Subtotal resection of gastrocnemius muscles for hypertrophic muscular calves in Asians.

ABSTRACT

BACKGROUND: Many Asian women are bothered by plump calves, which they consider to be unsightly. In the past, liposuction was frequently performed to treat oversized legs, but little effect could be obtained if the condition was caused by hypertrophy of calf muscles. METHODS: Gastrocnemius muscle resection for hypertrophic muscular calves was performed in 20 patients at Buddhist Tzu Chi General Hospital from May of 2001 through September of 2004. One patient underwent resection of the medial head only, two underwent total resection of both medial and lateral heads, and the other 17 patients underwent subtotal resection with preservation of the proximal 4 to 6 cm of muscle of both heads. RESULTS: The resected gastrocnemius muscle weighed from 250 to 430 g per calf (mean, 343 g). The maximal calf circumference was between 32 and 41 cm (average, 35.2 cm) preoperatively and 26 and 35 cm (average, 30.5 cm) postoperatively. Calf reduction was 3.5 to 7 cm (average, 4.7 cm), or 10.1 to 21.2 percent (average, 13.3 percent). Two patients developed seroma and three developed late hematoma. One patient had dragging of one foot because of incidental severance of the nerve to the soleus muscle that lasted for 6 months, until complete recovery occurred. No patient complained of functional deficits during gait or sports activities after 3 to 6 months. CONCLUSIONS: Subtotal resection of both heads of the gastrocnemius muscle can result in satisfactory calf reduction without impairment of leg function and avoid hollow deformity in the popliteal fossa. Five patients still had scar problems during the short-term follow-up period, but all were rather satisfied with their reduced calf sizes.