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Safety and Efficacy of Subfascial Calf Augmentation

Andjelkov, Katarina M.D., Ph.D.; Sforza, Marcos M.D.; Husein, Rodwan; Atanasijevic, Tatjana C. M.D., Ph.D.; Popovic, Vesna M. M.D., Ph.D.

Plastic and Reconstructive Surgery: March 2017 - Volume 139 - Issue 3 - p 657e–669e
doi: 10.1097/PRS.0000000000003120
Cosmetic: Original Articles

Background: Calf augmentation surgery is one of the least popular procedures among plastic surgeons; in contrast, it is by far one of the most gratifying procedures among patients. In this article, the authors present a retrospective analysis of a surgeon’s extensive experience with calf implants.

Methods: The authors retrospectively analyzed 134 patients having calf augmentation for cosmetic and reconstructive surgery in their practice from 2003 to 2015. All patients were divided into two groups: primary cases and patients who had previously been operated on and who were referred to our service as patients who had complications after calf augmentation surgery. The subfascial approach was the preferred approach by authors for all primary cases. The authors analyzed indications, complication rates, results, and pitfalls. Secondary cases were further divided into three groups according to the origin of the problem and some possible solutions.

Results: Subfascial calf augmentation surgery is safe and easy to reproduce, with a short recovery period and a low complication rate (<1 percent). To achieve the best aesthetic results, surgeons should choose appropriate implants for each case. In secondary cases, fat grafting is a powerful tool and can be used alone or in combination with calf implants.

Conclusions: There are several groups of patients seeking calf augmentation surgery (e.g., bodybuilders, women, those with reconstructive problems). Therefore, treatment should be planned individually. The development of a new implant is necessary and should be based on detailed anatomical findings and in accordance with surgical techniques. The process is intriguing and rewarding.


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Belgrade, Serbia; Ponte-Nova, Brazil; and Leeds, United Kingdom

From the BelPrime Clinic, the Faculty of Medicine, University of Belgrade, and the Institute of Forensic Medicine; Faculdade Dinamica; and the University of Leeds.

Received for publication April 26, 2016; accepted September 9, 2016.

Disclosure: The authors have no financial interest to declare in relation to the content of this article. No financial support or benefits have been received.

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Katarina Andjelkov, M.D., Ph.D., BelPrime Clinic, Ohridska 16, Belgrade 11000, Serbia,

©2017American Society of Plastic Surgeons