Calf Augmentation

Calf augmentation with implants is a cosmetic surgical procedure that helps enhance, reshape and better define the contours of the lower leg. A number of factors can affect the size, shape and proportion of the calves. The shape depends on muscle development as well as on fat distribution, the latter especially in women. Calf shape also depends on ethnicity and genetics. Sometimes when people have long legs with short gastrocnemius muscles—the large muscle that makes up the bulk of the calf—it may be too highly positioned and unable to develop properly. 

Calf augmentation with implants is a cosmetic surgical procedure that helps enhance, reshape and better define the contours of the lower leg. A number of factors can affect the size, shape and proportion of the calves. The shape depends on muscle development as well as on fat distribution, the latter especially in women. Calf shape also depends on ethnicity and genetics. Sometimes when people have long legs with short gastrocnemius muscles—the large muscle that makes up the bulk of the calf—it may be too highly positioned and unable to develop properly.

The goal of calf implant surgery is to simulate the shape and volume of the gastrocnemius muscle. This is the most superficial muscle in the back of the calf and the easiest to imitate with implants. Once implants are in place, you can see improvements from the front, back and on both sides of the legs. The improvements on the sides are visible from the front as well. As for what is considered attractive when it comes to calf shapes and sizes, the proportions of the calf to the leg confirmto the classic golden ratio or golden proportion, as do most parts of the human body. Symmetry between the two legs matters, too.

Although increasingly in demand for cosmetic purposes, calf implants were originally developed to correct defects on one or both legsdue to medical conditions. People who have or have had polio, clubfoot, spina bifida or Charcot-Marie-Tooth disease can benefit from calf implants during the leg reconstruction process. They are also useful for those who have suffered traumatic injury to their lower legs which have left their calves deformed, undeveloped or diminished.

While calf implants are not in demand on the same scale as breast implants, worldwide demandamong men and women is growing. Studies show that the satisfaction and improvement in body image among those who receive calf implants is often similar to the positive effects experienced among breast implant recipients.

Reasons for choosing to have calf implants

People opt for calf implants for a number of reasons. Calf muscles are notoriously difficult to develop, even with the most rigorous and difficult workouts. Calf implants offer a quick and easy solution to healthy men and women who want to better contour their calves.

You are a good candidate for calf augmentation with implants if any of the following conditions apply:

• Your lower legs lack muscle contours, and you wish to improve their shape and proportion.
• You are having liposuction because of heavy thighs and knees, and want to improve the look of your calves at the same time.
• You are a male athlete or body builder and want to enhance the appearance of muscle bulk and add a more masculine look. Implants offer an easy solution, because the shape and volume enhancement that is possible with calf implants cannot be achieved with exercise, regardless of effort.
• Your calves are unbalanced and asymmetrical.
• You have congenital defects or medical conditions that affect the normal development of the calf and lower leg. People with conditions such as spina bifida, clubfoot, Charcot-Marie-Tooth disease or those who have weak and undeveloped calf muscles due to polio can benefit from calf implants.
• Calf implants may also be used in the reconstruction process following accidents and burns that have affected the lower legs.

You are a candidate for calf implant surgery if you are in good health and average physical condition.

Things to consider once you’ve decided to have calf implants

Once you have decided to go ahead with calf implants and have chosen a surgeon who is experienced in the procedure, your key decisions involve selecting an appropriate type and size of implant and deciding on the implant brand. Your surgeon will guide you in these decisions.

Size and shape of implants

Implant sizes can vary in length, width and thickness as well as in their contours. Unlike choosing breast implants, it can be difficult to visualise what different sizes and shapes of calf implants will look like once they are in the leg. Sometimes it helps to place the implants on the sides of the calf and wear stockings over them to see the potential improvement. Your surgeon will help you with this decision.

Especiallyin cosmetic calf enhancement, two implants are needed to mimic the calf muscle, because it has two muscle bellies or thick areas. Using one large implant can give an unnatural contour to the leg.

The size of implants chosen can impact pain and discomfort following the implant insertion and the sustainability of the implants. If you choose a size that is too big for your legs, you may encounter problems arising from excessive pressure. Pain, muscle problems and nerve impingement are common issues with very large implants. The section on possible risks and complications provides more details.

The best approach in calf implants is to start with a smaller size and later upgrade to a larger size if necessary.

Type of implants

You can find a variety of calf implant types. While all calf implants are made of soft solid silicone, some surgeons prefer to use contoured implant-grade silicone carving blocks made of soft-solid silicone elastomer. These can be tailored for your specific measurements and allow surgeons much flexibility and precision. They come in different sizes and shapes to make the fine tuning easier. The other option is to use pliable and sculptable silicone calf implants in pre-made sizes, just as with breast implants. These do not have to be trimmed. The decision is yours, but your surgeon will be able to recommend the best option for you and will have personal preferences from past experience.

Because they do not contain liquid or gel, calf implants will not rupture easily or be damaged in contact sports and other vigorous activities.

Brand of implants

Your surgeon will suggest the implant appropriate for you. There is one option in Australia to choose from at present. This is an Allied Biomedical implant, currently owned by Implantech. This company has been making implants for yearswith an excellent track record.

