Lower Leg (Ankle, Calf and Knee) Slimming


Thickness of lower legs can be troublesome for many women more than thought. When we say “lower legs”, we mean the knees, calves and ankles. (Now there is a term of “cankle”, that is for the calf and ankle together.) Many women, even if they are very thin or fit, can complain about the thickness of their legs. They express their utter about being unable to wear the dress or skirt they want, or choose a shoe that they like. Especially the fat tissue around the ankle can quite be depressing because stilettos or flats do not look good on their feet. The thickness in the calf area may also be problematic, especially in choosing boots; so many women have to buy custom-made boots that fits their legs. The fat tissue around the knees makes a straight column appearance and the kneecap stays undefined. A nice lower leg can be described as a defined kneecap, nice curves and transitions of this area, a slim and long calf area in a good shape (no X-bind or O-bind deformity) and thin ankles without any fat tissue falling on the foot.


So… Is there a solution of this stressing condition that upsets many women? What can be done to have slimmer, thinner legs with better and defined shape? Why doesn’t every cosmetic surgeon treat lower leg deformities? What are the risks of lower leg liposuction? What are the benefits of “Cankle Aesthetics”? Now we will answer these questions and more.


The answer of the first question is, yes, fortunately, there is a solution. But, how? To understand better, we will first take a short glance at the lower leg anatomy. On our legs, we have bones, muscles, fat tissue and we have our skin that covers them all. A thick leg is mainly caused by three factors: 1- Thick leg bones 2- Muscle hypertrophy (enlarged muscles) of the lower leg muscles and 3- Fat tissue between muscles and skin. As we cannot change the thickness of the bones, we must focus on reducing the volume of muscle or fat to obtain a nice, slim leg.  Fat reduction is the easier and safer part of this idea. Fortunately, with liposuction (either with classical, laser or vaser suction) it is possible to get good results of a thinned knee, defined kneecap, a slimmed and nicely curved calf, and thinned nicely shaped ankle. The result of this surgery depends on the proportion of the muscle and fat tissue. If there is muscle enlargement of the legs, the patient will still benefit from the operation but not as the one with more fat volume and less muscle volume. So the question is; is there a way to reduce the muscle size? The answer is complex. There are some techniques that damage the nerve that works these muscles or directly remove of a part of the muscle and thus reduce the volume of the lower leg. However these techniques are not as safe as fat removal and they do not afford the risk taken for an aesthetically targeted procedure. The nerve ablation and muscle removal may endanger the functions of the leg and may cause irreversible muscular impairment. Only one option is left to reduce the muscular content: Calf botox. This only works in the calf area and does not work on knee or ankle because there is very little muscle bulk there to thin. The widest application of botox is in face rejuvenation and wrinkle treatment, and it can be also used in many areas on the body with different implications. Here, the botox is applied on the main leg muscle named as “Gastrocnemius Muscle” to temporarily and partially reduce its function and volume. The advantage of botox for the Gastocnemius Muscle Hypertrophy is that it can be safely applied and does not intervene with walking functions and does not cause complications. The disadvantages are the temporary effect that lasts 6 months and necessitates repeats, until the muscle goes to atrophy after 6-8 injections. To stick to that kind of treatment sometimes can be boring and frustrating for the patient. However, it is very beneficial in the population that has mainly muscle thickness and lower fat proportion.


As we discussed the risks of the muscle manipulation, the most logical approach remains as the liporeduction of the legs. But there are still some questions: Is it risky to have lower leg liposuction? Are there any complications? Why do some aesthetic surgeons avoid from this operation? Is it worth to have this surgery?


Lower leg liposuction is a special procedure that bears some risks and requires experience and confidence especially on this part of the body. The reason of this is the risk of “deep vein thrombosis (clotting of the blood within the veins)” and it can be fatal if the necessary precautions are not taken. Some people are vulnerable to blood coagulation because of their genetic background or the drugs that they use. It is important to know it before operation and do the necessary test to eliminate such condition. Anticoagulants are given in necessary doses and the operation is done in special positions. In the postoperative period, patient uses pressure garments for legs to squeeze the leg veins for precaution. The amount of the solution given for liposuction is carefully adjusted. After the surgery, the anticoagulant treatment goes on for three days. (May be longer depending of the patient) Legs are elevated, walking is encouraged and diuretic drugs, painkillers and antibiotics are used. When the necessary care is taken the risk is minimal for this operation. Many surgeons avoid performing lower leg suction because of these risks. Experience is of utmost importance to foresee and manage any upsetting situation.


Well we talked about the risks, that might be a little nerving now let’s get to the benefits. Why do so many women are seeking for a clinic or surgeon that does this operation?  How come they travel to a country from the other side of the world?  The answer is; this lower leg thickness makes women unhappier than thought. They are searching for a trustable, caring and experienced surgeon with an reliable surgical period, with minimal risk and maximum comfort.