above shown a case one month after Botox injection into gastrocnemius. The before circumference of calf was 33cm. It was reduced to 31cm after Botox injection.
 
Selective neurectomy　



 

Above was an example of a patient following neurectomy. MG bulge improved when she stand on her toes 3 months after the operation. However, the patient felt that the results were inadequate since her calf circumference reduced by only 1 cm. She noted that the muscle(MG) bulged out agin 4 years after neurectomy. 
 

One year after neurectomy of MG, MG shrunk in size(left figure). But 4 years later, bulges (arrow in right figure) were noted.  The other disadvantage of neurectomy is compensatory hypertrophy of the remaining calf muscles which has been mentioned before.  



The above case underwent neurectomy in other clinic three years ago. After operation, the MG shunk in size. But because of compensatory hypertrophy of LG and Sol, the calf bulged out in lateral side(hypertrophy of Sol) and lateral-posterior side (hypertrophy of LG). 

Below illustrations showed the effect of neurectomy on the cross section of legs.


The above illustrations showed that how MG shrunk in size was unpredictable.


The above illustrations showed that after neurectomy of MG the compensatory hypertrophy of LG and Sol will change the contour of legs.
 
Total excision of Gastrocnemius 

 
 
Partial excision of muscles (muscle sculpture)

     
 
The above pictures are the bird-eye view comparison between before and after operation (calf reduction by partial excision of MG, LG and Sol).
 
Partial excised muscles still keep their function?

Sculpturing (partial excision of muscles).        

Muscle sculpture of calf muscles

 
After partial excision of MG, LG and Sol, the legs can be reduced to better shape and size.

Dr. Jong developed instruments to facilitate the operation. Under endoscope guide, complications were reduced. The attached picture show endoscope view of sural nerve and LG. 


         
 
Long-term Follow Up:



What is RF (radio-frequency) ?

 
Following is the table comparing these operations.