Eligible patients are categorized under 3 groups:

Patients with prior polio: In case one of the limbs were affected, there is a difference with regard to the diameter and foot size (shoe size) between the two legs of these patients. The asymmetry between two legs may be corrected by placing the implant in the calf muscle (gastrocnemius) of the affected leg. In case both limbs were affected, implants can be placed in both legs.

Ladies with thin, crooked-legs (knock knees) (bandy legs problem) and men with bow legs (genu varum): Very thin legs of women are referred to as bandy legs problem in the colloquial language. Another problem faced by women patients is the crooked appearance of legs (knock knees) due to insufficient development of the inner muscle in the calf. This situation may be corrected by placing a calf implant in the area, thus reconstructing the calf and closing the gap between the two legs. In this way. Same deformity encountered in men patients (genu varum) is referred to as bow legs problem in the colloquial language. This situation may also be corrected using silicone calf implants.

Those engaged in bodybuilding: The gastrocnemius muscle, which gives the calf a plump appearance, is difficult to develop. It is quite obstinate. Although bodybuilders develop other muscles of their body, their calf muscles may not develop at the same rate. In this case, the desired image of the legs can be provided by placing the implant in the calf muscles.

Patients with prior polio usually suffer a developmental retardation with regard to the muscles of the affected leg which causes that leg to remain weak. Due to insufficient development of the gastrocnemius muscle, the calf diameter is lower compared to the healthy leg. The patient may suffer a gait disorder resulting from the loss of muscular strength and may be dragging one leg slightly.

A surgical procedure in which an implant is inserted into the calf muscle may correct the difference in diameter between the legs however this will not help the loss of muscular strength. The intervention be performed will only correct the outlook (loss of muscular strength in the lower limb will not improve). Patients who avoided wearing skirts and shorts before the surgery shall begin to wear patterned socks, skirts or shorts, as the asymmetry between their legs is corrected.

An important point that should be notified to these patients is: the recovery period lasts much longer compared to patients applied only because of the crooked leg/knock knees problem without a prior polio. There are several reasons for this outcome. First; these patients may need two implants to be inserted; one each into both medial and lateral gastrocnemius muscles. They already have lower muscular mass and muscle strength due to history of poliomyelitis. When 2 implants are placed into that paralyzed leg, the leg muscle, the fascia (membrane) of the muscle and the skin will be rather stretched. Therefore it takes longer for these patients to regain their preoperative gait (which is already distorted because of prior polio) compared to non-paralyzed patients. This recovery period can sometimes reach 2-3 weeks.

In some patients with prior poliomyelitis, the leg is affected from the hip down; the outlook of the leg is thin beginning from the hip down to the ankle. I refer to these patients as "patients with a progressive post-polio syndrome (PPS, poliomyelitis sequelae)”. Even in these cases, it is possible to augment entire leg from the hip down and correct the asymmetry between two legs. This aesthetic correction may require several sessions of fat injection and replacement of the implants in the future. Another problem with these patients, besides the thinness of the affected leg, is: the sturdy leg is well-built and more muscular than the other. As patients get used to walking by lying heavy on their sturdy legs, the muscles of the sturdy leg will remain strong and this will further deteriorate the asymmetry between the two legs. Even this situation may be corrected. Fat injection is applied to the upper part of the knee in the limb affected by polio, while fat is grafted from the other leg. On the other hand, augmentation below the knee is performed with a calf implant. Please see the following video about this surgery:

If you cannot view the video below, click here to watch it on YouTube.

Many female patients suffer from this problem, however they do not know that it may be corrected. It is the development retardation with regard to the calf muscle that gives the legs a distorted appearance. This condition causes a distorted appearance, where there is a distance between two calves ('Bow' legs or genu varum deformation). Due to this problem, ladies avoid wearing short skirts; they hide this appearance of their legs with a long skirt or pants. Surgically inserting a calf implant into the inner calf muscle (gastrocnemius) of both legs will correct this problem. The opening between the two calves is corrected, the legs attain a more feminine outlook and the distorted appearance is resolved.

Developmental retardation with regard to the calf muscle causes the legs to remain thin. This condition causes a distorted appearance. Legs will have a bandy look when a short skirt or shorts are worn. However, the fullness of the calf muscles and the curvature provided by this fullness give the legs a feminine/sexy look. Under normal conditions, the calf circumference (measured from the widest area) should be 34-36 centimeters. The legs of a person with a calf circumference of 32 centimeters and below may be mentioned as thin. For sure, it would be wrong to expect both legs to be the same size one-on-one. Usually there is a difference of 2-3 cm. between the two legs. This is normal. In the event that this difference does not attract attention when viewed from outside, it does not create a problem from an aesthetic point of view; it is considered normal.

Another cause of crooked legs is the curvature of the leg bones. If there is an (O) shaped curvature in the leg bones, the two legs will still appear separated. This condition is actually more common in men and is known as football player's leg. Instead of correcting the curvature of the leg bones, camouflaging the curvature with calf implants will give more practical results (cutting and correcting crooked leg bones is a much more painful, long-lasting and risky treatment). A calf implant placed in the gastrocnemius muscle in both calves ensures that the gap between the two legs is closed and the crooked leg appearance disappears.

Under normal conditions, patients can regain their gait usually within 7-10 days after this surgery.

Patients engaged in bodybuilding acknowledge that calf muscles are resistant to development. No matter how hard you work out, this muscle may not develop as much as desired. In such cases, calf augmentation is performed using specific silicone calf implants. It is important to keep in mind that asymmetric implants usually provide a muscular appearance. Asymmetric implants are recommended in these cases as they provide a muscular appearance.

In addition to calf augmentation, other cosmetic surgery procedures preferred by athletes working out for bodybuilding are pectoral implant surgery (for defining the chest muscles) and gluteal implant surgery (procedure for defining the butt region). All of these surgeries are usually bloodless, completed in a short time and have a high satisfaction rate.

Op. Dr. Oytun İdil

(Plastic, aesthetic and reconstructive surgery specialist)

• Whatsapp: +90 533 569 0649    +90 553 985 8087
• E-mail: oytunmd@gmail.com
• Op. Dr. Oytun İdil: +90 533 569 0649
           +90 505 296 5569
• Asistant: +90 553 985 8087
• Office line: +90 212 296 3656
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  Nişantaşı, şişli - Istanbul / Türkiye