Abstract
Background
Liposuction alone is not always sufficient to correct the shape of the lower leg, and muscle reduction may be necessary.
Objective
To assess the outcomes of a new technique of selective neurectomy of the gastrocnemius muscle to correct calf hypertrophy.
Methods
Between October 2007 and May 2010, 300 patients underwent neurectomy of the medial and lateral heads of the gastrocnemius muscle at the Department of Cosmetic and Plastic Surgery, the Second People’s Hospital of Guangdong Province (Guangzhou, China) to correct the shape of their lower legs. Follow-up data from these 300 patients were analyzed retrospectively. Cosmetic results were evaluated independently by the surgeon, the patient, and a third party. Preoperative and postoperative calf circumferences were compared. The Fugl-Meyer motor function assessment was evaluated 3 months after surgery.
Results
The average reduction in calf circumference was 3.2 ± 1.2 cm. The Fugl-Meyer scores were normal in all patients both before and 3 months after surgery. A normal calf shape was achieved in all patients. Six patients complained of fatigue while walking and four of scar pigmentation, but in all cases, this resolved within 6 months. Calf asymmetry was observed in only two patients.
Conclusion
The present series suggests that neurectomy of the medial and lateral heads of the gastrocnemius muscle may be safe and effective for correcting the shape of the calves.
Level of Evidence V
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References
Tsai CC, Lin SD, Lai CS, Lin TM (2000) Aesthetic analysis of the ideal female leg. Aesthet Plast Surg 24:303–305
Moller AP (1992) Female swallow preference for symmetrical male sexual ornaments. Nature 357:238–240
Fong TH, Wong CH, Lin JY, Liao CK, Ho LY, Tsai FC (2010) Correction of asymmetric calf hypertrophy with differential selective neurectomy. Aesthet Plast Surg 34:335–339
Mladick RA (1999) Advances in liposuction contouring of calves and ankles. Plast Reconstr Surg 104:823–831 discussion 832–823
Watanabe K (1990) Circumferential liposuction of calves and ankles. Aesthet Plast Surg 14:259–269
Lee JT, Wang CH, Cheng LF, Lin CM, Huang CC, Chien SH (2006) Subtotal resection of gastrocnemius muscles for hypertrophic muscular calves in Asians. Plast Reconstr Surg 118:1472–1483
Kim IG, Hwang SH, Lew JM, Lee HY (2000) Endoscope-assisted calf reduction in orientals. Plast Reconstr Surg 106:713–718 discussion 719–720
Lemperle G, Exner K (1998) The resection of gastrocnemius muscles in aesthetically disturbing calf hypertrophy. Plast Reconstr Surg 102:2230–2236
Lee HJ, Lee DW, Park YH, Cha MK, Kim HS, Ha SJ (2004) Botulinum toxin a for aesthetic contouring of enlarged medial gastrocnemius muscle. Dermatol Surg 30:867–871 discussion 871
Tsai FC, Mardini S, Fong TH, Kang JH, Chou CM (2008) Selective neurectomy of the gastrocnemius and soleus muscles for calf hypertrophy: an anatomical study and 700 clinical cases. Plast Reconstr Surg 122:178–187
Midrio M (2006) The denervated muscle: facts and hypotheses. A historical review. Eur J Appl Physiol 98:1–21
Hwang K, Kim YJ, Chung IH, Won HS, Tanaka S, Lee SI (2003) Innervation of calf muscles in relation to calf reduction. Ann Plast Surg 50:517–522
Wang HB, Lin SQ, Xu DC, Sun ZS, Xu X, Wen GM, Luo SK (2013) Anatomic study of selective neurectomy of gastrocnemius muscle for calf reduction in Chinese. J Plast Reconstr Aesthet Surg 66:e162–e165
Park YJ, Jo YW, Bang SI, Kim HJ, Lim SY, Mun GH, Hyon WS, Oh KS (2007) Radiofrequency volume reduction of gastrocnemius muscle hypertrophy for cosmetic purposes. Aesthet Plast Surg 31:53–61
Xie Y, Li Q, Zheng D, Lei H, Pu LL (2007) Correction of hemifacial atrophy with autologous fat transplantation. Ann Plast Surg 59:645–653
Gladstone DJ, Danells CJ, Black SE (2002) The fugl-meyer assessment of motor recovery after stroke: a critical review of its measurement properties. Neurorehabil Neural Repair 16:232–240
Hwang K, Jin S, Hwang JH, Han SH (2008) Proximity of the common peroneal nerve to the tibial nerve entering the gastrocnemius muscle: the implications for calf reduction. Aesthet Plast Surg 32:116–119
Lee CJ, Park JH, Park SW (2006) Compensatory hypertrophy of calf muscles after selective neurectomy. Aesthet Plast Surg 30:108–112
Lenhart RL, Francis CA, Lenz AL, Thelen DG (2014) Empirical evaluation of gastrocnemius and soleus function during walking. J Biomech 47:2969–2974
Phisitkul P, Rungprai C, Femino JE, Arunakul M, Amendola A (2014) Endoscopic gastrocnemius recession for the treatment of isolated gastrocnemius contracture: a prospective study on 320 consecutive patients. Foot Ankle Int 35:747–756
Acknowledgments
This project was supported by a Grant from the Guangdong Provincial Science Foundation (A2007143). The authors acknowledge the invaluable participation of the patients.
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Haibin Wang and Xiang Xu have equally contributed to this article.
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Wang, H., Xu, X., Sun, Z. et al. Safety and Efficacy of Selective Neurectomy of the Gastrocnemius Muscle for Calf Reduction in 300 Cases. Aesth Plast Surg 39, 674–679 (2015). https://doi.org/10.1007/s00266-015-0535-3
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DOI: https://doi.org/10.1007/s00266-015-0535-3