Recently, hypertrophic calf can be said to be a common aesthetic problem in Korean women, and classified into muscular, fatty, and mixed types according to the relative distribution of muscle and subcutaneous fat. Until now, many surgical methods including liposuction have been introduced for calf contouring.
The authors had performed selective neurectomy of motor nerve branched to medial gastrocnemius muscle for hypertrophic calves of muscular or mixed type in 65 cases of 33 patients from January 1998 to December 2000. Under local anesthesia, horizontal 3 cm incision was made on popliteal crease and selective neurectomy of motor nerve branched to medial gastrocnemius muscle was done. In 9 cases(13.8%), we could observe the anatomical variation that the number of motor nerve branched to medial gastrocnemius muscle was more than one. The average result of reduction of maximal calf circumference at the time of 2 weeks, 1, 2, 3, 6, 12 months after the operation was 8, 9, 15, 20, 22, 23 mm. The average result of reduction of maximal calf circumference at the time of 3 months after the operation was 23 mm in muscular type and 17 mm in mixed type. We could obtain the good results in muscular type than in mixed type. There were no specific complications such as walking instability, numbness, or weakness of ankle strength.
In conclusion, through our clinical experience of 65 cases, we were able to prove that selective neurectomy is a effective, satisfactory method in esthetic and functional aspect for hypertrophic calves of muscular and mixed type.