Journal Logo

LETTERS

Questions about Subtotal Resection of the Gastrocnemius Muscle

Yang, Chien-Wen

Author Information
Plastic and Reconstructive Surgery: January 2008 - Volume 121 - Issue 1 - p 343-344
doi: 10.1097/01.prs.0000294962.45066.19
  • Free

Sir:

I am a medical student in Taiwan. After reading “Subtotal Resection of Gastrocnemius Muscles for Hypertrophic Muscular Calves in Asians,” by Lee et al. (Plast. Reconstr. Surg. 118: 1472, 2006), and looking for some textbooks and papers, I have three questions to ask. I have contacted several professors about them. Since their answers varied, I write this letter to obtain further information.

First, according to my knowledge, the gastrocnemius muscle is composed of fast fibers in high percentage, whereas the soleus muscle is composed of slow fibers.1 The gastrocnemius muscle also contributes to muscle power more than does the soleus muscle in plantar flexion during exercise.1 Muscle power plays an important role in balance and speed.1,2 My question is whether it will cause any problems once the patient becomes pregnant,3 ages,2 or is involved in an emergency.

Second, the article by Lee et al. declared that the patients’ muscle power was regained based on another study that used the Cybex test.4 However, the Cybex test limits the angular velocity of contraction to some preset rate that cannot be exceeded, no matter how forcefully the subject pushes the level arm.5 I am curious about whether it can test if the patient can generate equal muscle power as before.

Third, I have heard the Declaration of Helsinki in medical ethics class, and I would like to know whether this surgery was reviewed by the institutional review board based on the Declaration.

In my personal opinion, I think the definition of beauty should be judged by one’s personality rather than one’s appearance. Beauty is in the eye of beholder that comes from mind, not camouflage. However, in Asian society, soft and slim are always considered hallmarks of beauty. For example, foot binding was once a very popular procedure to make women more feminized in ancient China.

As a young Asian woman, I can easily understand the eagerness of those patients who have undergone the calf reduction operations. Nevertheless, there is still something that I worry about. I do not know if those people can meet the definition of “patients” who look for a cosmetic surgeon to deal with their appearance. I am afraid that if we do not consider the long-term potential risk of surgery thoroughly, they may someday become real “patients.”

Chien-Wen Yang

Department of Medicine

Tzu Chi University

No. 701, Sec. 3, Jhongyang Road

Hualien City 970, Taiwan

92311123@stmail.tcu.edu.tw

REFERENCES

1. Powers, S. K. Exercise Physiology: Theory and Application to Fitness and Performance. 5th Ed. New York: WCB/McGraw-Hill, 2004.
2. Spirduso, W. W., Francis, K. L., and MacRae, P. G. Physical Dimensions of Aging. Champaign, Ill.: Human Kinetics, 2005.
3. Butler, E. E., Colon, I., Druzin, M. L., et al. Postural equilibrium during pregnancy: Decreased stability with an increased reliance on visual cues. Am. J. Obstet. Gynecol. 195: 1104, 2006.
4. Kim, I. G., Hwang, S. H., Lew, J. M., et al. Endoscope-assisted calf reduction in Orientals. Plast. Reconstr. Surg. 106: 713, 2000.
5. Kottke, F. J., and Lehmann, J. F. Krusen’s Handbook of Physical Medicine and Rehabilitation, 4th Ed. Philadelphia: Saunders, 1990.

Section Description

GUIDELINES

Letters to the Editor, discussing material recently published in the Journal, are welcome. They will have the best chance of acceptance if they are received within 8 weeks of an article’s publication. Letters to the Editor may be published with a response from the authors of the article being discussed. Discussions beyond the initial letter and response will not be published. Letters submitted pertaining to published Discussions of articles will not be printed. Letters to the Editor are not usually peer reviewed, but the Journal may invite replies from the authors of the original publication. All Letters are published at the discretion of the Editor.

Authors will be listed in the order in which they appear in the submission. Letters should be submitted electronically via PRS’ enkwell, at www.editorialmanager.com/prs/.

We reserve the right to edit Letters to meet requirements of space and format. Any financial interests relevant to the content of the correspondence must be disclosed. Submission of a Letter constitutes permission for the American Society of Plastic Surgeons and its licensees and asignees to publish it in the Journal and in any other form or medium.

The views, opinions, and conclusions expressed in the Letters to the Editor represent the personal opinions of the individual writers and not those of the publisher, the Editorial Board, or the sponsors of the Journal. Any stated views, opinions, and conclusions do not reflect the policy of any of the sponsoring organizations or of the institutions with which the writer is affiliated, and the publisher, the Editorial Board, and the sponsoring organizations assume no responsibility for the content of such correspondence.

©2008American Society of Plastic Surgeons