Calf Implants

What are calf implants?

Calf implants give your lower legs (your calf muscles) a shapelier and more defined contour. The implants can make your calf muscles look fuller and more muscular. A plastic surgeon places calf implants through small incisions in the creases in the back of your knees.

What are your calf muscles?

Your calf muscles are part of your musculoskeletal system. They help you flex your feet and rotate your ankles. They’re the reason you can walk, run and jump.

You can see these muscles in the back part of your lower legs behind your shinbones (tibias). Your calf muscles start at your knees and extend to the Achilles tendons in your ankles.

Two main muscles make up your calf muscles:

• Your gastrocnemius forms the bulk of your calf muscle. It’s the muscle that gives your calf muscles their shape.
• Your soleus muscle is wide, flat and sits deeper in the leg. You can’t see this muscle.

What are other names for calf implants?

You may also hear these terms for calf implants:

• Calf augmentation.
• Calf enhancement.
• Calf enlargement.
• Calves implants.

Why do people get calf implants?

All sexes who want shapelier calves may choose calf implant surgery. There are many reasons why:

• To enhance leg shape: Most people get calf implants as part of cosmetic surgery to improve their physique. Bodybuilders may want calf implants to build up the bulk and size of their lower legs beyond what they can achieve through exercise. Or you may have underdeveloped calf muscles that are smaller or out of proportion to your thighs.
• To correct a leg issue: Some people with leg injuries or congenital defects that cause muscle imbalances get calf implants as part of reconstructive surgery.
• To achieve a masculine appearance: People assigned female at birth (AFAB) who identify as male may get calf implants as part of gender affirmation surgery. The implants give their lower legs a more muscular, masculine look.

Who is a candidate for calf implant surgery?

The ideal candidate for calf implants is someone who:

• Is exercising and strength training to build calf muscles.
• Has a fully formed adult musculoskeletal system.
• Doesn’t smoke or can quit smoking before the procedure (nicotine raises the risks of surgical complications and hinders healing).
• Has realistic expectations about the outcomes of calf implant surgery.

Do calf implants come in different materials and sizes?

Calf implants are often made of medical-grade silicone. This soft, rubber-like material has the look and feel of muscle. You can choose between solid silicone calf implants or ones filled with silicone gel, as breast implants have. A benefit of solid implants is that your surgeon can sculpt them into the desired shape before insertion. Sculpting isn’t possible with gel implants.

There are also different shapes and sizes. Your surgeon will take measurements of your legs before the procedure to select the best implant shape and size. You may get one or two implants in each leg.

Most people get the same calf implants in both legs to ensure symmetry. But individuals with muscle imbalances may need different-sized implants. Bodybuilders may also want different calf implants in each leg for a more dramatic look. You and your surgeon can discuss the calf implants most likely to help you achieve your goals.

What other procedures may take place with a calf implant?

Your healthcare provider may recommend body contouring procedures to achieve the look you seek. These procedures may take place at the same time as the implant surgery. For instance, you might get liposuction to remove fat deposits from your hips, butt and thighs.

Some individuals get a fat transfer or fat grafting procedure to give even more volume to their lower legs. After using liposuction to remove fat deposits, your surgeon injects the purified fat cells into your lower legs. You may need more than one fat transfer procedure to achieve the desired look.

Who performs calf implant surgery?

A plastic surgeon performs calf implant surgery. This medical doctor specializes in cosmetic and reconstructive procedures. Calf implant surgery is most often done as an outpatient procedure, which means you go home afterward. The procedure may take place in a surgical suite at your healthcare provider’s office, surgical center or hospital.

What happens before calf implant surgery?

You should follow your healthcare provider’s instructions on how to prepare for calf implant surgery. You may need to:

• Get a physical exam and blood tests to ensure you’re well enough for surgery.
• Get photographs taken to help your healthcare provider plan the procedure and compare before-and-after results.
• Fast (not eat or drink) for a certain period before the procedure.
• Not take certain medications before surgery, including vitamins and supplements.
• Take antibiotics to lower the chances of postoperative infection.
• Quit smoking.

What are the types of calf implant procedures?

There are two ways your plastic surgeon can place the calf implants:

• Subcutaneous: The calf implant goes just beneath the connective tissue between your skin and gastrocnemius calf muscle. Your surgeon may recommend this method because it’s less invasive. You should recover more quickly with less pain. However, a subcutaneous implant is more prone to shifting, which can require additional surgery to correct. You may also be able to see and feel the implant, and it may give a less-than-natural look.
• Submuscular: The calf implant goes under your gastrocnemius calf muscle, making for a slightly longer and more painful recovery. Because your surgeon more securely and accurately places the implant into the muscle, you get a more natural look and feel.

