[Calf Duhan Plastic Surgery] - [The Calf Procedure That Suits Me]

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#Calf recurrence #Calf vein recurrence #Calf liposuction #Ankle fat #Thick calf complex #Making slender legs #Making beautiful legs #Beautiful legs #Leg plastic surgery

#Calf #Calf radiofrequency #Calf radiofrequency recurrence #How to manage calves #Calf care tips #Calf muscles #Calf muscle surgery #Calf muscle reduction #Calf Botox care

#Calf muscle surgery #Calf muscle resection #Calf muscle resection recurrence #Calf muscle removal #Calf muscle reduction #Calf muscle reduction surgery #Calf line #Calf Botox effect

#Calf swelling #Reducing calf swelling #Calf obesity #Losing calf fat #How to lose calf fat #Calf fat-loss exercise #Calf plastic surgery #Calf plastic surgery procedure #Calf plastic surgery clinic #Revision surgery

#Calf surgery #Calf skinny #Calf procedure #Calf neurectomy #Calf neurectomy recurrence #Calf revision surgery #Calf recurrence surgery #Calf recession revision surgery #Nerve block

#Calf nerve block #Calf nerve block procedure #Calf muscle #Calf muscle massage #Calf muscle Botox #Reducing calf muscle #How to reduce calf muscle #How to reduce calf muscle #Calf muscle surgery

#Calf muscle procedure #Calf muscle removal surgery #Calf thinning surgery #How to slim calves #Calf fat #Calf fat breakdown #Calf fat grafting #Leg fat grafting #Calf liposuction

#Duhan #Duhan Plastic Surgery #Director Shin Duhan #Duhan Calf Plastic Surgery #Duhan Non-incisional Ultrasound-Guided Selective Nerve Block Procedure #Calf reduction #Calf reduction surgery #Calf reduction procedure #Calf recession

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The Calf Procedure That Suits Me

Types of calf procedures,

We will guide you to the appropriate calf procedure

according to the cause~

What are the calf plastic surgery methods?

Muscle recession surgery - non-incisional ultrasound-guided selective nerve block

This method blocks only the motor nerves that go to the gastrocnemius muscle, causing the muscle to naturally atrophy without damaging the muscle.

At our clinic, we accurately locate the nerves with ultrasound and effectively block them, significantly reducing side effects and recurrence rates.​

Subcutaneous fat bulk - calf liposuction

This method reduces volume by suctioning the fat between the calf muscle and the skin.

It is used when there is a limit to reducing calf volume with muscle recession surgery, or when there is more fat than muscle.

Leg veins (varicose veins) - scarless surgery and sclerotherapy

When unsightly veins are visible in the legs, minimally invasive surgery or sclerotherapy can effectively remove the veins.

Appropriate calf procedure methods according to the cause

When there is bulging caused by calf muscles

If the calf muscles are developed congenitally or have become developed due to a lot of exercise after birth, muscle recession surgery is needed.

Muscles develop and become thicker and firmer when used.

Even without exercising much, some people have constitutionally developed muscles.

There are cases where only the inner muscle develops, and cases where both the inner and outer muscles develop.

Example of bulging calves caused by muscles

What is selective nerve block for muscle recession?

Selective nerve block works by blocking the gastrocnemius nerve, which branches from the tibial nerve to the gastrocnemius, so that the gastrocnemius loses its mobility.

A muscle whose nerve has been blocked cannot contract or relax, so it loses mobility, and over time the muscle atrophies.

It is a method that blocks nerves by using the principle that unused muscles atrophy.

What is ultrasound-guided selective nerve block for muscle recession?

With the standard device used for nerve block procedures, finding nerves that are not visible to the eye with a nerve locator is very difficult and time-consuming.

Also, when nerves deviate from their normal route, finding them becomes very difficult, and there are many cases in which the procedure is not performed properly.

If the nerves are not located properly, the procedure’s effectiveness decreases, side effects may occur, and the recurrence rate is high, among other problems.

To overcome these drawbacks, ultrasound-guided selective nerve block adds ultrasound imaging to the basic equipment, allowing the nerves to be searched quickly and accurately and multiple nerve branches to be effectively blocked within a short time.

It is an advanced procedure with the advantages of improved effectiveness, fewer side effects, and a significantly lower recurrence rate.

What are the advantages of ultrasound-guided selective nerve block?

It can quickly and accurately locate nerve branches, so the procedure is highly effective.
It significantly shortens the procedure time compared with using basic equipment alone.
Because the nerve branches are located accurately, other tissues are not damaged, so side effects do not occur.
Since the procedure time is shortened, there is less pain after the procedure and recovery is faster.
Because the procedure is performed with accurate nerve localization, the recurrence rate drops significantly.

