In my opinion calf augmentation with implants is the only reliable and effective method. Indeed, like any surgery there is some pain (~ 2 weeks of difficulty walking) that usually resolves completely. There are also some risks, such as infection (~ 5%), wound healing complications (~5%), nerve injury (<2%), as well as others even less common although nothing really life threatening as it relates directly to the implants. The good news is, once all is said and done, most patients are satisfied with the results. Because very few, even board certified plastic surgeons, perform this procedure, I recommend consulting with only someone that specializes in calf implants. Glad to help...