Last updated date: 24-May-2023

Medically Reviewed By

Written by

Dr. Yahia H. Alsharif

Originally Written in English

Calf Augmentation


    Calf augmentation, also known as calf enhancement, is a cosmetic surgery treatment used to increase the form and size of the calf in order to improve leg proportions. Calf augmentation can assist to improve body proportions and give the legs a more balanced and defined look.

    Birth abnormalities or physical problems later in life might result in calf muscle definition that is hard to build or recover with natural activity. A calf implant may be appropriate for people who want to improve the look of this area by increasing the calf's weight or proportions in comparison to the rest of the body (typically, the thigh area).


    Where is the Calf Muscle?

    Calf Muscle

    The gastrocnemius and soleus muscles are the two primary muscles in your calf. Because these two muscles link to the Achilles tendon above your heel, some providers refer to the gastrocnemius and soleus as a single huge muscle with two portions.

    In addition to these two huge muscles, a tiny muscle called the plantaris runs along the length of the lower leg between the gastrocnemius and soleus. These three muscles are known as the triceps surae. However, not everyone possesses a plantaris muscle. Only around 10% of people have two larger muscles.

    The main muscles in the calf are:

    • Gastrocnemius:

    This muscle is located in the rear of the lower thigh, right beneath the skin. Because the gastrocnemius is so close to the skin's surface, its contour is typically visible. It makes up the majority of your calf muscle.

    The gastrocnemius has two heads that begin on the inner and outside of the femur (thighbone). The gastrocnemius muscle travels down the back of the leg and connects to the Achilles tendon. Gastrocnemius strains are prevalent due to the fact that the muscle connects to two joints (the knee joint and the ankle joint).

    • Soleus:

    The soleus is a broad, flat muscle that rests just below the gastrocnemius. It begins just below your knee and continues down your lower leg, connecting to the Achilles tendon above your heel. Because the muscle only traverses the ankle joint, soleus injuries are uncommon.

    The soleus muscle links to the tibia and fibula (the bones in your lower leg). The soleus works with your gastrocnemius to help you walk, run, and jump. It also aids in the support of your legs, allowing you to keep proper posture.


    What does the Calf Muscle look like?


    The gastrocnemius and soleus are skeletal muscles that are part of your musculoskeletal system. Skeletal muscles are made up of many separate fibers. These fibers band together to form a striated (striped) pattern.


    How can I keep my Calf Muscle Healthy?

    Calf Muscle

    To avoid problems with your calf muscles, you should:

    • Maintain a healthy weight: People who are overweight are more prone to strain a muscle. Excess weight puts strain on your legs and increases your chance of injury, such as a strain. If you are overweight or obese, see your doctor about the ideal weight for you.
    • Keep hydrated: Drinking enough of water and other fluids reduces the likelihood of having a leg cramp.
    • Warm up and stretch before exercising: Warm calf muscles are less prone to stretch too far or rip. Warm up before engaging in physical activity to stretch your calves and develop flexibility. When exercising, progressively raise the intensity.
    • Watch your medications: Certain medications can cause leg cramps. Talk to your provider about taking another drug that does not cause this side effect.


    Why get Calf Augmentation?

    Calf Augmentation

    Even with regular exercise, some people are unable to acquire the calf definition they seek. Calf augmentation may be ideal for you if you have underdeveloped calves that do not improve with training or a muscular imbalance caused by physical trauma or congenital abnormalities.

    Below are some of the benefits of calf implants:

    • Enhance and reshape the calf
    • Add bulk to your calf muscles (usually men)
    • Adjust your lower legs to be more anatomically proportionate to your thighs (usually women)
    • Add mass and definition to your calves (common with bodybuilders who’ve reached the plateau of calf development with exercise)
    • Restore symmetry if one of your calf muscles is smaller than the other or you suffer from a birth defect (such as polio, clubfoot, or spina bifida)
    • Improve your self-image and self-confidence


    Calf Implant Options

    Calf Implant Options

    Calf implants are available in a range of forms and sizes and are made of solid silicone or silicone gel. Your surgeon may place one or two implants in each leg, depending on your specific needs and desires. For this calf augmentation, fat transfer is not a possibility.

