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Calf Reduction

A slim leg curvature is indispensable for the perfect stature of females and is also a focal point drawing the attention of males; thus, possessing a pair of well-proportioned legs has become the objective that many females have spent efforts to pursue. In the field of plastic surgery, there are many calculations for the golden proportion of female legs. The relatively common standards as follows:

  • Upper half body:lower half body:: 4:6
  • Thigh:lower leg::3:5 or 2:3
  • Thigh circumference (fattest site of the thigh) < height (cm) × 0.3
  • Calf (fattest site of the lower leg) < height (cm) × 0.2
  • Ankle circumference (foot neck) < height (cm) × 0.12

Apart from these calculation standards for the length and circumference of beautiful legs, another important requirement is straightness, which is judged by the standard that the medial side of the thigh, knee, and ankle contact each other and leave no space when both feet are put together. It is acceptable if the space between the medial sides of both knees is within 1 cm, but if the span is over 2 cm, it signifies O-shaped legs. Because oriental females commonly have short statures, only an extremely minority of females meet these strict standards. Because a majority of patients are nowhere near the criteria, they have to avail of various calf reduction surgeries to achieve perfectly proportionate legs.

Confined by the congenital skeletal framework and muscular structure, thigh reduction can only be achieved by doing liposuction to redress hypertrophy or the bulky appearance, but calf reduction comes in various surgical and non-surgical methods. The most common non-surgical treatment is the injection of Botox. A high dose of botoxin is injected into the prominent muscular site at the medial calf (thunder hypertrophy) to temporarily relax muscles and shrink the calf by blocking muscle and nerve receptors. The advantages are the non-requirement of surgery to experience leg slimming results and zero risk during the treatment, but the disadvantages are that the effects are temporary, lasting for 6 months on average, and that the effects may be limited or decrease in a minority of patients with a Botox antibody or those receiving long-term injections. Because a majority of patients cannot tolerate repeated injections, this method is frequently used to simulate and sample results before undergoing the operation. Considering the durability and stability of leg slimming results, patients should finally undergo calf reduction surgeries. As for surgical management, the following two methods are available in light of the different conditions of patients:

Selective Nerve Blocking (Calf Neurectomy)

Calf Muscle Resection

Calf liposuction

Comparison of calf reductions

Nerve block Muscle resection Botox injection
Ideal candidates Patients with moderate muscular thunder hypertrophy Patients with a congenitally bulky leg, a tubular leg, an elephantine leg, or severe calf hypertrophy Patients with mild to moderate calf hypertrophy
Surgical concept Cut and ligate the nerve governing the muscle to deprive muscles of nutrients, which results in them becoming atrophied and shrunken Directly remove the hypertrophic muscle to reduce the calf volume Block the receptor of muscle cells receiving nerve conduction to induce temporary muscular atrophy
Anesthesia method General anesthesia General anesthesia Topical anesthesia
Surgical duration 1.5 h 2 h 30 min
Surgical scope Medial gastrocnemius muscle Medial/lateral gastrocnemius muscle Medial/lateral gastrocnemius muscle
Surgical incision A 1.5-cm incision at the posterior knee A 4–5-cm incision at the superior calf and another 1.5-cm incision at the inferior two-third of the calf No
Calf slimming degree 1–2 cm calf circumference 3–4 cm calf circumference 1–1.5 cm calf circumference
Leg shape sculpting Yes No Yes
Compensatory recurrence Probable No Must
Result durability Permanent Permanent 6 months on average