It's possible to create some very noticeable improvements in a person's physique and rescue them from the trap of their genetics. However, there is a limit to what plastic surgery can accomplish. Too often, patients come to see me with pictures cut out of top-ranked professional bodybuilders. In spite of their present appearance, they want me to be able to supply them with the outstanding parts that make these people champions. I truly wish I could do this, but I graduated from a school of medicine, not a school of sorcery.

            Calf implants are a prime example. Only a small number of surgeons have experience in this procedure and disastrous results have occurred at the hands of surgeons inexperienced in this surgery. Too often, the individual is hung up on the tape measure. A patient will come to me asking for 20-inch calves even though nature may have seen fit to limit his natural calves to 15 inches. He may not even have taken the girth of his thigh sweep into consideration. 

            As I carefully point out to each patient, the surgery involves placing the implant within the muscle compartment. The muscle consists of muscle fibers encased in an outer fascial covering that shapes the muscle. With my procedure, the implant is within this fascial covering. The elasticity of this tissue determines what the largest safe size implant would be. Attempting to place too large an implant would crush the muscle fibers and deprive them of a blood supply. It's the experience with the surgery that allows the surgeon to know this safe limit. As a general rule, a two-inch increase in girth is attainable. 

            The experienced surgeon also knows that there are different shaped implants, as well as different sizes, and by using the right shape, the right  contours to the leg can be obtained. This does not mean I can perfectly simulate the calves of Mr. Olympia. Yet, the patient will bring in the picture of the large, chiseled, diamond-shaped calves of his hero and demand the same.  Implants are space fillers. They create the appearance of more fullness and shape in a more limited fashion. Done well, the surgery creates a natural look and not one of cannon balls stuffed into the leg. I can assure a noticeable improvement. Anyone who promises more has never attempted the surgery.

            Shaping Reality

Pectoral implants can give more fullness to the chest. They can also hide pectoral tears and absent chest muscle. Again, patients often want the largest chest possible, even though it may be out of proportion with their deltoids and arms. They wave a picture of Arnold's chest and demanding the same. And there are patients who complain that the implant used for a pec tear doesn't look right when they flex. It has to be stressed that the surgery creates a façade. The implant properly placed behind the person's own muscle should look natural in a relaxed state and even with motion. While there are different shapes to accentuate the regions of the chest, if your muscle attachments are not in precise alignment, that perfect square contour may be approachable, but not entirely possible.

            Another complaint is that the implants don't feel natural. That is true, because the implants are not natural. The newer implants are softer and better, but they are still implants. Placing them properly will give the best feel.

            Abdominal etching is another procedure that has its limits. Physique models have that defined six-pack because of their genetics. You had to have picked the right parents. Abdominal etching does not create a six-pack; it reveals it. It eliminates the extra padding and highlights the muscular development. It requires that the patient has the proper genetically-shaped muscle bellies and has put in the necessary work to develop them. It removes the overlying fat that can only be lost naturally at the expense of upper body mass. It can optimize what you have. The end results also depend on your individual skin thickness and elasticity. The procedure can give a very noticeable improvement in most cases, even if it doesn't look like the picture in the magazine.

            Plastic surgery can increase your inheritance by giving the appearance of overcoming some genetic limitations. It can take you past what dieting and exercise can accomplish. It does have its limitations, though. In many ways, plastic surgery is like the scenery in movies. It gives the appearance of being real, but it is a façade. The surgeon experienced in these procedures can approach the reality more closely, just as the experienced set designer can make fantasy look attainable.