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Calf Implant

Calf Implants

Also known as calf augmentation and calf enlargement

Have you ever wished that your calves looked more muscular and defined? Calf augmentation uses implants to reshape the appearance of the lower leg, increasing muscle definition and the volume of the calves. This procedure is popular among both women and men, and is performed for both cosmetic and reconstructive purposes. During the calf augmentation procedure, the implant may be placed either below the muscle, which is referred to as submuscular placement, or above the muscle, which is referred to as subfascial placement.


During your consultation your surgeon will ask you about your wishes and desires for the outcome of your surgery.

The ideal candidates for calf implants are those:

  • Who have underdeveloped calf muscles
  • Who want to improve the shape of their lower legs
  • Body builders – where exercises has failed to develop calf muscles
  • Where contouring with liposuction is not an option
  • Affected by injury or diseases eg. Polio, Spina Bifida or Clubfoot
  • Wanting to correct “bow legs”
  • With asymmetry of the lower legs
  • Wants to increase the attractiveness of the calf contour.

The Procedure: Step-by-Step Guide

Calf augmentation is performed while the patient is lying on his or her stomach and approximately take three hours to complete. The following provides an overview of how calf augmentation is performed.

  1. General anesthesia is administered,
  2. The surgeon makes an incision behind each knee. This incision enables the surgeon to insert the implants without creating a significant scar.
  3. Either above or below the muscle, the surgeon will create a tissue pocket where the implant will be placed. The implants used for calf augmentation are dense silicone, with a feeling similar to that of well-toned muscle.
  4. Once both implants have been positioned in the calves, the incision will be closed with sutures.

Implant Placement
The implants can be placed either subfascially (just beneath the fascia) or submuscularly (within the muscle). Subfascial placement is used more frequently because the procedure is less invasive, less difficult, and leads to a faster, less painful recovery for the patient. However, subfascial placement can sometimes result in implant rotation and a palpable implant, and the postoperative appearance can be less than desired, because the calf shape is defined more by the implant and less by the muscle tissue. This can occur using either silicone-gel or solid silicone implants. Lastly, subfascial placement requires more attention to implant placement.

Submuscular placement is considered more difficult because your surgeon must dissect deeper into muscle tissue. You can also expect a few additional days of recovery and greater discomfort. However, the implant is more securely and accurately placed within the muscle and results in a better aesthetic outcome, including a more natural shape because the calf muscles cover the implant. Surgical complications such as vascular or nerve damage can be more easily controlled with submuscular placement.

Safety Information

Calf augmentation is considered a very safe form of plastic surgery; less than 4 percent of all calf augmentation patients report any type of post-surgery complications. There is a slight risk of anesthetic reactions, infection, or fluid collection, as with all surgical procedures. Using the submuscular technique for deeper placement of the implant gives the surgeon more control over the aesthetic results as well as the potential for nerve damage and other complications. Subfascial implantation carries a slightly elevated risk of rotating or drifting implants, since they are not placed as deeply within the body. Rotating or drifting can cause asymmetry, requiring revision surgery for correction.

Preparing for Your Procedure

How do I prepare for a calf implants procedure?

Your surgeon will provide thorough preoperative instructions, answer any questions you may have, take a detailed medical history, and perform a physical exam to determine your fitness for surgery.

In advance of your procedure, your surgeon will ask you to:

  • Stop smoking before undergoing surgery to promote better healing
  • Avoid taking aspirin, certain anti-inflammatory drugs, and some herbal medications can cause increased bleeding
  • Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery.
  • Possibly have blood and urine tests, and a pregnancy test for women, to prepare for anesthesia

Calf augmentation is usually performed on an outpatient basis. Be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery.

What You Can Expect During Recovery

During the recovery period, patients should avoid walking or performing any other activities that involves the use of the legs for several days. Side effects that commonly occur during the recovery include pain, tenderness and swelling. Most  patients will be able to resume their normal activity level within a week to ten days, although exercise routines requiring use of the leg muscles should be avoided for about a month to allow the calves to heal. After the recovery, there should be no adverse impact on the use of the leg muscles, since the muscles themselves are not cut or detached during the procedure.

Limitations and Risks

Fortunately, significant complications from calf implants are infrequent. Your specific risks for calf implants will be discussed during your consultation.

All surgical procedures have some degree of risk. Some of the potential complications of all surgeries are:

  • Adverse reaction to anesthesia
  • Hematoma or seroma (an accumulation of blood under the skin that may require removal)
  • Infection and bleeding
  • Changes in sensation
  • Scarring
  • Allergic reactions
  • Damage to underlying structures
  • Unsatisfactory results that may necessitate additional procedures

Other risks specific to calf implants are outlined below:

  • Visible implant due to incorrect pocket dissection or incorrect implant placement
  • Nerve and/or muscle damage
  • Slippage
  • Asymmetry

Benefits of the procedure:

  • Increased confidence
  • Increased self-esteem
  • Improve and enhance lower leg shape
  • Increase bulk and projection
  • Restores proportion
  • Corrects calf muscle wasting deformities