Radiofrequency Volume Reduction of Gastrocnemius Muscle Hypertrophy for Cosmetic Purposes

Abstract

Muscularly prominent calves, caused mainly by hypertrophy of the gastrocnemius muscle (GCM), are prevalent among Asian women, and this condition can be a significant factor leading to psychological stress. The authors have devised a method for contouring the calf using radiofrequency (RF) applications to the GCMs to correct thick, muscular legs. This study was performed to investigate the effects of RF energy in reducing enlarged GCMs for 250 patients (249 women and 1 man) who sought aesthetic consultation for problems such as thick, muscular, asymmetric, or bowed calves. The operations were performed from June 2004 to April 2006. The patients first received a local anesthetic and sedation. After application of RF current, the prominent muscular contours improved, and the GCMs were contoured to an appropriate proportional volume. The range of the reductions in the calf circumferences at their thickest levels was 1 to 6 cm (mean, 2.5 cm) during the follow-up visits 6 months after the procedures. Most of the patients could return to their activities of daily living, except for exercise, after 1 to 7 days, and they were satisfied with the improved aesthetic contour lines of their lower legs. Clinical photography and ultrasonic examination were performed, and the leg circumferences were measured. Radiofrequency-induced coagulation tissue necrosis of the muscles caused no functional disabilities, and the clinical improvement was well maintained after the treatments for up to 17 months of follow-up evaluation.

Ankle Plantar-Flexion Contracture Complication After Aesthetic Calf Volume Reduction Procedure

“…2 Trends have shifted from invasive partial or total muscle resection toward lessinvasive procedures such as botulinum toxin injection, selective neurectomies, chemical, and radiofrequency ablation. 1,4,5,7,8 Clinicians have used nerve-sacrificing procedures with reconstructive surgical experiences in mind, that sacrificing gastrocnemius and hemisoleus muscles have minimal functional consequences. 12,13 Published postoperative gait analysis results indeed show no significant functional deterioration after selective neurectomy.…”

“…Chemical blockade of the involved nerves and radiofrequency ablation of gastrocnemius have also been described. 7,8 This often leads to muscle atrophy and volume reduction of the denervated muscles. Previous articles report a 1-to 4.6-cm reduction of calf circumference as early as 6 months after the operation with minimal functional deterioration of the lower leg.…”

A pilot study comparing the efficacy of two formulations of botulinum toxin type A for muscular calves contouring

“…This enlarged calf might be due to fat accumulation and/or muscle hypertrophy. Calf‐contouring is a condition that used to be neglected and now is getting into attention . Several invasive surgical methods had been attempted for reducing the calf circumference, but there are some considerable disadvantages, such as the risk associated with anesthesia, postoperative hemorrhage, edema, hematoma, infection, scarring, sensory impairment and surface irregularity .…”

“…Calf‐contouring is a condition that used to be neglected and now is getting into attention . Several invasive surgical methods had been attempted for reducing the calf circumference, but there are some considerable disadvantages, such as the risk associated with anesthesia, postoperative hemorrhage, edema, hematoma, infection, scarring, sensory impairment and surface irregularity . Liposuction, on the other hand, may not be much of useful because the shape and the size of calves are determined mainly by the gastrocnemius muscle rather than by subcutaneous fat …”

Safety and Efficacy of Selective Neurectomy of the Gastrocnemius Muscle for Calf Reduction in 300 Cases

“…The diagnosis of gastrocnemius hypertrophy was based on the observation of prominent muscular calves when the patient stood on tiptoes, and patient distress relating to the shape of the calves [14]. Inclusion criteria were: (1) the patient had normal flexion and extension of the ankle and knee joints; (2) the patient accepted selective neurectomy of the gastrocnemius muscle as the only therapeutic approach; and (3) the patient was followed up for at least 12 months.…”