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The most common lower leg aesthetic augmentation method is that of calf implants. They are used for those patients who want larger calfs due to natural lower leg disproportion (‘chicken legs’), muscle atrophy due to injury (e,g. achilles tendon rupture) or congenital underdevelopment. (clubfoot)

Calf implants have been around for decades in the U.S and have evolved in both styles and size options as well as in their feel. (softer today resembling closer to muscle) But even with their softer feel (lower durometers) they have always been made of solid silicone and not gel-filled devices like breast implants.

In the June 2020 issue of the Aesthetic Surgery Journal an article was published on this topic entitled ‘Correcting of Calf Atrophy With a Custom-Made Silicone Implant: Contribution of Three-Dimensional Computer-Aided Design Reconstruction: A Pilot Study’. In this clinic study twenty-two (22) patients with calf atrophy due to illness were implanted with custom made solid silicone calf implants made by computer designing for each patient. The calf implants were packed through incisions in he crease of the back of the knee.

A total of forty-one (41) implants were placed. Medical complications included one case of seroma. Aesthetic revisions included two patients who sought implant size reduction. Concomitant fat grafting was performed in five patients.

This clinical study pretty much parallels my experience with solid calf implants in general. They have a very low complication rate in terms of infection and seromas due to their subfascial position on top of the muscle. There are always going to be potential size issues, as with any implant, but it is fairly low. This study, because of its non-USA location, views solid silicone calf implants as novel. But that is the norm here in the US where gel-filled calf implants have never been FDA approved or used.

The novelty of this calf implant study is the custom approach using CT scans for the design. Certainly that can make good estimates of they existing long and widths of the two heads of the gastric muscles and would provide the most accurate volumetric assessment when calf asymmetry exists. But with the large number of solid soft silicone calf implants styles and size ranges available today the custom design approach is more limited int usefulness than what it may have years ago.

Dr. Barry Eppley

Indianapolis, Indiana

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