Men and women alike wish to have a more muscular and toned physique, and the calf region is not exempt from this. Despite vigorous exercise and body building, some people are unable to attain the definition that they desire in the calf. Many patients who present for consultation want to look good in shorts and skirts but due to a hypoplastic calf say that they are unable to do so. To that end, calf implants of various shapes and sizes have been created to increase volume in the calf.
CALF IMPLANT PROCEDURE
A cut is made on the posterior aspect of the leg, horizontally in the posterior knee fold. A pocket is made between the lining of the muscle and the calf muscle itself with blunt instruments to minimize bleeding and unnecessary pain post-operatively. The implant is then placed in the pocket. The muscle lining is sutured with absorbable sutures and subcuticular sutures are used to close the skin. Over time, the implant becomes surrounded by a scar tissue pocket, where it stays for the rest of the person’s life.
Calf augmentation was originally designed to fill defects left following oncologic surgery, after trauma or infection, or due to genetic abnormalities. There are many causes for unilateral or bilateral calf deformities and they include but are not limited to the following: 1. Congenital hypoplasia due to agenesis of a calf muscle or adipose tissue reduction; 2. As a sequelae of clubfoot (talipes equinovarus), cerebral palsy, polio, and spina bifida; 3. Due to poliomyelitis or osteomyelitis; 4. Following fractures of the femur and as a result of burn contractures. While calf implants do not improve function of the affected extremity, patients are pleased with the improved aesthetic appearance of the leg after implantation.
Since its initial introduction, calf augmentation surgery has become a widely popular aesthetic procedure to help patients gain more shapely legs. Whether it is a body builder that is looking to “bulk up” the leg despite a vigorous exercise regimen or the average patient who wants a more shapely calf region, there are implants of various shapes and sizes to help add volume to a hypoplastic calf.
Some authors have noted that calf prostheses have the disadvantages of being unable to adequately correct ankle deformities, having a risk of displacement, having a risk of capsular contracture, and potentially having problems with extrusion. While we do agree that calf augmentation does not correct ankle deformities, we feel that this can be addressed with judicious fat grafting to the ankle region via small stab incisions at the medial and lateral malleoli.
THE CONSULTATION / IMPLANT SELECTION
Based on the patient’s existing anatomy and desires, the surgeon will find an implant suited to that patient.