Liposuction is done for two fundamental purposes, to either debulk larger fatty areas or treat smaller areas for more refined shaping. The latter is often referred to as ‘liposculpture’. Such finesse or refinement liposuction is often done on smaller body areas which are resistant to improvement through diet and exercise and often escape awareness that such areas can even be treated.
One of these often unrecognized areas that can be dramatically improved by liposuction are the bottom half of the lower extremities. Specifically the calf and ankles can be treated with results that can be both life changing and lifelong lasting. Ankle liposuction used to be considered dangerous and off limits to fat reduction efforts but that view is now historic. As long as there is good circulation and an absence of chronic lymphedema around the ankles, there is no reason it can not be treated.
One important technical aspect of the procedure is the need to use small cannula sizes. Today’s cannula designs are not only small but have a multiple hole designs as well. This makes treating the smallest fat collections possible and with great effectiveness. Given the bony nature of the ankles, working around the the malleoluses requires small and short cannulas to reach the small fat pads which are frequently found around them. Power-assisted liposuction (PAL) is particularly effective as its oscillating tip breaks up the more fibrous fat around the ankles as well.
One key to cankle liposuction is to use the silhouette approach. It is not absolutely necessary to obtain a circumferental reduction. Reducing the inner and outer aspects of the ankle up to the midpoint of the calfs makes the ankle thinner. But it still allows adequate lymphatic drainage to occur from the top of the foot and over the achilles which are not treated. This also reduced the potential risk of chronic lymphedema.
In my experience, liposuction on the ankles and calfs is not only successful but the only answer for those patients who do not have genetics in their favor with disproportionate fat accumulation in the ankle and lower edtremity areas.The one negative side of cankle liposuction is the protracted swelling that will last several months until the final result is finally seen. This is usually twice that of the recovery of almost any other body area treated by liposuction.
Dr. Barry Eppley
Indianapolis, Indiana