How Are Calf Implant Sizes Determined?

Q: Dr. Eppley, I have some questions about calf implant surgery. I have very small calfs, like toothpicks below my knees, due to being born with clubfeet. I know that I can never have normal size calfs but any improvement woutl be a plus. My questions about calf implants are:

 -What is a conservative estimate of the recovery period?

-What is the likelihood of needing a follow up surgery?-Where is the surgery being performed and what is the rate of secondary infections there?

-What are the chances and risk of other complications/what complications?

-How extensive will scarring be?

-How is the size of the implants determined, what is the chance of them shifting, what would be the risk involved, and how would they be adjusted if necessary?

-What is the expected prognosis?—lifetime of implants? Eventual need for replacement implants? Longterm risk of side effects/complications?

-How will this overall affect Quality of Life?

-What are the other options and how do they compare?

A: in answer to your calf augmentation questions:

  1. Recovery from calf implants is related to the ability to walk and fully flex one’s foot. Most patients return to normal after about 3 weeks from surgery.
  2. Surgery is performed in my private outpatient surgery center. Because this is a facility where only elective surgery is done on healthy patients, unlike a hospital, the infection rate is very low. (way less than 1%)
  3. The biggest risks of calf implants are infection (< 1%) and potential visibility of the implant’s outline in patients with thin tissues. (10%)
  4. The implants are placed through a horizontal 3 cm wide incision in the skin crease behind the knee. (popliteal fossa) That scarring is minimal although in patients with more skin pigment there may be an initial hyperpigmentation reaction around the incision.
  5. Calf implant sizing is done by taking measurements of the medial gastrocnemius muscle and matching the implant size to muscle dimensions. Calf implant size options range from small (5cm x 15 cm, 70cc volume), medium (6cm x 20 cm, 135cc volume) to large. (6cm x 24 cm, 170cc v olume) Calf implant shifting is very rare since the tissue pocket made is very narrow and the tissues are naturally tight.
  6. Calf implants are made of soft low durometer silcioen elastomer material that will never degrade, break down or need to be replaced.
  7. Like all body augmentation surgery, this is an operation whose intent is to make you feel less subconscious about your congenitally small calf size. if this objective is achieved then your self-image and quality of life in theory should be improved.

Dr. Barry Eppley

Indianapolis, Indiana