The slimness and shape of the calf is mainly determined by the skeletal and muscular structure. Subcutaneous fats, which are similar to back fats, are mostly superficial fats and account for less than 20% of calf hypertrophy. Therefore, liposuction only attains the limited results of calf reduction and should generally be combined with other surgeries such as nerve blocking or partial muscle resection to obtain complete results. At present, calf liposuction is mainly used to treat patients with congenitally thick legs or lower limb edema such as elephant or tubular legs. It utilizes on Ultra-Z liposuction to maximally remove superficial fats (particularly in the superior area of the ankle or posterior side of the calf) and sculpt the muscular curvature to achieve slim leg shapes. This surgery is conducted by making a 0.5-cm incision at the back of the knees and ankles superior and inferior to the calf. First, Dr. Chuang infuses hemostatics and painkillers and introduces an ultrasonic lipolysis tube to the subcutaneous layer to melt and lyse fats; then, various size of liposuction probes are inserted into the subcutaneous layer to remove fats. The liposuction area is primarily confined to the two-third region of the posterior calf, and attention should be paid to avoid liposuction near the shin at the anterior one-third region to avoid skin irregularity or depression. As this surgery is aimed at sculpting the leg shape rather than slimming effect, fats removed are generally not enormous, approximately 100–150 cc on average at either side. Patients should also wear elastic stockings for 2–3 months postoperatively before the results become stable.