Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Institute for Forensic Medicine, Faculty of Medicine, University of Belgrade, Serbia.
Aesthet Surg J. 2021 Jan 25;41(2):NP26-NP35. doi: 10.1093/asj/sjaa080.
Calf augmentation can be achieved by fat grafting, calf implants, or a combination of both methods (composite augmentation). For safety reasons, it is important to be aware of important calf anatomic features, specific physiologic considerations, and some health conditions that can hinder the outcome of these procedures.
The aim of this study was to present our experience with performing composite calf augmentation, and to describe indications, surgical techniques and safety issues.
We retrospectively analyzed 63 patients who had undergone composite calf augmentation for cosmetic and reconstructive surgery in our practice. We reviewed group demographics, complications, and results, and identified all the pitfalls encountered in our cases. Additionally, dissection of the calf regions in fresh cadavers was performed to obtain more accurate anatomy. We also measured intracompartmental pressures before and after calf augmentation with implants in 6 cases to determine pressure changes.
All cases received subfascial implant insertion and fat grafting as a delayed procedure. If there is a need for multiple implants, we recommend a staged procedure. Our study showed high muscle sensitivity to pressure increase after augmentation. Hence, from the standpoint of safety, we advocate subcutaneous fat grafting only. No patients developed compartment syndrome.
Composite calf augmentation surgery is safe and easy to reproduce, with a short recovery period and a low complication rate when done as a staged procedure and respecting specific anatomic and physiologic calf features.
小腿增粗可通过脂肪移植、小腿植入物或两者结合的方法（复合增粗）来实现。出于安全考虑，了解重要的小腿解剖特征、特定的生理考虑因素以及可能阻碍这些手术结果的一些健康状况非常重要。
本研究旨在介绍我们在进行复合小腿增粗手术方面的经验，并描述适应证、手术技术和安全问题。
我们回顾性分析了在我们的实践中因美容和重建手术而接受复合小腿增粗的 63 名患者。我们复习了组内的人口统计学资料、并发症和结果，并确定了我们病例中遇到的所有陷阱。此外，还在新鲜尸体上进行了小腿区域的解剖，以获得更准确的解剖结构。我们还在 6 例患者中测量了植入物置入前后小腿间隙内的压力，以确定压力变化。
所有病例均接受筋膜下植入物插入和脂肪移植作为延迟手术。如果需要多个植入物，我们建议分期手术。我们的研究表明，肌肉对增粗后的压力增加非常敏感。因此，从安全角度出发，我们仅提倡皮下脂肪移植。没有患者发生筋膜间室综合征。
复合小腿增粗手术是安全且易于复制的，当分期进行并尊重特定的小腿解剖和生理特征时，恢复期短，并发症发生率低。
