Background: Liposuction is a very versatile procedure that can be done just about anywhere on the body where there is fat. Subcutaneous fat exists under any skin area in the body and is amenable to be treated if the right cannula size is chosen. Very small cannulas are available today for fat extraction done at the 1.5mm to 2.0 mm inner diameter size which are effective even in the most minute of fat areas.ht line.
Fat lipodystrophy is most well known on the legs in the thigh area, particularly in the classic saddle bag or outer thigh region. But unsightly fat accumulations can also occur in other areas of the legs even below the knee. A thick calf that extends straight down to the ankles also has a classic moniker known as ‘cankles’. When there is no evident break or taper from the lower calf into the ankle and top of the foot, the drop from the knee to the ankle can appear just like a straight line. This makes the calf and ankle look like a combined structure when aesthetically and anatomically they are two distinctly different structures.
Case Study: This 52 year-old female wanted to have some liposuction done on her legs to give them a better shape. She had always had big thick legs but was most bothered by her legs below the knees which were unnaturally thick. From the middle portion of her calfs down to the ankles it was a straight line on their inner aspect. You might say her ankles were ‘fat’ compared to her calfs.
Under general anesthesia, she initially had a Hunstad solution infitrated along the entire ankle and inner and outer calf areas as well as the inner knees. Then using a 3mm cannula, the inner and outer ankles and the inner leg from the ankle up to the mid-portion of the calfs had liposuction done. The amount of fat aspirate obtained from both lower leg areas was 240ccs. She was wrapped at the completion of the procedure in foam covered with ace wraps from the ankles to the knees.
Her postoperative course was marked by a lot of swelling which was expected. She stopped wearing any compression stockings one month after surgery when they no longer provided more comfortable support. By three months after the procedure, she had a very visible difference in the shape of her lower legs with a clear tapering of the calf into the ankle area.
Small volume liposuction, such as the treatment of cankles, can be thought of as liposculpture which implies shaping rather than gross or high volume reduction. While the calfs and ankles are have relatively small amounts of fat compared to the abdomen, for example, it can still be selectively removed and even small amounts of removal can make a verty visible improvement.
Case Highlights:
1) Cankles is a well known description of lack of any definition between the calf and the ankle.
2) Small cannula liposuction can be safely done below the knee and a little fat removal in the right place can create a more defined calf and ankle transition.
3) Liposuction below the knee is associated with prolonged swelling that will takes months to see the benefits of the procedure.
Dr. Barry Eppley
Indianapolis, Indiana