Calf Augmentation

Calf augmentation procedures can define and enlarge small or underdeveloped calves. Lower leg implants are a safe and effective way to increase the size of the calves in a minimally invasive procedure.

Calf Augmentation Overview - 1090

The Skinny


It can be said that some of the most common plastic surgery procedures like breast augmentation, tummy tucks, liposuction, and blepharoplasty are strongly associated with female patients. While it is true that women overwhelmingly make up the largest percentage of plastic surgery patients across the board, there are procedures made especially for men—like pectoral implant surgery, and breast reduction for men (gynecomastia).

Aside from these procedures designed just for men, there are other cosmetic surgery procedures meant for both men and women where males make up the majority of patients. These procedures include hair transplantation and chin augmentation (mentoplasty). Another area where men dominate as patients are calf augmentation surgeries, a procedure meant to enhance the calf muscle to give the lower leg a more balanced and refined shape. According to statistics from the American Society of Plastic Surgery, men accounted for 57% of all calf augmentation patients in 2017, with 378 of 658 surgeries performed in the United States.

Calf augmentation with solid silicone implants or silicone gel implants can be restorative in nature—performed to improve the contour of the lower legs after illness or injury, or cosmetic, as a way to improve the aesthetic appearance of “chicken legs.” In either case, when performed by a skilled and board-certified plastic surgeon, calf augmentation surgery with implants is widely considered to be a safe and effective surgery with very satisfying results. Whether you are a man or a woman and are interested in having this surgery, take a look at this guide to learn more about the process and what kind of results you can expect from this relatively new and increasingly common surgical procedure.


Before & After Images by Provider

Calf Implant Before, Female 31 - 1981Calf Implant After, Female 31 - 1981
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The Specifics

Who is an Ideal Candidate for Calf Augmentation, and What Are Typical Cosmetic Goals for Calf Surgery?

Ideal candidates for calf augmentation procedures are men and women in general good health and who have the desire to improve the look of the lower leg, either for restorative or cosmetic reasons. Ideal candidates are also realistic about the outcome of their procedure and will clearly understand the risks and possible surgical complications associated with having this surgery.

In restorative cases, patients seek calf augmentation surgery to correct the proportion of the leg after experiencing shrunken lower leg symptoms after congenital illnesses, infections, or disease—for example, spina bifida or clubfoot. In other cases, defects are caused by physical trauma to the size or shape of the calf muscle on one or both legs. Calf augmentation is a solution to regain the balance and symmetry of both lower leg areas.

In cosmetic procedures, ideal candidates are both men and women with naturally skinny, underdeveloped calves or those born with asymmetrical calf shapes. Many potential candidates for this surgery are bodybuilders that have failed to reach a more aesthetically pleasing thigh-to-calf muscle ratio through their weight lifting and exercise efforts. This is usually the goal for most men, who are bodybuilders or not—that seek to emulate the look of a bulging calf muscle after experiencing little to no progress building muscle in that area. In these cases, patients request an augmentation of both the inner and outer lower leg areas or the medial and lateral areas of the calf.

Female patients that are not bodybuilders usually request medial calf implants alone, instead of both medial and lateral augmentation. This creates an effect that adds definition to the calf area without looking too bulky or overly muscular, enhancing the balance and proportion of the calf with the rest of the leg.

Who Should Not Have this Surgery?

Not everyone is a good candidate for plastic surgery, especially for procedures like calf augmentation—where results are not medically necessary, and the reason for the surgery is typically cosmetic. A potential candidate for calf augmentation surgery might be denied treatment by their doctor for a number of reasons, which are usually due to mental or physical health problems and existing medical conditions.

Smoking, high blood pressure or diabetes, obesity, heart and lung problems, and other health issues might be reasons why a patient could be considered unsuitable for calf augmentation surgery. Additionally, body dysmorphic disorders and other psychological issues could also be reasons why a doctor might refuse to operate on a patient.

How Should I Prepare for Calf Implant Surgery?

Once you have been scheduled for calf augmentation with implant surgery with a board-certified plastic surgeon, you will be given instructions on how to best prepare for your surgery. This might include various health tests, or a pregnancy test for women that could be expecting.

After patients have taken all examinations and are cleared for surgery, they will be advised to stop smoking at least two weeks or longer before their surgery date, and at least two weeks after. Patients will also be asked to cease taking certain types of herbal medications if applicable, and certain anti-inflammatory drugs like aspirin and ibuprofen to prevent excessive bleeding during and after surgery.

Calf augmentation is not an inpatient procedure, and patients will not be required to spend the night in the hospital or surgical center. For this reason, patients should make sure to have arranged for transportation to their homes from the hospital or surgery center, and for someone to care for them at least 24 hours after surgery.

Are There Side Effects or Risks of Complications from Calf Augmentation?

While all surgical procedures offer a certain degree of risk, calf augmentation with implant surgeries are generally considered to be very safe and complications are rare. Some complications include adverse reactions to anesthesia, including allergic reactions, hematoma or seroma, excessive bleeding, infection, scarring, and a loss of sensation, or changes in sensation in the legs.