What happens during calf implant surgery?

During calf implant surgery, you lie face down (prone) on the surgical table. You receive may receive general anesthesia to help you sleep through the procedure.

Your surgeon:

1. Makes a small incision into the natural crease of skin behind your knee.
2. Inserts special surgical tools into the incision to create a space (pocket) between your connective tissue (skin) and gastrocnemius calf muscles (subcutaneous implant). Or your surgeon makes a pocket in your actual calf muscle (submuscular implant).
3. Takes great care not to disturb the nerves; a sciatic nerve branch that provides motor and sensory functions to your lower leg and foot is here.
4. Slides the calf implant through the incision, positioning it into the surgically made pocket.
5. Sometimes places a thin drainage tube below the incision to temporarily drain fluids and reduce swelling (not everyone needs drainage tubes).
6. Closes the incision with stitches and covers the wound with a bandage.
7. Wraps your leg in a compression bandage or garment.
8. Repeats these steps on your other calf.
9. Finishes surgery and then gently rolls you over to the face-up (supine) position for recovery.

What happens after calf implant surgery?

Someone must drive you home after the procedure. You go home wearing compression bandages on your legs to keep the implants in place and minimize swelling (edema).

You should follow your surgeon’s instructions for incision care, as well as taking care of the drainage tubes. Your doctor will remove the stitches (if they’re not dissolvable) and drainage tube within two weeks. You may stop wearing the compression bandages at this time.

What is the point of calf implants?

There are many benefits to calf implants. The implants can:

• Create more contoured calves.
• Give more volume to your calves.
• Bring your lower and upper legs into balance.
• Make your right and left legs more symmetrical.
• Treat birth defects or problems that affect how your legs look.

Are calf implants safe?

Only a small percentage of people who get calf implants experience significant problems. In rare instances, a silicone gel calf implant can leak or rupture. You’ll need surgery to remove and replace the implant. Both solid and gel implants can shift out of place, requiring a surgical fix. Movement is more likely to occur with subcutaneous implants.

What are potential calf implant side effects?

Calf implant surgery carries a risk of:

• Unwanted reaction to anesthesia or the implant.
• Bleeding, bruising and blood clots.
• Capsular contracture (shrinking and tightening of scar tissue around a silicone gel implant, which causes pain and an unnatural firmness).
• Implant edge that you can feel through your skin (a palpable edge is more likely with solid implants).
• Infection.
• Extrusion.
• Muscle spasms.
• Nerve damage and numbness.
• Skin discoloration, sensitivity and swelling.

What is recovery like after a calf implant?

You’ll have some pain and discomfort for several days after the procedure. Your lower legs will feel swollen and sore. Your skin may look shiny as it stretches to accommodate the implant and enlarged calf.

Walking — although uncomfortable and stiff at first — is good for your recovery. It gets blood flowing to your lower legs. Someone should help you move around for the first couple of days to prevent falls. Your walking gait should be back to normal by the second or third week.

You should be able to return to work in two weeks and resume most activities within six weeks. You may need to wait longer to resume exercises like running, biking and strength training.

To aid recovery, you can:

• Elevate your legs when lying down or sitting.
• Take prescription or over-the-counter acetaminophen-based pain relievers.
• Apply ice packs to your legs.
• Continue taking antibiotics if prescribed.

What results should I expect from a calf implant?

Results from calf implants are immediately noticeable. Still, it can take several months for the swelling to subside completely. By then, you should be able to see the full effects.

Most people are pleased with the results. If you’re dissatisfied, you can talk to your surgeon about possible solutions. You may choose to have another surgery to try different implants.

When should I call the doctor?

You should call your healthcare provider if you experience:

• Excessive bleeding, swelling or bruising.
• Muscle spasms.
• Nausea and vomiting.
• Severe pain.
• Signs of infection, such as pus from the incision site or fever.

Are calf implants permanent?

Calf implants are removable. Over the years, silicone gel implants may start to break down. You may need surgery to place new implants. You may also need surgery to remove and replace implants that shift.

Are calf implants obvious?

Rarely, a subcutaneous calf implant has an edge that you can feel through your skin. This implant edge may be more noticeable. You may need another surgery to replace or reposition the implant.

When correctly positioned, most calf implants have a natural muscular look and feel. Your plastic surgeon will make incisions in the creases in the backs of your knees to hide the scars.

A note from Cleveland Clinic

If you’re unhappy with the way your lower legs and calves look, calf implants can give you the definition and shape you seek. It’s important to have realistic expectations about any cosmetic procedure. To ensure you get the desired outcome, you should meet with a few plastic surgeons and review before-and-after photographs of their calf implant procedures.