The curvature of the medial or inner part of the leg gives a nice shape to the leg as a whole and a good distinction between the calf and the ankles accentuates this.
Many patients present with the problem of feeling uncomfortable wearing short dresses because of embarrassment about their legs be it in short skirts or shorts, as their legs and calves are either too thin or too thick.
Skinny legs are treated by augmentation with implants or AFT, while thick legs are treated by liposculpture.
Skinny legs usually occur because the calf muscle is deficient or not as well developed. Usually it is the medial (inner) component which is more involved as it gives the bulk and contour to the leg. The calves can be augmented using either own fat (AFT) or via implants.
Calf Augmentation using Autologous Fat transfer is done when diffused enlargement is needed and if even the ankles are skinny.
Usually done under sedation plus local anaesthesia or a regional block
The calf implantation procedure was developed by Dr Aiache in the US.
This is performed by inserting an implant. The incision is behind the knee within the knee fold, from where the implant is inserted. Because of the deep positioning there is no implant show.
The implant size and shape have to be assessed pre operatively after measuring the leg, which will give an idea about the size. Like a breast implant the volume of the implant has to be decided according to the skin quality and the size of the leg.
Too big an implant might compromise the blood supply to the skin or the leg as a whole. In women usually a single implant on the medial side gives adequate results where as in men two implants for the medial(inner) and lateral(outer) sides is required the medial being larger than the lateral.
The patient needs to take rest for a week following the surgery, though they are ambulated the same day. One has to wear heels for the next three weeks
Pain and discomfort slowly decrease over the next 2 – 3 days and can be up and about for all routine activities, around a week after surgery.
Running is avoided till around three weeks after surgery.
Scars usually heal without much problem as they are in the skin crease.
It is usually a very well tolerated procedure if the pre operative planning has been done properly and the implants are the right size for the leg.
If too big implants are used or if too many in a tight leg, it may lead to problems like extrusion of the implant or a compartment syndrome which is basically like stuffing too many people into a small windowless room.
Liposuction is ideal for patients with thick legs. Here the smooth curves of the leg are lost and the leg looks like a “tree trunk legs” with no distinction between the upper and lower leg, also known in many circles as ""cankles"".
Reshaping / liposculpting of the leg involves bringing out the muscular shape of the leg so that the gentle curve from the calf down to the ankle is seen, broad in the upper third and thinner at the ankle.
This is carried out under anaesthesia preferably. The shaping must be performed all around the leg, through small incisions at the front / back of the ankle and front / back of the knee. The patient needs to wear compression stockings for three to four weeks following surgery. The bruising usually subsides by two weeks, but swelling resolves slowly over three months.
Well tolerated procedure. The problems usually are of unevenness and ridges seen in the leg in the initial periods. But, with massages and as the swelling subsides these ridges also settle down.
Rarely there might be a need to refine these ridges with a session of superficial liposuction usually a minor procedure.
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Dr. Surindher is a graduate from G.R.Medical College in Gwalior. He completed his Medical undergraduate studies and then his Post Graduation in Surgery. Visit Website »
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