What are the problems with selective nerve block performed at other hospitals?

▶ Because it is necessary to find nerve branches that are not visible, it is technically difficult.
▶ If the nerve branches are not located properly, the procedure’s effectiveness is very low or recurrence is likely.
▶ If the practitioner is inexperienced, they may damage nerves or blood vessels other than the gastrocnemius motor nerve.

∴ In general, trying to find invisible nerves with the basic nerve locator and perform the procedure often leads to little or no effect from the start because the nerves cannot be properly found, and it is common for the procedure to seem effective at first but recur after several months.

A poorly performed nerve block can produce worse results than not doing it at all, so caution is needed.

Therefore, selective nerve block must be free of recurrence and its effect must be close to 100%; unless the nerves are directly located and checked visually using ultrasound imaging, it is difficult to achieve good results.​

Comparison between ultrasound-guided selective nerve block and general selective nerve block

Category	Ultrasound-guided selective nerve block	General selective nerve block
Scar	No scar	No scar
Procedure time	Relatively short	Procedure time is longer because the nerves are not properly located.
Procedure effect	Very effective	The procedure is often weakly effective or ineffective.
Recurrence rate	Almost no recurrence	Very high recurrence frequency
Side effects	Because only the nerves are accurately located and treated, other tissues are not damaged, so there are no side effects.	Because multiple punctures are needed during the procedure, there is more damage to other tissues.

How are the calf treatment areas selected?

1. Inner muscle recession surgery If development of the outer muscle is mild and only the inner muscle is highly developed, only the inner side can be selectively treated.
2. Outer muscle recession surgery In most cases, the outer muscle is less developed than the inner muscle, so in general only the outer muscle is not treated. However, if the inner-side surgery such as neurectomy was excessively performed at another hospital and the outer muscle developed compensatorily, only the outer side may be treated.
3. Inner and outer muscle recession surgery If both the inner and outer calf muscles are developed, both sides are treated.​

Examples of muscle recession surgery (ultrasound-guided selective nerve block)

Appropriate calf procedure methods according to the cause

When there is calf obesity caused by subcutaneous fat

Example of calf obesity​

What are the indications for calf liposuction?

This is a method that reduces volume by suctioning fat from the subcutaneous fat layer when the cause of thick calves is subcutaneous fat.

If muscle and fat are both developed, liposuction may be performed together with muscle recession surgery, and in some cases liposuction alone is performed.

How are the areas for calf liposuction selected?

1. Liposuction of the inner side If the outer fat layer is thin and only the inner side has thick subcutaneous fat, liposuction can be performed selectively on the inner side only.
2. Liposuction of the outer side If the inner fat layer is thin and only the outer side has thick subcutaneous fat, liposuction can be performed selectively on the outer side only. In most cases, the fat layer is thicker on the outer side than on the inner side, because the inner side is an area where the muscles are more developed, so the fat layer is thin, while the outer side has thinner muscles but a thicker fat layer. Therefore, in some cases the inner side undergoes muscle recession surgery while the outer side undergoes liposuction to balance the shape.
3. Liposuction of both the inner and outer sides If muscle development is mild but the subcutaneous fat layer is thick throughout the calf, liposuction is performed on both the inner and outer sides of the calf.
4. Ankle liposuction If there is a lot of subcutaneous fat around the ankle near the Achilles tendon, the ankle looks thick and is not aesthetically pleasing. In such cases, only the ankle may be selectively suctioned. The ankle is divided into three areas: the inner and outer sides of the Achilles tendon, and the outer side of the shinbone.​

The liposuction areas are broadly divided into the calf and the ankle, and then further subdivided. The calf is divided into two areas, inner and outer, while the ankle is divided into three areas: outer side, inner side, and the outer front of the ankle.

The areas to be suctioned differ from person to person, so the suction areas vary depending on where fat is concentrated and which areas the patient wants reduced.

Areas that do not need suction or are not desired do not have to be suctioned, so it is important to clearly decide on the suction areas after examination and then perform the procedure.

How is calf liposuction performed?

The subcutaneous fat between the skin and muscle can be treated with liposuction.

For calf liposuction, a thin cannula must be used so that the skin and nerves are not damaged, and the procedure should use minimal incisions to leave almost no scar.

The procedure can be performed by area and must be divided into the inner side, outer side, and ankle.

The key to the procedure is to perform the suction precisely without aftereffects such as unevenness or sensory disturbance.

What is the key to calf liposuction?

Select the areas where the effect can be seen and treat only the necessary areas.
Use a fine cannula so that sensory disturbance does not occur.
Perform suction precisely so that uneven contours do not appear in the leg.
Use minimal and small incisions to minimize scarring.

