Liposuction on calves may seem to be a chip shot. However, it should be approached with much caution. To begin with, the calves are the most distally located body part on our body other than the feet from the heart. This makes blood flow to this region most compromised. When you consider this fact with the side effect of liposuction that is associated with irritating microvessels, then you can appreciate our concern! Concerns of inadequate blood flow are further compounded by the fact that the lower leg where the calves are located is tight and encircled by the skin. This means any amount of swelling is likely to cause a tourniquet effect and further compromise blood flow. To make matters worse, the back of the lower leg where the calve muscles live is bordered by very important nerves and vessels that cannot be injured.
Medially, these vital structures include the great saphenous vein and branches of the saphenous nerve. Laterally, these vital structures include branches of the lateral sural nerve. The goal of liposuction on calves involves improving the definition of the medial and lateral gastrocnemius bellies. The medial belly is wider and extends lower whereas the lateral belly is narrower and shorter. Specifically, the fat that is located over the soleus muscle is the fat that must be removed in order to improve the gastric muscle definition. The soleus muscle actually provides a guide to the limits of liposuction; as such, liposuction should be limited to the medial and lateral borders of the soleus muscle in order to avoid injury to the bordering vital structures.
The port site for liposuction on calves is actually positioned at the central junction of the medial and lateral gastrocnemius bellies. Central structures that must be preserved include the medial sural cutaneous nerve and the small saphenous vein proximally and the Achilles tendon distally. Now you can appreciate why I am so keen on performing only conservative liposuction of this region. Despite the technicality and conservative approach, the results of liposuction on calves can be remarkable.