Cases report        
 
Case 1 
This is the first calf reduction case done in our clinic in 1997.  The patient had poliomyelitis which resulted in shrinkage of her right leg.  To compensate for the lost function of right leg, her left calf muscles got larger (hypertrophic).To make her legs symmetric, silicone prothesis was implanted into her right leg and the hypertrophic calf muscles of her left leg were partially excised. The patient was quite satisfied with the final result. 

Case 2
After excision of MG 30 gm, the circumference of calf decreased from 33 cm to 31 cm.  The legs look slender after operation.  When she stands on her toes, the MG ( the circle on the third picture) looked smaller.  
She walks and jumps normally.  The scar will take time to fade away.



Case 3
After partial excision of her MG (200 gm muscle of both side of MG was excised) and liposuction of calf, the circumference of calf decreased from 38 to 35 cm on six months after operation.



Case 4
The case underwent muscle sculpture and liposuction of her legs. 240 gm muscle of both side of MG and 130gm muscle of both sides of LG and Sol were excised. The circumference of calf decreased from 38 to 34 cm two months after operation.
 


Case 5
The patient underwent neuectomy half an year ago at another clinic.  She was not satisfied with the result. The circumference of calf was 33.5cm (left-handed picture). She visited our clinic.  After undergoing muscle sculputre surgery, she is happy with the result. The calves reduce to 31cm (right-handed picture). 　

Case 6
Below shown a case after liposuction of calves and total calf muscle sculputre.  The amount of excised MG,LG and Sol was 160gm totally.The extracted fat was 400c.c.  The before calf circumference is 40.5 cm.  It was reduced to 35 cm after operation.

Case 7
The below case underwent partial excision of her MG.  The circumference of her legs before operation was 36cm.The legs reduced to 33cmafter operation.  The above picture was taken after two years after operation. 


 

Case 8
The circumference of legs of the below case was 36cm before operation (left picture).  The operation procedure was partial excision of MG, LG and Sol and some liposuction of her legs.The circumference of her legs became 32cm three weeks after operation (right picture).  The scars on her posterior knee would fade away gradually. Below showed the sonographic pictures of her legs.  MG was the part between two arrows.  Left picture showed the thickness of MG before operation was 2cm.  After operation MG thinned to 1cm (right picture).




Case 9
The preoperative circumference of Case 9 is 35cm.  There is obvious bowing of lateral curvature of her legs.  After muscle sculpture, including MG,LG and Sol, the circulference became 32cm. The pictures on left sides are taken one and half an year after operation.  Muscle suclpture technique can improve bowing of legs.  On the contrary,neurectomy or total muscle excision will deteriorate bowing due to the compensatory pertrophy of Sol muscle.


Case 10
The medial calf of the above case was not so bulged, but the lateral calf, especially lower lateral calf, bulged out due to fat accumulation.  After liposuction and muscle sculpturing (included MG, LG and Sol), the circumference of calf was reduced from 34cm to 30 cm one month after operation. The right picture was taken one month after operation
Case 11
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The preoperative circumference of above case was 37 cm. After muscle sculpturing of legs (partial excsion of MG, LG and Sol), the legs, which were measured at three weeks after operation,were reduced to 32 cm.
The ultrasound examination showed that the thickness of MG ( the area between two arrows) was reduced from 2.1cm to 1.0 cm.

The pictures showed the result on seven months after operation.  The circumference of legs reduced from 37cm to 32cm.The leg scars on Oriental people take time to fade away.
 Case 12

The preoperative circumference of the above case was 33 cm.  Her legs did not look very thick, but she liked to slim her legs.Using the principle of muscle sculpturing, we trimmed her MG, LG and Sol. After 14 months the leg size was reduced to 30cm.  The beautiful shape of legs was kept.  No compensatory hypertrophy was noted. 
 Case 13



Althogth the legs of above case are not thick (the preoperative circumference of leg is 33cm), the patient asked for slim legs.The size has been reduced to 29.5cm one month after operation (left picture).  The medial and lateral curvature of legs also became more straight after operation.  Below is the follow-up picture of the case 16 months after.
 Case 14

Before operation, the MG and LG were quite bulged when patient standed on her toes.  The right picture was taken on 10 months after operation (partial excision of MG, LG and Sol).  The legs were not muscular after surgery.

Case 15

She underwent neurectomy 2 years ago.  After neurectomy, her legs got smaller.  But in a few months she noted that her legs became thicker.
Ultrasound check revealed that fiber angle of her MG increased when she stood on her toes.  It means that her MG could contract when she stood on her toes, maybe because the nerve controlled the MG was growing back into the muscle again.  After muscle sculpture operation in our clinic, the legs got slimmer.  The lateral and medial curvatures of legs became more straight.

Case 16

Case 17

Case 16 and 17 underwent partial excision of their MG.The postoperative pictures, taken on six months after operation, revealed that the legs got slimmer.  The leg muscles looked smaller when they stood on their toes. 
 
Case 18

The above pictures showed the result of calf reduction by partial excision of MG, LG and Sol on 8 months after operation. The leg became slimmer.
 
