Calf reduction — the one operation on this site where walking is part of the result

Calf reduction is surgery to reduce the thickness of the calf.

Half of this page goes to a distinction, because what is making it thick changes the operation completely.

• subcutaneous fat — the territory of liposuction. It cannot be undone either, but little of it touches function.
• muscle (mainly the gastrocnemius) — this is the body of the page. Reducing muscle means cutting a nerve or removing part of the muscle.
• the thickness of the bone and the axis of the leg — not a matter of surgically reducing thickness. That belongs to another kind of consultation.
• swelling — if what looks thick is oedema, the cause comes first.

When this operation is discussed in Korea it is usually the muscle route. And that is what has to be written most heavily among the surgery pages on this site. For one reason.

The calf muscle is used for walking.

The other surgery pages here mostly deal with shape. With double eyelid, rhinoplasty or buccal fat, a result you dislike does not affect walking. This one is different. The gastrocnemius points the foot down, and it is used to walk, run, climb stairs and stand on tiptoe.

There are broadly two methods.

One, blocking or cutting the nerve. Cut the nerve branches to the muscle and the muscle goes unused and shrinks over time. A cut nerve cannot be undone.

Two, removing part of the muscle. Reducing it directly. Muscle that has been removed does not come back.

Either way it cannot be undone. And reducing muscle with botulinum toxin is not this page — that comes back after a few months. Talk through in a consultation the order of trying a reversible route first.

This site does not deal in prices, clinics or reviews.

Walking is the heaviest item in this operation. Reduce a muscle and what that muscle did is reduced. Feeling short of power when walking or running for long, climbing stairs, or standing on tiptoe has been reported. How much remains depends on how much was reduced.

It matters especially if you do sport. If you run, hike, dance or play ball sports — anything with a lot of pushing off from the ankle — say so before surgery.

A cut nerve cannot be undone. And how much nerve to cut is hard to fine-tune on the table.

A difference between the sides can remain. The muscle mass of the two legs differs to begin with. And legs are compared with each other.

The shape can end up uneven. Reducing only part of a muscle can leave a visible border with what remains, showing especially when you tense.

Sensation can change. Nerves serving the calf and foot pass near the operative field.

Collected blood, infection and deep vein thrombosis are reported. If one leg alone swells and hurts, or you become breathless, seek emergency care immediately.

Swelling lingers here. The leg is at the bottom of gravity, so swelling is slow to go. Judging the final shape takes six months to a year.

Walking is restricted for days to weeks. Put it in your plans in advance.

Establish first what is making it thick. That is the most important sentence on this page. Standing on tiptoe shows how much the muscle bunches, and in a consultation ultrasound can separate the thickness of muscle from fat. Different causes, different operations.

Talk about a reversible route first. Reducing muscle with botulinum toxin comes back after a few months. There is an order in which you first see, reversibly, how much slimmer suits your own eye. Ask in a consultation whether that order suits you.

Ask which method will be used. Cutting the nerve, removing muscle, or taking only fat. They differ in how far they can be undone and how far they touch function.

Say what sport you do. If you do something with a lot of pushing off from the ankle, that belongs in the decision.

Look at both sides together. Reducing one side alone makes the difference more visible.

Not smoking matters. The leg is slow to heal.

Check in advance how long walking is restricted and how long compression garments are worn.

Wait for the swelling to go. Six months to a year. Deciding before that, because it 'did not reduce enough', is the dangerous move.

Of the surgery pages on this site, this is the one where function is part of the result. The others discuss whether you like the shape. This page has to discuss shape and function together. Writing that difference down is what this site can do.

It cannot be undone. Neither a cut nerve nor removed muscle comes back.

Muscle decreases on its own with age. The buccal fat removal page here makes the same kind of point — an operation that moves the same way age does has to be thought about twenty years out.

What counts as a good calf varies greatly with culture and fashion. This site does not say which calf is good. It says what changes, which of those changes cannot be undone, and which of them touch function.

The result is hard to agree from photographs. A calf looks very different tensed and relaxed. Look at both states and talk about both.

Whether to have it done is settled with a doctor, and it is better not to settle it on one consultation alone. Especially for this one.