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Biceps augmentation using solid silicone implants has been increasingly requested in recent years despite a paucity of literature evaluating the safety and efficacy of this procedure.The purpose of this study was to provide information about complications, surgical planning, and aesthetic outcomes of biceps augmentation.A retrospective chart review was conducted for patients undergoing solid silicone biceps augmentation in the author's practice from April 2011 through May 2016. Collected data were analyzed to assess the indications for surgery, quantity of complications, and need for surgical revision, and to evaluate aesthetic outcome.Twenty-one male patients were included in the study. The mean age was 42.6 years and the mean follow up was 7.1 months. Indications for surgery include a desire to increase biceps size (n = 16), and correction of biceps deformity after biceps tendon rupture (n = 5). Eight patients underwent subfascial implant placement and 13 submuscular implant placement. Complications occurred in 10 patients (48%) including asymmetry (n = 4), seroma (n = 3), surgical site infection (SSI) (n = 1), cellulitis (n = 1), and hematoma (n = 1). The overall reoperation rate was 23.8%. Implant malposition occurred in 3 of the 8 (38%) of subfascial implant placement patients. Complications requiring revision surgery were higher for subfascial implants 37.5% vs 15.4% for submuscular.Biceps augmentation with a solid silicone implant can increase upper arm volume and correct asymmetry and deformity resulting from muscle injury. Submuscular biceps implant placement is recommended over subfascial insertion to avoid implant malposition.