Can Calf Implants Be Used In Clubfeet?

Q: Dr. Eppley, I have clubfeet and even with exercise, my calfs are still smaller than my forearms. Would calf implants make a difference in their appearance? Also I have really good insurance, would I be able to use it for a procedure like this?

A: Your questions are two-fold; 1) Will calf implants improve the appearance of your calfs, and 2) will insurance pay for it? While calf implants can improve the size of one’s calfs, the person born with congenital calf hypoplasia (clubfeet) poses a unique problem. The skin over and around the calfs is very tight as the muscle never fully developed. This ‘shortness’ of skin limits the size of calf implants that can be safely placed. It also makes it very difficult, if not impossible, to get subfascial placement so the implant will lie completely in the subcutaneous fat space. Secondly, insurance will not pay for calf implants because they do not provide any functional medical benefit, such as improved range of motion, more calf strength, etc. Since only appearance is improved, the procedure will be deemed cosmetic in nature.You may feel free to send me some pictures of calfs for my assessment. Please send them directly to me at the following address:

I shall look forward to receiving them and giving you my recommendations.

Barry Eppley

Indianapolis, Indiana