I can't get rid of my big Calves and cankle. Any suggestions?

Question

I am very skinny female 38 years old and have big calves and cankle for as long as I remember. exerciser has not helped much. I have not worn skirts for years :( I was suspecting maybe I have insufficient veins but ultrasound showed that was not the case. I think So my issue is a combination of fat and minor edema. What is the difference between cool sculpting and vaser liposuction? Do you think those can help me? Is there any other recommended method? Thanks in advance, Sara

Larry S. Nichter, MD, MS, FACS · Answer

In the proper hands of a skilled board certified plastic surgeon, liposuction is usually effective in improving your "cankles" and calves. An exam would be required for the best opinion.

Samir S. Rao, MD · Answer

As someone who does both calf/cankle reduction surgery and Coolsculpting, I can say with confidence that I don't think coolscultping would work well for the calf region.  They way machine works would not allow the calf region to be treated.   Liposuction is my preferred treatment for calf reduction and improving the definition between the calf and the ankle.  It has to be performed very carefully in this region, the results are modest, and the results may take longer to appreciate because swelling may persist for longer.

Libby Copeland-Halperin, MD · Answer

Thank you for your question. It is difficult to say without examining you, but what you describe is very common. Many women are bothered by the appearance of their calves and ankles and have what is sometimes referred to as “cankles.” As you mention, this can make patients feel self-conscious and uncomfortable wearing shorts/skirts/dresses and also makes it challenging to wear boots. Fortunately, it is possible to reduce the size of your calves/ankles with liposuction. I use a combination of liposuction techniques, including SmartLipo or laser liposuction, power-assisted liposuction, and regular liposuction using very fine cannulas inserted through small incisions to sculpt and shape the lower leg and ankle. I perform this surgery in our fully-accredited operating room under IV sedation as an outpatient procedure. While there is some discomfort with any surgery, patients are able to be walking right away. You will need to wear a compression garment after surgery to help with bruising and swelling and I also include a special light touch lymphatic massage after surgery to help with healing and recovery. While coolsculpting can be an effective treatment for other areas of the body with excess fat, I would not recommend it in this area, as this requires more sculpting to create a shapely and proportional lower leg. I recommend you meet with a fully-trained plastic surgeon who is familiar with performing lower leg liposuction/liposculpture to discuss your options.

Michelle Copeland, MD, DMD · Answer

Although it is difficult to say without an in person examination, liposculpture as an outpatient procedure under I.V. sedation can reduce the bulge that some people have in their calves and ankles and restore a more shapely leg. Unlike other areas of the body the ankles and calves require a certain delicacy which is why I use several innovative forms of liposuction, including SmartLipo, to contour and resculpture the area while providing the most beautiful results with minimal scarring. SmartLipo, used in combination with other forms of liposuction or alone, is a procedure that uses laser light to liquefy fat and tighten the surrounding skin. It’s thought to involve less downtime and side-effects than traditional liposuction and is particularly good for small areas of fat deposits like the ankles. New technology that's gentler and faster than ever before not only allows the removal of fat, but also resculpts the legs. When looking for a surgeon for something very specific, such as liposuction of the calves and ankles, it is important to find a doctor who routinely performs the procedure and who can show you before and after pictures of patients that they have operated on. These images will not only give you a sense of the surgeon’s skill, but will help you to better visualize the procedure for yourself. I suggest making an appointment with an experienced board certified plastic surgeon who can explain in detail to you what your options are.

Larry Fan, MD · Answer

Dear Sara,Liposuction can be a good way to slim the calves and eliminate cankles.CoolSculpting is a great way to reduce unwanted fat without surgery but, unfortunately, is not suitable for the calves and ankles.Please see an experienced, Board Certified Plastic Surgeon for an evaluation.Warmest wishes,Larry Fan, MD

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