Case 19

After partial excision of MG, LG and Sol, the circumference of legs of above case was reduced from 36 to 32 cm.
 
Case 20

After calf reduction surgery, the circumference of legs was reduced from 37cm to 32cm.  The bird-eye view also revealed how the leg's contour was sculptured to slim shape.

Case 21

The preoperative circumference of the legs of above case was 35cm.  After muscle sculpturing, the circumference became 30 cm, measured at three weeks after operation.
 
Case 22

The before circumference of legs of above case is 37 cm.  After muscle sculpture, the size reduced to 32 cm on three months after operation. 

Case 23

The above pictures showed the result of calf reduction surgery on a gentleman after half an year.  The size reduced from 39 cm to 36cm.  The shape of legs changed a lot. 
 
Case 24




The above case underwent calf reduction with neurectomy with neurectomy 5 years ago.  The left MG became atrophy after neurecotmy, but right MG did not.  The ultrasound examination in our clinic showed that left MG was dense and thinner, signs of muscle atrophy, but right MG was thicker without signs of atrophy.
She underwent muscle sculpture and calf liposuction in our clinic.  The before size of legs were left:34.5 cm right:35.5 cm.Postoperative size is 32cm. 
 
Case 25




The above case was an athlete when she was a student.  About 30 % of our cases have been athletes in their studentship.Although they are no more active in exercise when they graduated, the sizes of their legs did not shrink.  The preoperative size of above case was 37 cm. Her legs were quite muscular. After muscle sculpture, the sizes of legs reduced to 32 cm. The above are pictures of before and one year after. 
 
Case 26




The size of above girls was reduced from 35cm to 31cm.
 
Case 27

After muscle treatment and liposcution of legs, the size of above case reduced from 36.5 to 32.5cm on 5 months after surgery. Ultrasound examination on one year after surgery showed that thickness of MG has been reduced from 21 mm to 13 mm. MG function is well.

Case 28



The leg size of above case was reduced from 34 cm to 31 cm after muscle treatment and liposuction around ankles and medial knees.  The legs looks quite slim after surgery.  The shape of Achilles tendons could be easily identified after liposuction. 
 
Case 29



The MG of the above case were quite thick. LG and Sol are normal in size. The case wanted to treat his thick MG.The three-month after picture showed that his leg shape improved a lot after partial excision of his MG.  Ultrasound examination showed that before thickness of MG was 16 mm.  The thickness of MG has been reduced to 11mm.
The 5 mm reduction in thickness improved leg shape, but would not effect leg funcion.
 
Case 30

The above case showed the comparision between before and 9 months after calf muscle sculpture

Case 31

The above picture showed the before (38cm in size) and after picture (35.5cm in size).  She underwent muscle sculpture surgery.

Case 32, 5 years follow up. 

Upper left was the before picture.  Her leg size was 34cm.  Upper right is the picture after 5 years.  Her leg size was 31.5cm.
Below left was the ultrasound before picture of her right MG.  The thickness of her right MG was 17 mm.  Below right picture showed that her MG after 5 years is 12 mm in thickness.  Her legs keep in smaller size and shape in these 5 years.


Case 33

The preoperative size of above case was left: 39 cm.  Right: 37 cm.  The size measured on fifth months after surgery was 34.5 cm on both legs.

Case 34


The above case underwent calf reduction by partial excision of muscle at another clinic. Uneven surface was noted after surgery. Arrow pointed to the bulge due to hypertrophic Sol. Above right picture was taken after revision surgery at my clinic on 1.5 years later. The bulge sites were trimmed and depressed site on her right leg was filled with fat. 

Case 35


The above case underwent neurectomy at another clinic 4 years ago, but she said her legs got bigger in half a year after neurectomy.  Left picture showed her left leg was bigger than right leg and uneven surface was noted on her right leg. Middle picture showed the  picture after revision calf reduction operation at my cliic at 2.5 years later.  Above right picture marked the bulge sites to be treated before operation. 

Case 36


The right picture is the picture taken six and half an year after calf reduction surgery. The difference in shape comparing with before picture is quite obvious.

Case 37


Right picture was taken half an year after surgery. The size was reduced from 37.5 to 33 cm. But the scars got hyperpigmented. It will take time to fade.

Case 38


The right picture was taken after 10 months. The size was reduced from 35 to 32cm. 

Case 39


The before size of above lady was 33 cm. The legs basically was the ideal shape and size for most of women, but she hoped to have more slimmer legs. The right pictures was taken 7 months after surgery. The size has been reduced to 29 cm. 

Case 40

The above case had neurectomy twice and several times of Botox injection at another clinics without satisfactory effects. Right picture is taken two years after partial muscle excision at my clinic. The size has been reduced from 33.5 to 30 cm. Shape of legs has been changed a lot. 

Case 41


The right picture was taken three months after surgery. The size has been reduced from 38 to 33.5cm. 

Case 42


The above case had neurectomy at another clinic. She said the effect lasted only for two years. She had Botox injection to Gastrocnemius since 19 years old. She decided to have calf reduction surgery at my clinic.  Right picture is taken 4 years after surgery. The size has been reduced from 32.5 to 30.5 cm. Shape of legs has been changed a lot. 

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