Q; Dr. Eppley, I was born with club foot and now my right leg is slightly smaller than the left. I’ve attached two pictures. Let me know if you need another. My basic concern is having to do multiple implants and have also been thinking about fat transfer. I believe to make my right leg look symmetrical I will need one of the longer implants, because it would need to follow down to very bottom of my leg if possible. I have no Achilles tendon and your able to see my fibula bone if I flex my leg.
A: Your best obtainable result is going to come from a combination of calf implants and fat transfer. Calf implants do not go all the way to the ankle nor can any implant go past midway between the knee and the ankle. (can not go past the gastrocnemius muscle/fascia) Below this level any augmentation has to be done with fat transfer although it is important to be aware that fat grafting below the calf survives very poorly due to the tight tissues. Given the small size of your calf you will need both medial and lateral calf implants.
Dr. Barry Eppley