Expert Doctor

Calf Implants

Calf implants are used to improve the look of the legs, as well as the entire body, by adding proportion and definition to the lower legs. Also known as calf augmentation, calf implants can be considered a cosmetic and reconstructive surgery. Implants can add fullness and definition to enhance the appearance of the legs and correct muscle imbalance which often occurs because of physical defects. By inserting a soft implant made of FDA-approved solid silicone into the calf, patients can benefit from the look of a higher definition calf muscle where they once lacked proportion. Calf implants will not hinder the ability of the patient to work out and build more leg muscle but they can provide a muscular pair of legs.

Am I a Good Candidate for Calf Implants?

GOOD CANDIDATES for calf implants include:

  • A male or female with unshapely calves
  • Patients who would like to have more developed-looking muscles
  • Patients who are at, or near their ideal weight, and are already somewhat muscular
  • Those who wish to surgically enhance the definition of their calves without exercise
  • Patients who have a birth defect, or were involved in an injury where one leg muscle is smaller than the other, can create symmetry between the two legs with calf implants
  • Patients who suffer from club foot (a range of congenital foot abnormalities where the foot is twisted downward and inward) may use implants to treat the lack of muscle bulk
  • People who want to improve the proportion of their entire appearance by adding volume to their slim calves
  • Patients who suffer from Charcot-Marie-Tooth disease (CMT), which can cause a loss of muscle in the calves, may benefit from implants to restore the contour of the lower legs

Those who are NOT GOOD CANDIDATES include:

  • People with chronic skin infection of the legs
  • Patients with poor circulation or chronic swelling of the lower extremities
  • Those with unrealistic expectations that expect “perfect calves” or request larger than what will safely fit
  • People with a history of bleeding or blood clotting disorders

How is a Calf Implant Performed?

Prior to the procedure, the patient will meet with the surgeon for a consultation. Since there are several sizes of implants, the patient will choose the most appropriate implant to meet his or her goals. Implants that are tapered all the way around the edges typically have a more natural appearance. Implants that have a rounded edge do not easily blend into the tissue and this can cause the lump and outline of the implant to be more visible and look unnatural.

Calf implants are generally performed on an outpatient basis and the procedure takes up to 3 hours to complete. The patient will lie on their stomach during the procedure and general anesthesia is administered. The surgeon makes an incision in the natural crease behind each knee to allow the implants to be inserted without creating a significant scar. The surgeon will create a pocket within the tissue for the placement of the implant but does not cut or damage the muscle.

The implant may be placed below the muscle (submuscular) or above the muscle (subfascial). Some surgeons do not recommend the implants to be placed below the muscle since this method has a greater potential for complications. The pocket will usually be created between the muscle and the fascia (the thick connective tissue that covers the muscle). Therefore, the implant will rest on top of the muscle but under the fascia.

Furthermore, the implants may be placed on either the medial (upper inside) or the lateral (outside aspect) of the leg. This region, which consists of muscle and fat, will form a capsule or scar tissue to help keep the implant in place. Calf implants can also be placed on both the medial and lateral aspects for a larger appearance. The incision is closed with very fine hairline sutures and a compression bandage will be applied. Scarring is usually minimal and not very noticeable.

Combined with Other Procedures:

Calf implants are generally not performed with other procedures but they can be combined, if needed, with other cosmetic surgery procedures:

  • Liposuction of the ankle and/or leg to create a more defined contour
  • It can also be combined with gluteal implants and/or pectoral implants for men

What is the Cost of Calf Implants?

The cost of calf implants depends on fees charged by the doctor, the area of the country where it is performed and the type of implant that is placed. The cost is generally around $4000-$7500 no matter what type of implant is placed. When calf implants are purely for aesthetic purposes, health insurance companies will not cover the cost. If the procedure is considered reconstructive due to a disease or birth defect, the insurance company may cover a portion of it.

Recovery and Downtime

For the first 24 to 48 hours of the RECOVERY process, the patient should spend most of the time lying in bed with their legs elevated above the heart to help reduce swelling. Patients should avoid walking, or performing any other activities which involve using the legs, unless they are taking short walks to the bathroom or kitchen. Patients will wear a compression bandage to help with any swelling for the first week or two. The surgeon may prescribe pain medication for the first few days.

After the first 48 hours, patients are encouraged to resume light walking that will progress into routine walking within the first or second week. Depending on the extent of the procedure, it can sometimes take a week or two before the patient is able to walk again. This is especially true when a patient has two implants placed in each leg (one medially and one laterally).

A follow-up visit with the surgeon will occur one or two days after the procedure as well as one week later. During the first visit, the compression bandage will be exchanged for above the knee support hose which will be worn for 6 to 8 weeks. Patients can shower after the first post-operative visit. There are generally no sutures to remove since most surgeons use dissolvable sutures, below the skin, to alleviate hatch marks and promote better healing. Most patients can resume non-strenuous activities after a DOWNTIME of 2 to 3 weeks. Any exercise routine that involves the use of leg muscles, such as bicycling and jogging, should be avoided for 6 to 8 weeks to allow the calves enough time to heal. Complete healing can take up to one year.


The results of calf implants are permanent and can be seen after the swelling has subsided. Since calf implants do not impede the muscle from building, bodybuilders can resume heavy weight training after proper healing. However, any scar tissue can take up to a year to heal. The appearance of the scar is dependent on the diligence of the patient applying scar prevention medication and the healing rate of the individual patient. Most scarring is hidden in the natural crease of the knee and is not easily visible. Nevertheless, patients should follow the recommended activity level and all post-surgical instructions to gain the best outcome.

The results of calf implants can change with age and weight fluctuation. As a person ages, skin becomes lax and does not hold the form around the muscle as tightly and this causes the implant to become less defined. Patients who gain weight may also hinder the lasting results due to less visibility of the implant form because of the added weight.   

Limitations of Calf Implants

Limitations of calf implants include:

  • The size of the implant which will fit and look natural. The anatomy of the patient, along with the desired results, will determine the size of the implant used.
  • When treating club foot, patients may be limited to only one small implant per calf due to the tightness of the overlying skin. This is because large implants over a small muscle and tight skin can cause issues.

Risks of Calf Implants

Calf implant risks include:

  • Adverse reaction to anesthesia
  • Infection
  • Bleeding
  • Compartment Syndrome with nerve and/or muscle damage
  • Not allowing proper healing time can cause subfascial implants to rotate or drift out of position since they are not placed as deeply as other implants
  • Asymmetry
  • Calf implants can weaken the nearby muscles (in rare cases)
  • Bruising
  • Swelling

Calf Implants can Boost Self-Confidence

Many patients choose calf implants due to their inability to build muscle mass on the lower legs. The placing of calf implants can also increase self-confidence and pride in their appearance. Patients who are insecure about their thin legs, have been teased about having “chicken legs” or just desire more definition to their lower legs usually find calf implants a rewarding solution. Patients should consult with a board-certified doctor to determine if calf implants will give them the look they desire with their legs.


Written by Cosmetic Town Editorial Team- MA

Based on an exclusive interview with Sam Gershenbaum, MD in Miami, FL