Three doctors and three opinions. That must be very frustrating. Who can you trust? Before we start talking about treatment options, I would like to personally congratulate you on your weight loss. I myself lost 50 pounds a few years ago and know the feeling of both being overweight and of having shed the pounds. Let me also start off by saying that a partial neurectomy or removing part of your muscles sounds like a very bad idea. I don't know who suggested this or if this person has any experience with these types of procedures, but it is something I would strongly be against. Your options are liposuction or accept yourself as you are. Many plastic surgeons are reluctant to do liposuction below the knees. As such, there may be less enthusiasm for doing this procedure. My practice is almost entirely devoted to body contouring using liposuction and fat transfer. I have had excellent experiences doing liposuction on calves and ankles. As is true with all liposuction procedures, technical expertise and patient selection is critical to maintain high patient satisfaction. Based on your pictures, I believe you have enough subcutaneous fat to have an improvement from liposuction. I could be wrong, and there is no way to tell for sure without an examination. You could consider taking a picture of yourself pinching your skin on your calf in different positions. You could either repost the picture on RealSelf or email it to me directly. It is especially helpful to show how thick the fat layer is on the front part of your leg over the shin bone where most people have very little fat. Patients who have a fat layer there typically do very well with liposuction. I believe the reluctance in performing liposuction on this part of the body has to do with the fear of patients having swelling and pain for long periods of time after the procedure as well as technical difficulties in performing the procedure. There's no question that performing liposuction on this part of the body is a bit tricky. I can say from experience that it is the most difficult area on the body on which to perform liposuction with consistently great results. The foot and ankle block certain angles of entry, and the inherent shape of the leg is made up of sharp turns, which are difficult to reach with straight instruments unless many incisions are made. My standard approach is four openings. They tend to fade away over time and become a non-issue. This is especially true for people with fair skin. Swelling of the ankles may be an issue, but it is rarely a problem for someone your age. Expect the area to need a couple of weeks to recover, and you may need to do some leg elevations throughout the day if the swelling bothers you. I have worked for two major liposuction specialty clinics. We perform thousands of liposuction procedures at these clinics. I will refrain from naming them, but with a quick search on the Internet, you will probably find both of them. At the first clinic, I was the only plastic surgeon willing to perform liposuction of the calves and ankles. At the second clinic, they do not even offer liposuction on this part of the body. I mention this only to put this procedure into perspective in regards to the attitude of most plastic surgeons. Liposuction on this part of the body can give phenomenal results.Continue looking for a plastic surgeon who has particular expertise with calf liposuction.Feel free to send me an email if there is any thing I can do for you.Best of luck,Mats Hagstrom, M.D.