       1. Solid Silicone Implants:

    Calf implants made of solid silicone are soft and flexible, giving them the appearance and feel of actual muscle. Solid silicone implants will not leak or break since they are not formed of silicone gel or fluid. If you choose, your surgeon can order custom-carved solid silicone implants for you. When solid silicone implants are placed too near to the skin's surface, they might leave a perceptible edge (one that can be felt).

       2. Silicone Gel Implants:

    Silicone-gel calf implants are offered in symmetrical (general population) sizes and anatomical (asymmetrical) sizes, which are ideal for bodybuilders who want more dramatic volume than the average-build patient. The danger with silicone gel implants is that they will leak or tear. They can also induce capsular contracture (shrinking and tightening of the scar tissue surrounding the implant, producing discomfort, abnormal hardness, and distortion), but this is uncommon.


    Where will the Surgeon Place Calf Implants?

    Surgeon Place Calf Implants

    The calf implant will be placed either subfascially (in a space between your fascia skin tissue and gastrocnemius muscle) or submuscularly by your surgeon (within the muscle).

       1. Subfascial:

    This technique is more prevalent since it is less intrusive, less difficult, and results in a quicker, less painful recovery. Subfascial insertion, on the other hand, might occasionally result in implant rotation and a palpable implant. If this occurs, the outcome may be less than ideal since the implant dictates the calf form rather than the muscle tissue. This can happen with either silicone-gel or solid silicone implants.

       2. Submuscular:

    Because it is a more challenging surgery, its placement is less usual. Your surgeon will need to cut deeper into the muscular tissue. You can also expect a few more days of recuperation and increased discomfort. The implant, on the other hand, will be more secure and precisely implanted into the muscle. Because the calf muscles cover the implant, the visual outcome will be better and the contour will be more natural. Another advantage of submuscular insertion is that you are less likely to encounter surgical problems such as vascular or nerve damage.


    What can I expect during a Consultation?

    Patient consultations

    Because of the in-depth nature of the consultation, the initial appointment normally has a cost attached with it.

    You will have the opportunity to discuss your aesthetic goals at your initial appointment. Your surgeon will determine whether you are a good candidate for calf augmentation and explain what the procedure entails. Prepare to describe your desired alterations so that your surgeon can assist you in selecting the form and size of your implant. In addition, for your medical record, your surgeon will inspect, measure, and photograph your calves.

    You should come to the consultation prepared to discuss your complete medical history, such as your: 

    • Previous surgeries.
    • Past and present medical conditions.
    • Allergies and current medications.

    Once your surgeon understands your goals and medical condition, your surgeon may recommend alternative and additional treatments.


    What happens after the Consultation?

    After the Consultation

    Based on your goals, physical characteristics, and your surgeon’s training and experience, your aesthetic plastic surgeon will share recommendations and information with you, including:

    • An approach to your surgery, including the type of procedure or combination of procedures.
    • The outcomes you can anticipate.
    • The financial investment required for the procedure.
    • Associated risks and complications.
    • Options for anesthesia and surgery location.
    • What you need to prepare for your surgery.
    • What you can expect to experience during and after surgery.
    • Before and after photos of cases similar to yours.
    • Answers to any of your questions.

    After conducting your research and meeting with your surgeon, you should be able to make an informed choice about whether calf implants are suitable for you and whether a surgeon is a good fit. If you're still unsure how to continue, you should feel confident in asking follow-up questions or scheduling a consultation with a new surgeon.


    How do I Prepare for Calf Implant Surgery?

    Calf Implant Surgery

    To determine your surgical fitness, your surgeon will provide detailed preoperative instructions, answer any questions you may have, take a detailed medical history, and perform a physical exam.

    In advance of your procedure, your surgeon may ask you to:

    • Stop smoking before undergoing surgery to promote better healing.
    • Avoid taking aspirin, certain anti-inflammatory drugs, and some herbal medications that can cause increased bleeding.
    • Hydrate before and after surgery for safe recovery.
    • Possibly have blood and urine tests and a pregnancy test for women to prepare for anesthesia.

    Calf implant surgery is usually an outpatient procedure. You’ll need to arrange for someone to drive you home after surgery and stay with you at least the first night following surgery.


    What happens during Calf Augmentation Surgery?

    Calf Augmentation Surgery

    Calf augmentation is usually performed as an outpatient treatment. The main processes for calf implant surgery are outlined here, however they may differ based on the approach you and your cosmetic plastic surgeon choose.

