Aesthetic Plastic Surgery

, Volume 43, Issue 4, pp 973–979 | Cite as

Surgical Calf Augmentation Techniques: Personal Experience, Literature Review and Analysis of Complications

  • Dario MelitaEmail author
  • Alessandro Innocenti
Original Article Body Contouring



More attention is paid to calf appearance, both in males and females, and several surgical techniques are available. Different studies have been published over time for calf augmentation, but, to the best of our knowledge, no comprehensive literature review and complications analysis have been published.


The aim of the study is to analyse the overall complication rate of calf augmentation surgical procedures and complication rates associated with the investigated techniques, namely subfascial implant placement, submuscular implant placement and fat grafting or lipofilling. Demographic analysis, including age and gender, is also performed.

Materials and Methods

A literature review on the PubMed database was performed for clinical studies regarding calf augmentation surgical procedures. The authors selected and analysed 26 articles among the actual literature on this field and reported personal experience in calf augmentation surgery.


Twenty-six studies, published from 1993 to 2018, were included in the study for a total amount of 1498 patients, with a total of 2629 calves treated. Three different surgical techniques have been reviewed, excluding medical procedures: subfascial implant augmentation (n = 1929), submuscular implant augmentation (n = 435) and fat grafting (n = 265). The overall complication rate was 4.4883%. Calf augmentation with subfascial implants presented a total complication rate of 5.702%. The submuscular implant placement complication rate was 0.92%. Fat grafting presented a global complication rate of 1.509%.


Calf augmentation, with all reviewed surgical techniques, has a low rate of complications compared to other body contouring procedures, but a high rate of satisfaction among patients. Fat grafting has the lowest rate of complications, but multiple sessions are required. Specific complications of implants, such as capsular contracture, malposition or rupture, are less common compared to the use of implants for other cosmetic purposes. Procedures should always be performed by experienced plastic surgeons.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


Calf augmentation Calf implants Lipofilling Body contouring 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

For this type of study, informed consent is not required.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2019

Authors and Affiliations

  1. 1.Plastic and Reconstructive MicrosurgeryCareggi University HospitalFlorenceItaly

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