Calf Reduction by Partial Resection of Gastrocnemius Using a Suction-Assisted Cartilage Shaver

摘要

Background: Long-term aesthetic reduction of the legs in Asians is gaining increasing popularity among cosmetic patients. Current treatment options include botulinum toxin injection, radiofrequency, neurectomy, and total, subtotal, or partial muscle resection of the gastrocnemius. Partial resection using Kelly forceps was introduced in 2000. This article presents the use of a suction-assisted cartilage shaver to perform partial resection, describing the procedures and shaver modifications and evaluating its use. Methods: A retrospective review of 71 cases with a minimum 6-month follow-up (average, 36.5 months; range, 6 to 160 months) was performed. Twenty partial calf reductions were performed with a short shaver, 27 with a long shaver, and 24 with an endoscope-guided long shaver. Results: Mean reduction of calf circumference was 2 cm (range, –1 to 6 cm); the mean preoperative and postoperative calf circumferences were 35.8 cm and 33.8 cm, respectively. Mean tissue reduction per calf was 110 g (range, 25 to 300 g).Two patients developed larger calves after surgery, one because of weight gain and the other because of weight training. Complications included surface irregularity ( n = 4, 5.6 percent), numbness over the lateral ankle or lateral foot ( n = 9, 12.7 percent), hematoma clot requiring surgical evacuation ( n = 11, 15.5 percent), prolonged seroma ( n = 2, 2.8 percent), and left ankle plantar-flexion contracture due to tight, sustained postsurgery bandaging ( n = 1, 1.5 percent). Scar-related complications were hyperpigmentation ( n = 6, 8.5 percent), depressed scars ( n = 5, 7 percent), and hypertrophic scars ( n = 2, 2.8 percent). Conclusions: Short, long, and endoscope-guided long suction-assisted cartilage shavers for partial resection of calf muscles can be used effectively to reduce the calf. Several mostly treatable complications were noted. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.