Hi - I used these boards so much when I was planning I think I need to give back. I was born with cankles and large calves. My weight has fluctuated +/- 30 lbs and while my calves were a tad slimmer at lower weights, I always had cankles. I think I must hold some water weight as well because they are always puffy in the front.
13 months ago I got ankle and calf lipo from a reputable surgeon in my area. I think it is important to have realistic expectations. He definitely changed the shape of my legs - there is more definition instead of the straight up/down cankle look - but my ankles are still large. It is bone, not much you can do about that. That being said, I think it was worth it - to me. I've started wearing skirts and while I will never have fabulous legs, I am not deathly ashamed of them either. (it was a bit difficult when people at work were like "Wow I've never seen you in a dress". Ugh.
There is significant downtime, don't let anyone tell you any differently. Probably more than with lipo of other areas because of gravity. I was in bed for about a week. You definitely need someone to take care of you. Then it was 8 weeks before I could do any exercise - though I could walk fine. No heels for probably 3 months. The swelling gradually subsided over a period of 9 months - I would definitely recommend this as an early fall procedure. I still get a bit of swelling 13 months later if I wear high heels all day. And no more 4 inch heels for me - ever.
The pain was not bad at all, really more uncomfortable than painful. My doctor gave me hydrocodone. Definitely get some of the compression pants. I read tons of stuff about how long to wear compression pants. Some articles said it was bad for you some said leave them on as long as possible. I think it is best to do what your doctor recommends and just use your best judgement. I am pretty happy. I would say my cankles are more on the "canklette" side now. Not nearly as bad as they were.