The shape of the lower third of the leg is highlighted by the appearance of the calfs. Whether they are big, small or somewhere in between, they are the dominant shape between the knee and ankle. The shape of the calfs is largely controlled by the size of the paired medial and lateral heads of the gastrocnemius muscle. Usually the inner or medial head of the gastrocnemius is bigger than the outer or lateral head although the medial head is most commonly seen and used to judge the muscular characteristics of the calfs.
Unlike many other body parts, the calfs have not been as easy to augment or increase in size. It can be one of the toughest muscles in the body to build up by exercise. While silicone calf implants are the quickest and most assured method of calf augmentation, it does require some significant recovery like the placement of any body implant. With the rise and popularity of fat injections, the calfs have not been left out as a place to be treated with this natural method of aesthetic enhancement.
In the July 2013 issue of the Journal of Plastic, Reconstructive and Aesthetic Surgery, an article was published entitled ‘Calf Lipo-Reshaping’. In this paper, the authors looked at five (5) patients over two years who had been treated by fat injections for calf augmentation. An average of around 120cc as injected into each calf. Their follow-up was between six and eighteen months after the procedure and included circumferential measurements and magnetic resonance imaging (MRI) in two patients at the end of their follow-up. Their results showed that an average increase of just over 2.5 cms in circumferential enlargement occurred. Viable fat could be localized by MRI.
This is not the first article that has been published on the success of fat injections for modest to moderate amounts of calf augmentation. While lipoaugmentation is a viable alternative to the use of solid silicone implants, it is not a technique that is useful for many patients who seek a noticeable increase in the size of their calfs. One has to have enough fat to harvest for an adequate amount of fat to be injected and some patients with small legs/skinny calfs do not have enough donor material. There is also the question of how much fat will survive. This and other published studies to date, however, show that the calfs exhibit good fat retention and are not a more difficult place for its survival than most other body areas.
Should one have synthetic implants or fat injections for calf augmentation? This question is not that one is better than the other. Numerous factors come into play as to which one is best in any patient. But fat injection grafting has a legitimate role for calf enlargement, particularly those who are having other body contouring procedures and willing to accept a modest increase in calf size.
Dr. Barry Eppley
Indianapolis, Indiana