Endoscope-assisted calf reduction in Orientals

In general, Oriental women have shorter legs and thicker calves than Caucas ian women. Moreover, the thicker their calves, the shorter their legs appea r to be. As a result, they might be reluctant to adopt certain fashion styl es (shorter skirts) or they may feel conspicuous in beachwear. To date, no practical aesthetic method of lengthening the legs or thinning the calves e xists, with the exception of liposuction. However, liposuction does not sol ve the problem of muscularly prominent calves, because the shape and size o f the calves are determined mainly by gastrocnemius muscle rather than by s ubcutaneous fat. The authors have devised a method of contouring the calf b y partially shaving the calf muscle. Through two horizontal incisions (less than 2 cm) in the popliteal fossa, dissection is deepened to the crural fa scia, and the fascia is incised. The fascia is easily separated from the ga strocnemius muscle with an endoplastic retractor (Emory Endoplastic or Byrd Endoplasic Retractor, Snowden-Pencer, Tucker, Ga.). Medially and laterally , prominent muscle bellies are shaved in proper volume. Care should be take n not to injure the medial cutaneous nerve and the saphenous vein in the mi dline. Between October of 1994 and June of 1998, 115 calf reductions were d one. The differences between preoperative and postoperative circumferences in the most prominent regions of the calves were 3.0 to 7.0 cm, and promine nt muscular contours disappeared. There were no major complications and onl y a few transient minor complications, such as localized hematoma and surfa ce irregularity. A postoperative Cybex test of ankle power showed strength near the preoperative normal level from 6 months to 1 year after the operat ion.