    During your appointment, your surgeon will measure your legs to establish the appropriate implant size for your calves, and then order the implants for surgery.

    Before the operation, you will be given general anesthesia or highly sedated. On the operating table, you will lie face down in the prone position.

    Your surgeon makes an incision behind your knee, through the skin and fascia (a layer of connective tissue) that covers the gastrocnemius muscle.

    Once your surgeon has located the most important nerve (tibial nerve), he or she will proceed with your treatment with little fear for meeting other nerves or arteries because there aren't many in the calf area.

    The surgeon creates a tight pocket (big enough just for the implant) between this fascia and muscle before inserting the implant, or the implant may be inserted into the muscle.

    The incision is closed, and the operation is repeated on the opposite side (if needed). Following your treatment, you may be required to wear a compression garment to assist reduce edema and implant movement.


    What happens after Calf Augmentation?

    After Calf Augmentation

    After the surgery, you must be driven home by someone. You leave the hospital wearing compression bandages on your legs to maintain the implants in place and to reduce swelling (edema).

    You should follow your surgeon's recommendations for incision care as well as drainage tube care. Within two weeks, your doctor will remove the sutures (if they are not dissolvable) and drainage tube. You may remove the compression bandages at this point.


    What is Recovery like after a Calf Augmentation?

    Calf Augmentation recovery

    You will have pain and discomfort for many days following the treatment. Your lower legs will be bloated and painful. As your skin extends to accommodate the implant and expanded calf, it may seem glossy.

    Walking, while unpleasant and stiff at first, is beneficial to your recuperation. It increases blood flow to your lower legs. To avoid falls, you should have someone assist you in moving around for the first several days. By the second or third week, your walking gait should be back to normal.

    You should be able to resume most activities and return to work in two weeks. Running, riding, and weight training may require a longer recovery period.

    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.


    What will Calf Augmentation Incisions &  Scars look like?

    Calf augmentation incisions are commonly in the natural creases behind the knee. The incision length will depend on the size of your implant but usually are relatively small incisions. Typically, the bigger the implant, the larger the incision.

    After your incisions heal, your resulting scars should be barely visible. In most cases, your scars will fade and significantly improve over time, but your incision healing will depend on the steps you take to prevent infection (nutrition, not smoking, hydrating), and any underlying medical conditions or genetic tendencies.

    Aesthetic plastic surgeons make every effort to place incisions in hidden areas and minimize them, with the goal of achieving the desired results with the shortest possible scar. Special tissue handling and suture techniques further reduce scarring.


    Is Calf Augmentation Safe?

    Calf Augmentation

    Only a small fraction of persons who undergo calf implants have serious complications. A silicone gel calf implant might leak or burst in rare cases. The implant will have to be removed and replaced surgically. Both solid and gel implants can slip out of position, necessitating surgical intervention. Subcutaneous implants are more prone to movement.


    What are potential Calf Augmentation side effects?

    Calf Augmentation 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.


    Are Calf Implants Permanent?

    Calf implants can be removed. Silicone gel implants may begin to degrade over time. New implants may necessitate surgery. You may potentially require surgery to remove and replace shifted implants.


    Are Calf Implants Obvious?

    A subcutaneous calf implant with an edge that you can feel through your skin is uncommon. This implant edge could be more visible. Another operation may be required to replace or relocate the implant.

    Most calf implants, when properly positioned, offer a natural muscular appearance and feel. To conceal the scars, your plastic surgeon will make incisions in the wrinkles on the backs of your knees.



    Calf augmentation

    Calf augmentation is a technique used to improve the appearance of the lower leg. In persons who have a reduced lower leg as a consequence of accident or disease, an implant in the calf can be implanted to assist decrease the resulting deformity. Despite the fact that real leg function has not improved, the authors regard this operation as reconstructive because the purpose is to assist restore a more normal look.

    Some people have a naturally thin or undeveloped calf that remains tiny despite activity or nutrition. Calf augmentation may be requested by these patients for purely aesthetic or cosmetic reasons. Women may just want the medial or inner leg to be filled out. Bodybuilders may choose to fill out both the inner and outer lower leg.

    Calf augmentation is often accomplished by inserting a silicone rubber implant across the muscles on the medial portion of the calf. Some individuals, such as physique builders, may require a greater augmentation, in which case an implant may be put on both the medial (inner) and lateral (outer) portions of the calf.