What are the precautions for calf liposuction?

Compared with liposuction in other areas, the calf is a part that requires very precise treatment.

The overall calf thickness and the thickness of the fat layer must be assessed, and treatment should be performed only when the procedure is expected to be effective.

The calf has many sensory nerves, so if suction is done with a cannula that is too thick or if excessive suction is performed, uneven contours or sensory disturbance may occur.

Therefore, careful suction with a very thin cannula is necessary for effective treatment without side effects.​

What do the calf liposuction before-and-after results look like?

What are the other treatment methods?

▶ Fat-dissolving injections such as PPC

Fat-dissolving injections have almost no treatment effect.

Some hospitals perform procedures with drugs whose effectiveness has not been verified and that have not even been approved.

Although various fat-dissolving injections have been used, there have been no fat-dissolving injections that have shown proper treatment effects or been verified.

As the drug spreads, it is impossible to know where the effect will appear, and in most cases there is no treatment effect, so one should not be misled.

▶ Radiofrequency treatment

Fat cannot be broken down with radiofrequency.

Radiofrequency is a method that breaks down fat with heat, but it is a completely unverified procedure.

Using radiofrequency to melt fat has extremely weak or no effect at all.

▶ Laser treatment

Fat cannot be suctioned with a laser.

Laser is a method that breaks down fat with heat, but it is a procedure with almost no effect.

In most cases, the treatment effect is extremely weak or there is no effect at all.

The removal of fat, then and now, is most effective and safest when a cannula is inserted to directly remove fat cells, so this should be kept in mind.

What are the precautions regarding calf liposuction?

① Calf liposuction is the best procedure for reducing the volume of subcutaneous fat.

② It is difficult to expect proper results with methods other than liposuction.

③ Because the calf is an area with many sensory nerves, suction must be performed using a microcannula.

④ Laser or ultrasound-assisted suction may cause sensory disturbance or aftereffects from thermal skin damage.

⑤ Manual microcannula suction is the safest and most effective method for calf liposuction.

What are the pre- and post-procedure care instructions for calf liposuction?

■ Precautions before the procedure

1. Do not consume alcohol the day before the procedure. - Because anesthesia may not work well.

2. Do not overeat on the day of the procedure.

3. If possible, do not drive to the clinic on the day of the procedure; use public transportation instead. - Driving after sedation anesthesia can be dangerous.

■ Post-procedure course and precautions

1. After the procedure is finished, go home only after the sedation anesthesia has completely worn off.

2. On the day of the procedure, the legs will feel weak and there will be pain, so try not to walk too much and rest at home.

3. Wear the calf band provided by the hospital for about one week.

4. Return to the clinic to remove the stitches on day 7 after the procedure.

5. For about 1 to 2 weeks after the procedure, avoid strenuous exercise; running can be resumed after one month.

6. A pulling or stiff feeling in the calf is a normal process that occurs as the tissue heals.

7. The results of calf suction appear over three months, so the calf volume continues to decrease during those three months.

Appropriate calf procedure methods according to the cause

When calf veins are visible due to subcutaneous fat

Definition of varicose veins

Varicose veins are when blood stagnates because venous blood in the legs does not circulate properly, causing the blood vessels to dilate.

The symptom is that the blood vessels become abnormally enlarged and visible.

If severe, the vessels can bulge out in a twisted shape, creating an aesthetic problem.

In some cases, blue veins expand and spread like a spiderweb, and fine red capillaries can also appear like a spiderweb.

Example of varicose veins

What is the overview of varicose vein procedures?

When fine red vessels or thick blue vessels are visible on the thighs or calves, unsightly vessels can be removed with sclerotherapy or scarless surgery.

Even if a leg has beautiful lines, thick vessels showing through it do not look good.

Our clinic has been performing varicose vein procedures quickly and safely by adopting advanced European methods, the birthplace of varicose vein treatment, since 2001.

How are varicose veins diagnosed?

The simplest and most accurate diagnostic method for varicose veins is Doppler ultrasound, which can accurately assess vessel diameter and reflux.

During the examination, the patient stands while the ultrasound probe is applied to the area with the veins and the screen is checked to identify the problematic vein. The examination takes about 5 to 10 minutes.

What are the treatments for varicose veins?

There are two major types: surgery and sclerotherapy.

Surgical methods have developed in various ways over centuries, and treatment has often involved removing the offending vein from the body.

Currently, even in advanced European countries, surgical methods such as vein stripping and ambulatory phlebectomy are widely used, with sclerotherapy also used as an adjunct.