Some dangers that are specific to calf augmentation include the risk of unsatisfactory results, such as asymmetry or incorrect placement of the implant, damage to the underlying muscle or nerve damage, visibility of the implant, slippage, and other risks. Patients should know that their risk of these and other serious complications can be markedly reduced by choosing a board-certified plastic surgeon to perform their surgery. A licensed and qualified surgeon recognized by a plastic surgery board like the American Society of Plastic Surgeons will take the appropriate measures to achieve the best possible outcome for his or her patients, and will know how to minimize risks using the most effective techniques for calf augmentation.

What Happens During a Calf Implant Procedure?

Calf augmentation with implants surgery is considered a minimally invasive surgery with high satisfaction rates and a low risk for significant complications. The entire process from start to finish usually takes about two to three hours to complete. It is important to note that the technique the surgeon uses to complete your calf augmentation will affect the overall invasiveness of the procedure.

Before your procedure, your cosmetic surgeon will discuss your options with you, including the average cost or exact cost of calf implants, alternatives to the procedure—such as calf augmentation with fat grafting (autologous fat transfer), or lower body muscle training and regular exercise. You will also discuss the various options for calf augmentation with implant surgery to determine the best technique to use for your surgery to achieve the results you want—along with the associated risks involved including capsular contracture, nerve damage, and implant migration. During the initial consultation you will need to decide along with your surgeon:

  • The type of implant material, either silicone gel or firm, solid silicone implants
  • The size of the implants
  • The location of the implants (the medial calves, or the medial and lateral calves)
  • Placement of the implants (under the gastrocnemius muscle or between the fascia tissue and the gastrocnemius muscle)
  • The location of the incision

During the procedure, the doctor will place you under general anesthesia or local anesthesia and make a small incision, usually behind the knee. The implant will then be inserted into a pocket between the fascia and the muscle, or under the gastrocnemius muscle. The incision site is then stitched up and closed. The patient will be given a compression garment to wear for the first week or so post-surgery. Since this is an outpatient procedure, the patient will be sent home to begin the recovery process.

What to Expect: A Week-by-Week Guide to Recovering from Calf Augmentation Surgery

Recovering from calf augmentation surgery takes approximately four to six weeks. Here is what you can expect immediately after surgery and in the weeks afterward during the recovery process.

The First 24 Hours After Surgery Patients will need someone to help them immediately following surgery and for at least 24 hours afterward. Ideally, the person helping you will be someone you are comfortable with, as you will likely need help going to and from the bathroom for at least 24 hours following your procedure. During this period, you will be instructed to keep your legs elevated and to rest as much as possible in order to reduce swelling, pain, and bleeding.

After about 48 hours, patients are allowed to remove their bandages and dressings. At this point, they will also be allowed to take showers and to walk, although excessive movement and rigorous physical activity are still prohibited. Walking will likely feel a bit uncomfortable due to a stiff feeling in the legs—which is mostly due to tight skin and getting used to the implants.

The First Two to Four Weeks After Surgery After two weeks or so, patients will notice less bruising and swelling and feel their skin begin to loosen and adjust to the implants. While rigorous activities and excessive movement should still be avoided at this point, patients are encouraged to walk as much as possible to continue getting used to the new calf implant devices.

Four to Six Weeks After Surgery The patient should begin to feel much more comfortable with the implant around four to six weeks post-surgery. At this point, their doctor will clear them for most activities and in most cases will be able to return to work, the gym, and all normal activities according to the patient’s lifestyle.

In some cases, strenuous activities will be prohibited until at least two months after surgery. Ask your doctor if you intend on heavy weight lifting, long-distance running or intense sprint exercises, or other strenuous activities to make sure you return to these after an appropriate amount of time.

The Takeaway

Conclusion: The Pros and Cons of Calf Augmentation

The pros and cons of calf augmentation surgery should be thoroughly considered before deciding on having the surgery. A board-certified plastic surgeon will counsel you on what you can realistically expect from this procedure, your options for having the surgery (including the placement of the implant and implant materials), and what risks will be present during and after your surgery is completed.

In general, here are some of the pros and cons of calf augmentation surgery to help you make the best decision possible for you.

Pros of Calf Augmentation Surgery The most obvious benefits of calf augmentation surgery are aesthetic. Patients can expect to add definition and body mass to the lower leg area while sculpting the shape of the calf as they see fit. Additionally, calf augmentation is considered to be a simple procedure that is quick and easy for the surgeon to complete, and is known for offering satisfactory results without a long recovery process or significant pain.

Cons of Calf Augmentation Surgery While recovery times following calf augmentation surgery are not excessive when compared to other types of surgical procedures, patients will still need to prepare for at least four to six weeks of time off from most of their normal activities. During this time, patients report feeling discomfort with the calf areas, swelling, bruising, and tightness of the skin and around the incisions.

As with any surgery, there are certain risks to consider that might interfere with the quality of the results. If patients are unsatisfied with the results of their surgery, additional procedures might be necessary to correct, remove, or replace the implant.

If you are interested in having larger, more defined calves—calf augmentation surgery might be for you. For the best results possible, make sure to find a plastic surgeon that is licensed in your state for performing this surgery, and that is associated with a reputable board organization like the American Society of Plastic Surgeons or the American Board of Plastic Surgery.

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