Will the skin rebound after gastrocnemius muscle removal surgery? Will it leave scars?

Author: Fan Jincai, Chief Physician, Plastic Surgery Hospital, Chinese Academy of Medical Sciences

Reviewer: Fan Jufeng, Chief Physician, Beijing Chaoyang Hospital, Capital Medical University

Many women who love beauty are troubled by thick calves. There is a surgical method that is more thorough and effective in slimming down the calves. The calves are slimmer and the effect is immediate. This surgery is the calf gastrocnemius muscle removal. Because the muscle is removed, it will not rebound. It is a more thorough surgical method.

When the calf muscles are enlarged to a certain extent, especially regionally, with severe inward, outward or posterior convexity, if calf slimming by botulinum toxin injection and simple nerve division cannot achieve the desired effect, you can consider removing the entire gastrocnemius muscle together with the nerves and blood vessels.

The gastrocnemius is one of the posterior muscles of the calf. It is located tightly under the skin and is divided into the medial and lateral heads. The medial head originates from the medial condyle at the lower end of the femur, and the lateral head originates from the lateral condyle at the lower end of the femur. It goes down to join the triceps of the soleus muscle, forming a bulging calf at the upper part of the calf, and then continues to the Achilles tendon and ends at the calcaneal tubercle. The gastrocnemius and soleus muscles have three heads in total, also known as the triceps surae.

Figure 1 Original copyright image, no permission to reprint

The most common gastrocnemius muscle removal surgery for slimming the calf is the removal of the medial head of the gastrocnemius muscle. After the removal, not only the medial shape will be improved, but also the lateral shape. Because the medial head and lateral head of the gastrocnemius muscle are combined, after the medial head is removed, the lateral head will move to the middle due to the squeezing effect, so the lateral shape can also be improved, which is a major advantage.

Gastrocnemius muscle removal surgery usually uses a small incision, which is usually on the horizontal line of the popliteal fossa, about 5 cm. Through cosmetic layered tension-reducing suture, the scar is reduced to a minimum. The ideal result is a wrinkle-like scar. After half a year to a year, the scar is completely integrated with the popliteal transverse line, which looks more beautiful.

Figure 2 Original copyright image, no permission to reprint

After surgery, we have some preventive measures for patients with scar-prone constitution, including first-line treatment measures to prevent scarring, local application of some silicone products, anti-scar products, and wearing elastic stockings for six months to one year. If the scar is excessively proliferating, scar injection treatment can also be performed, including dye laser treatment, which is helpful for early recovery and morphological restoration.

Is there a big risk in gastrocnemius muscle removal for calf slimming? Before the operation, an assessment should be conducted to measure the length and circumference of the calf, and make morphological and aesthetic judgments; through magnetic resonance imaging and CTA (CT angiography), the muscles can be deeply understood; the general condition of the whole body can be understood, and auxiliary examinations can be used to determine whether the surgery can be tolerated to ensure the safety of the surgery.

The commonly used anesthesia method for surgery is general anesthesia. The muscles are in a very relaxed state, which greatly reduces the difficulty of the surgery. The entire operation takes about 2-3 hours. Calf gastrocnemius muscle removal uses a small incision and is performed when the visual field is not fully exposed, so the operation time is relatively prolonged. The operation requires the severance of muscles, blood vessels, and nerves, and the complete removal of muscles. You must stay in bed for one week after the operation to prevent the vascular ligation site from slipping. You can move around the bedside one to two weeks after the operation, and you can work normally 3-4 weeks after the operation. You often need to wear elastic stockings after the operation. Generally, elastic stockings are worn for at least 3 months. If anti-scar treatment is required, they are generally worn for 6 months.

If one or both heads of the gastrocnemius muscle are removed, its function can be replaced by other muscles, so daily life will not be affected, such as climbing mountains and stairs. However, if you do competitive sports, it may be affected because the calf strength will be weakened. This is something everyone needs to pay attention to.