What to expect

Calf implantation surgery is usually performed as an outpatient procedure under general anaesthesia. A calf implant can usually be completed within one to two hours, depending on the extent of the procedure involved.

The incision for calf implants is placed in the natural skin fold at the back of the knee. The incision typically measures between 5 and 7cm.

Calf implants are inserted into pockets created for this purpose. Sometimes, especially in reconstructive surgery, it is necessary to use tissue expanders like the ones used in breast augmentation to achieve the desired result.

During implant surgery, the surgeon creates a pocket and inserts the implant. The pocket is closed, and the skin and other tissue wounds closed up and repaired.

Calf implants can be placed within the leg in two ways: deeply within the muscle, or subfascially, in the deep thick tissue layer that binds the muscle to the bones and joints. The latter method is the one most popularly in use, since it requires less dissection, is less difficult and leads to faster recovery times. Patients also report feeling less pain with this method. There are, however a few difficulties that can arise from subfascial placement.

Placement in the pocket can lead to movement—drift or rotation—of the calf implant. Due to a combination of muscle tissue insufficient to cover it and the hardness of the implant, this movement can result in the edges of the implant being obvious to the touch. Subfascial placement can also produce outcomes that are not as pleasing as those possible with submuscular placement. This happens because with subfascial placementit is the implant that determines the ultimate shape of the calf region, instead of the muscle itself.

Before and after surgery

There are several things you can do to prepare for any surgery. There are also some things can you can do after any type of surgery, to speed up healing.

Before you have surgery, make sure you have everything on hand that you will need to stay at home during the recovery process.

After surgery

In addition to following the general steps that can speed up the healing process after surgery, there are important things you must do to ensure the success of your calf implantation.

After surgery you will be asked to wear stockings for two to three weeks. You will be encouraged to walk immediately, even though walking will be a bit uncomfortable for a few days. Take it at a pace you can handle. Wearing high heelscan help ease the pain. You will be prescribed pain medications.

Swelling and bruising is natural following calf augmentation surgery. Some people bruise easily while others do not. In most cases both swelling and bruising will subside over a week or two.

The scar on the outside will take about ten days to heal. It will most likely be hidden in the natural creases at the back of the knee. In time the scars will fade and become barely noticeable.

The area around the implants needs about six weeks to fully recover. This is why you need to be careful with your activities. You may be able to get back to work and normal activities within three to seven days following surgery, so long as you do not have to walk long distances, run, ride a bicycle or engage in heavy lifting. If this is part of your job, try to take two to three weeks away from work, but keep yourself moving at a steady pace that is comfortable for you.

You can get back to heavy exercising and all other normal activities without any restrictions four to six weeks after surgery.

How long it will take before you can see the new contours of your legs depends on the implants as well as on the individual. It may take a few months for the implants to settle, and for the final results to become fully visible.

Possible risks and complications

As with any surgical procedures there are risks involved in calf augmentation with implants. You should be fully aware of risk and potential complications inherent to any surgery before you elect to have the procedure. It is always better to err on the side of caution in any surgical procedure.

The best way to reduce risk in any surgery is to find a surgeon who is fully qualified, has received formal training in surgery and has performed the procedure many times.

Bleeding, excessive swelling and other issuesare complications that may arise from not following the post-surgical instructions given by your surgeon.

Here are some specific complications that may occur after calf implant surgery:

• Implant displacement is relatively rare. If it occurs in the early stages following implant insertion—say in the first ten days, before the implants have had time to settle—it can be moved without a new procedure. Displacement after this time will require a revision procedure. Once the implants heal and settle, they are unlikely to shift unless the area receives a severe blow, one that would normally injure both natural muscle and break bones.
• Complications related to silicone are also rare.
• Infections can be treated in a number of ways including implant removal, draining and antibiotics, either alone or in various combinations.
• Nerve injury could occur in two ways. Key nerves in the area can be damaged when pockets are created for the implants. It is also possible for nerves to suffer damage from the implants pressing on them after insertion. You could encounter severe pain that does not subside with time due to nerve injury or excessive pressure. Some nerves grow back or repair themselves, others do not.
• Closed compartment syndrome occurs due to excessive pressure on the muscles and nerves. If the implant is too big, it may have to be replaced with a smaller one to avoid excessive pressure. Your surgeon will have two choices here: to remove the implant to be reinserted on another occasion or to trim down and reinsert during the same procedure.
• Delayed complications such as infection or implant displacement are relatively rare.

Just as you would discuss potential benefits before surgery, it is alwaysadvisable to ask your surgeon to address the potential risks as they apply to you. They can also advise you on how to avoid or minimise some types of risk.

Rough costs involved

The cost of a calf augmentation with top quality silicone implants could come to around $ 11,000 (AUD). This includes the surgeon’s and assistant surgeon’s fees, cost of implants, anaesthetist’s fee, hospital and operating theatre costs and cost of follow up visits.

Medicare may reimburse some costs involved in contour reconstruction and implants in reconstructive surgery. Usually cosmetic treatments are not covered by Medicare. Please check with your reconstructive surgeon for more information.

Some Australian private health insurers may help pay for the hospital bed and theatre fees. Getting a doctor’s referral will enable you to make a claim on these costs.

This information is correct as of 2019.