From the Lih-Ren Plastic Surgery Clinic.
Plast Reconstr Surg. 2020 Apr;145(4):734e-743e. doi: 10.1097/PRS.0000000000006708.
Long-term aesthetic reduction of the legs in Asians is gaining increasing popularity among cosmetic patients. Current treatment options include botulinum toxin injection, radiofrequency, neurectomy, and total, subtotal, or partial muscle resection of the gastrocnemius. Partial resection using Kelly forceps was introduced in 2000. This article presents the use of a suction-assisted cartilage shaver to perform partial resection, describing the procedures and shaver modifications and evaluating its use.
A retrospective review of 71 cases with a minimum 6-month follow-up (average, 36.5 months; range, 6 to 160 months) was performed. Twenty partial calf reductions were performed with a short shaver, 27 with a long shaver, and 24 with an endoscope-guided long shaver.
Mean reduction of calf circumference was 2 cm (range, -1 to 6 cm); the mean preoperative and postoperative calf circumferences were 35.8 cm and 33.8 cm, respectively. Mean tissue reduction per calf was 110 g (range, 25 to 300 g).Two patients developed larger calves after surgery, one because of weight gain and the other because of weight training. Complications included surface irregularity (n = 4, 5.6 percent), numbness over the lateral ankle or lateral foot (n = 9, 12.7 percent), hematoma clot requiring surgical evacuation (n = 11, 15.5 percent), prolonged seroma (n = 2, 2.8 percent), and left ankle plantar-flexion contracture due to tight, sustained postsurgery bandaging (n = 1, 1.5 percent). Scar-related complications were hyperpigmentation (n = 6, 8.5 percent), depressed scars (n = 5, 7 percent), and hypertrophic scars (n = 2, 2.8 percent).
Short, long, and endoscope-guided long suction-assisted cartilage shavers for partial resection of calf muscles can be used effectively to reduce the calf. Several mostly treatable complications were noted.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
亚洲人长期追求腿部的美学效果，因此小腿美容术越来越受到求美者的欢迎。目前的治疗方法包括肉毒毒素注射、射频、神经切除术以及腓肠肌的全部、部分或次全切除术。2000 年引入了使用凯利夹行腓肠肌部分切除术。本文介绍了使用吸脂软骨刨削器进行部分切除的方法，描述了手术过程和刨削器的改进，并评估了其应用效果。
回顾性分析了 71 例接受小腿部分缩小术的患者资料，随访时间至少 6 个月（平均 36.5 个月；范围 6 至 160 个月）。20 例采用短刨削器、27 例采用长刨削器、24 例采用内镜引导的长刨削器进行 20 次小腿部分缩小术。
小腿周径平均缩小 2cm（范围 -1 至 6cm）；术前和术后小腿周径分别为 35.8cm 和 33.8cm。每侧小腿组织切除量平均为 110g（范围 25 至 300g）。2 例患者术后小腿增大，1 例是由于体重增加，另 1 例是由于举重。并发症包括表面不平整（4 例，5.6%）、外踝或外足麻木（9 例，12.7%）、血肿需要手术清除（11 例，15.5%）、长时间血清肿（2 例，2.8%）和由于术后持续绷带包扎导致的左踝跖屈挛缩（1 例，1.5%）。与瘢痕相关的并发症包括色素沉着过度（6 例，8.5%）、凹陷性瘢痕（5 例，7%）和肥厚性瘢痕（2 例，2.8%）。
短、长和内镜引导的长吸脂软骨刨削器均可有效用于腓肠肌部分切除以缩小小腿。注意到几种主要为可治疗的并发症。
临床问题/证据水平：治疗性，IV 级。
