Bilateral Calf Augmentation for Aesthetic Purposes

The shape of the calf is determined by the development of the soleus and gastrocnemius muscles, the length and orientation of the crural bones, and the distribution of subcutaneous fat. Some people have a naturally thin or underdeveloped calf that remains small despite exercise. Calf augmentation is indicated for cosmetic reasons or for reconstruction of a shrunken lower leg resulting from injury, illness, or congenital disability. A total of 53 consecutive patients (40 women and 13 men) had surgery for calf augmentation between January 2004 and January 2007. The patients ranged in age from 25 to 51 years (mean, 29.5 years). All the patients included in the study requested calf augmentation for aesthetic purposes. Asymmetric-base silicone elastomer smooth-surface implants were used. Overall satisfaction after silicone calf augmentation was rated on a scale of 1 (poor), 2 (fair), 3 (good), 4 (very good), and 5 (excellent). All the patients had surgery by the same team of surgeons (L.H.P., A.S., B.N.). The evaluation was made at follow-up office consultations after 1 year. The total mean follow-up time was 4.4 years. In this study, 53 bilateral calf augmentations were performed, for a total of 106 procedures. The 125-ml implant was used in 37 bilateral cases, the 70-ml implant in 10 cases; and the 175-ml implant in 6 cases. In three cases, unilateral seroma formation needed to be drained by a partial skin incision opening. There were no cases of infection or hematoma. Hypertrophic scar was observed in four patients bilaterally. One patient requested removal of the implants, and the procedure was performed on an outpatient basis. There were no cases of compartment syndrome or deep vein thrombosis, and no pulmonary embolisms occurred. There were no cases of rotation or displacement of the implant. At 12 months, 73% of the patients rated their appearance after calf augmentation as "very good" to "excellent," and 19% responded that their appearance was "good." Only 8% of the patients thought their appearance was less than good. At this writing, the average follow-up time for this group of patients has been 3.4 years. Calf augmentation by silicone-filled implants for cosmetic purposes appears to be effective, safe, and aesthetically pleasing, with minor side effects.