The legs are often overlooked when it comes to modification by plastic surgery. There are numerous procedures that can be done that focus on the thigh, knees and ankles. But before considering what to do, one has to know what makes a leg attractive. Most people know when they see a good looking pair of legs but describing why they look so is more difficult.
Whether it be female or male, the first important feature is a leg that is well proportioned to the rest of the body. It can not be too thick or too thin compared to the body frame onto which it is attached. The shape of the leg may even be more important with emphasis on its inner aspect. A straight line from the top of the thigh down to the ankle is desired with curves inward at the knee, top of calf and the ankle. As the line of the thigh crosses the knee, there should not be an outward bulge. Once below the knee, the line should curve inward and then out again at the top of the calf. The line then descends gradually inward towards the ankle. It is the straight inner line combined with curves around the knee that define an attractive leg.
These leg attractiveness concepts are important for a variety of plastic surgery procedures but none more significant than liposuction. While liposuction can not make a large leg small, it can create better shape. The bulges of the outer and inner thighs can be reduced to make the silhouette of the upper leg more straight. While this is commonly done, the knees and ankles are often overlooked. Many patients tell me they didn’t even know that these areas could be treated.
Liposuction of the knee can be one of the most gratifying areas to treat and the amount of fat removed can be substantial. The knee bulge can be eliminated and a straight line made that extends from the thighs across the knees. When suctioning the knees, it is important to create an indentation below the knee and at the top of the calf, creating an in and out line below the knee. This provides a separation of the knee and the calf.
A more shapely ankle can also be created with small cannula liposuction. The ‘cankle’ problem is the result of having no separation between the two. By removing fat from just above the angle on both its inner and outer aspects, the leg line can continue to move inward as it approaches the ankle. Liposuction can also be extended to the lower end of the calf to make it thinner also. Combining lower calf and upper ankle fat reduction helps make for greater definition of the bottom half of the lower leg.
Besides liposuction, there is another leg contouring procedure done below the knee….calf implants. Whether it is for calf asymmetry or calfs that are simply too thin, implants can be used to create the appearance of more muscle mass or bigger calfs. It is virtually impossible for ordinary people to build up the calf muscles through exercise. While the gastrocnemius muscle has two heads (inner and outer), most aesthetic augmentations are done on the medial or inner muscle head. This is because creating the outer bulge of the inner calf makes for a curvilinear shape below the knee. Calf implants, while creating a few centimeters of circumferential size increase, create their effects more by providing an increased calf outline and contour.
Greater leg attractiveness is desired for a variety of reasons which is almost an exclusive female concern. Being able to comfortably wear skirts and shorts is a primary objective. Through the artful use of liposuction, and occasionally calf implants, legs can be reshaped with a silhouette and lines that are more appealing.
Dr. Barry Eppley
Indianapolis, Indiana