you been working out?’ they ask. And I just say, ‘Yes, I joined the gym.’ ”

As it happens, however, Vicari is rare among pectoral-implant patients in that he is willing to reveal his name. Most are like one Southern California fitness instructor who admits, “Just from the little bit of feedback I’ve received, it hasn’t been real positive. And I didn’t want this to be a negative thing for me.”

Still, the 26-year-old says, he would have the surgery again “in a New York second. I’ve gotten a lot of attention.” And, he adds, no one unaware that he’s had implants has detected them: “Let’s just say I’ve had several intimate situations, and no one has said anything.”

Prospective patients should be aware that pectoral implants are not accomplished without some discomfort. A 33-year-old Orange County man who had implants on only the left side of his chest, which was atrophying because of nerve damage, recalls, “It hurt like hell. I don’t think I’d want to do it again.”

But the fitness instructor says, “I don’t think it’s that big a deal. We go through so many painstaking things to improve our appearance. My braces were certainly more painful than this.”