Endoscope-assisted calf reduction in Orientals.

In general, Oriental women have shorter legs and thicker calves than Caucasian women. Moreover, the thicker their calves, the shorter their legs appear to be. As a result, they might be reluctant to adopt certain fashion styles (shorter skirts) or they may feel conspicuous in beachwear. To date, no practical aesthetic method of lengthening the legs or thinning the calves exists, with the exception of liposuction. However, liposuction does not solve the problem of muscularly prominent calves, because the shape and size of the calves are determined mainly by gastrocnemius muscle rather than by subcutaneous fat. The authors have devised a method of contouring the calf by partially shaving the calf muscle. Through two horizontal incisions (less than 2 cm) in the popliteal fossa, dissection is deepened to the crural fascia, and the fascia is incised. The fascia is easily separated from the gastrocnemius 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 taken not to injure the medial cutaneous nerve and the saphenous vein in the midline. Between October of 1994 and June of 1998, 115 calf reductions were done. The differences between preoperative and postoperative circumferences in the most prominent regions of the calves were 3.0 to 7.0 cm, and prominent muscular contours disappeared. There were no major complications and only a few transient minor complications, such as localized hematoma and surface irregularity. A postoperative Cybex test of ankle power showed strength near the preoperative normal level from 6 months to 1 year after the operation.