Background and objective.

Nowadays, people currently hope to obtain a better contour and symmetry of their legs, consequently, in Plastic Surgery, we develop techniques to satisfy this demand.

We present our experience and technical variant of calf augmentation using asymmetric silicone gel implants.

Methods.

Retrospective and descriptive study of 7 years (2012-2018) in private practice evaluating results in 57 female patients with thin and/or bowed calves who underwent surgery to improve the aesthetic appearance of this anatomical area with a surgical technique in which we introduced as a variant the obliteration of the access tunnel between fasciae.

Results.

Initially, we placed the implant under the superficial fascia without closing the dissected path between the superficial and deep fascia up to the gastrocnemius, with closure in two planes and an elastic bandage. The final aesthetic satisfaction of the patients with this technique was 63.64% (7 of 11 patients). As complications: migration of the implant in 2 cases (18.18%), palpation of the implant in 3 cases (27.27%), hyperpigmented scar in 4 cases (36.36%), seroma proximal to the incision in 1 case (9.09%), partial wound dehiscence in 4 cases (36.36%), infection in 1 case (9.09%), unacceptable final aesthetic appearance in 4 cases (36.36%), re-intervention due to aesthetic dissatisfaction in 2 cases (18.18%). With these data, we modified the technique by placing the implant under the deep fascia, obliterating the dissection path between the fasciae, with directed closure and vascular elastocompression. In these cases, the final aesthetic satisfaction was 95.65% (44 of 46 patients). As complications: there were no cases of migration or palpation of the implant, seroma, infection or non-acceptance of the final aesthetic result, there was 1 case of partial hyperpigmentation of the scar (2.17%) and 1 of partial wound dehiscence (2.17%) .

Conclusions.

In our experience, placement of calf augmentation implants under the crural fascia with obliteration of the access tunnel between fasciae is an easily reproducible technique that considerably reduces complications and provides greater patient satisfaction with the results.

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