Botox for Slim Legs?

How effective is Botox used to treat big leg calves and how many units are needed?

Doctor Answers 16

Botox not to be used on legs

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Botox will not make your calves smaller, it is an off label use, will probably make you unable to walk and would require a huge amount of Botox that would be cost prohibitive.

Botox for slim legs

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Botox and Dysport can be used to soften the muscular show of the calf muscles and create a slimmer look.  The calf muscles are large and the results will be dose dependent.  I would consider starting with 50 units in each calf and then titrate the dose upwards on future visits until you get the desired result.

Calf Reduction with Botox

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This is a common request from Asian patients.  The calf muscles are treated either surgically or non-surgically (with Botox/Dysport) to slim them down.  Please consult with a board certified specialist who can better assist you with this process.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

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Botox to slim calves not a good idea

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Hi Dida,

This is one of the most unique questions we have ever received about Botox use. The panel has weighed in and it seems like we are all in agreement. This would not be a good idea.

This area is not FDA approved, would require a tremendous amount of product and may very well not lead to your desired outcome. We would try and find a different pair of shows instead, one that would ut less emphasis on the claves. Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Botox is not for legs

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 Botox is not for legs.  Please do not let anyone inject your legs with Botox.  This would be a very bad idea.  It would negatively affect your function and would also be cost prohibitive since it would require a very large quantity of Botox.

You're Kidding Right?

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Do you or anyone you know really want to paralyze the gastroc muscles of your legs? I'm sorry but this is one of the more outlandish things I've heard. The calf gastroc muscle is the power muscle for foot plantar flexion. Although this could be carried out by the soleus muscle if the gastroc isn't available the power would be significantly less. Large calf muscles come from moving heavy weight, either in the gym on the body. The muscle will slim if more fast motion and less weight is used. There is also a genetic component that you cannot fix. Botox is definitely not a cure all and definitely not for this purpose.

Underground Botox

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Any practitioner that is recommending Botox to shrink the calf muscles is using the material in an off label indication. It is effective for narrowing the jaw, but the muscles here are much smaller than the calf muscles. The amount of Botox that would be necessary to shrink the calves would be toxic.

Not indicated

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Botox would not be a good choice for large calves.  I would recommend diet & exercise.  Despite this recommendation, for many, this doesn't work.  You may also consider liposuction.


Another Voice

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If you need another voice to decry this treatment here it is. I agree fully with my colleagues who have answered this question, that the risks outweigh the benefits. To achieve its effects, the physician administering the Botox might be reaching toxic levels. The muscle to achieve this is a strong muscle and, bilaterally, would require high dosages. Then once muscle weakness is achieved, the cosmetic improvement would have to be balanced with the functional impairment. Not a fair tradeoff in my opinion.

This cosmetic use is sort of sad when you think of all the children who pray that they don't develop muscular weakness in these same muscles ( Duchenne muscular dystrophy).

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

Desperate doctors preying on desperate patients.

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Botox has a lot of great an novel uses, but this one just doesn't satisfy the risk-benefit equation. I know that there are all kinds of websites and medical practices peddling the idea of calf reduction with Botox, but that doesn't make it a good idea.

In order to achieve any meaningful reduction in calf size (medial head of the gastrocnemius, anyway) the dose of Botox really starts to get into the higher range. In addition, frequent applications of the toxin are required to induce atrophy. In both cases the risk of adverse events rises.

This procedure does seem very effective at reducing a patient's bank account, however. ;-)


David C. Pearson, MD
Jacksonville Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.