Sclerotherapy is a treatment in which a sclerosing agent is injected into the vein without surgery. Its advantages are that anesthesia is not needed and no scar is left at all.

In other words, it is a method of injecting the sclerosing agent into the vein using a syringe in the same way as a regular blood vessel injection.

Other treatments include transillumination-powered phlebectomy (TriVex), endovenous laser treatment (EVLT), and dye laser treatment for capillaries, but there are concerns about various side effects, the treatment effect is often inferior to surgery or sclerotherapy, and the vessels that can actually be used are limited.

These methods are rarely used in advanced European countries, which are at the forefront of varicose vein treatment worldwide.

Phlebologists advise caution when using these treatments.

What are the types of varicose vein procedures?

1. High ligation of the saphenous vein

This method blocks the reflux area of the saphenous vein valve. Unlike saphenous vein stripping or ambulatory phlebectomy, which completely remove the enlarged diseased vein, this method preserves the vein while blocking only the reflux area.

In other words, it is similar to repair work to block a hole in a dam.

It is a surgical method used to block reflux in the early stages before the vessels are severely enlarged.

The key to the surgery is to block reflux in all the branches of the vessel to prevent recurrence.

These vascular branches are not resolved by laser-based treatment.

2. Saphenous vein stripping

This method strips out and removes the vein at the starting point of the superficial vein where reflux is present.

When there is severe blood reflux and the vessel is excessively enlarged, this is a fundamental method of blocking reflux by performing high ligation and removing the vessel at the same time.

It is applied when there is reflux and severe vessel enlargement.

3. Ultrasound-guided sclerotherapy

When blood reflux is present and high ligation is needed, this procedure can replace high ligation.

It is a method of blocking reflux with medication by injecting a sclerosing agent at the point where reflux begins.

It is performed when there is fear of surgery or when the patient does not want scars.

However, its effectiveness is lower than surgery and recurrence is more common.

4. Compression sclerotherapy

This is applied when treating vessels with a diameter of 4 mm or less.

When very thin and small vessels are widespread, it is difficult to address them, so sclerotherapy is used as the main procedure.

After sclerotherapy, compression stockings are worn to reduce the formation of clots and promote faster recovery; this is called compression sclerotherapy.

5. Simple sclerotherapy

In cases of localized red capillary telangiectasia or blue reticular vein dilation, a sclerosing agent is injected.

When the affected area is small, wearing compression stockings is not really necessary, so treatment is done with sclerotherapy alone.

Examples of varicose vein and vascular dilation procedures

What are the post-procedure care instructions after varicose vein treatment?

■ Precautions before the procedure

① Do not consume alcohol the day before the procedure. - Because anesthesia may not work well.

② Do not overeat on the day of the procedure.

③ If possible, do not drive to the clinic on the day of the procedure; use public transportation instead. - Driving after sedation anesthesia can be dangerous.

■ Course and precautions after high ligation, saphenous vein stripping, and ambulatory vein extraction

① After the procedure is finished, go home only after the sedation anesthesia has completely worn off.

② On the day of the procedure, the legs will feel weak and there will be pain, so try not to walk too much and rest at home.

③ Return to the clinic after 2 days to remove the bandages.

④ Showering is possible on the second day after the procedure once the bandages are removed.

⑤ Return to the clinic to remove the stitches on day 7 after the procedure.

⑥ Wear the compression stockings provided by the hospital for about 1 to 2 weeks.

⑦ For about 1 to 2 weeks after the procedure, avoid strenuous exercise; running can be resumed after one month.

⑧ A pulling or stiff feeling in the calf is a normal process that occurs as the tissue heals.

⑨ The scar at the site where ambulatory vein extraction was performed remains dark red for about 3 to 6 months and then gradually fades until it becomes inconspicuous.

■ Course and precautions after sclerotherapy

① After the procedure, walk for about 1 hour if possible so that the sclerosing agent does not remain inside the vessel.

② Showering is possible starting the day after the procedure.

③ Compression stockings can be washed with soap, but do not twist them dry or iron them.

④ Wear the stockings continuously for the prescribed period, usually about 1 to 3 months.

⑤ Put the stockings on in the morning when you get up and take them off before going to bed.

⑥ Bruising and hematoma formation along the vessel after sclerotherapy are understood as part of the normal treatment process.

⑦ Bruising along the vessel varies in degree, and the time it takes to disappear also varies; it usually fades almost completely in about 2 to 3 weeks.

⑧ The period for sclerotherapy to be completed and the vessel to be fully closed and disappear is about 1 month.

■ Follow-up schedule after sclerotherapy

① After the first procedure, visit the clinic every 1 to 2 weeks, usually 3 to 4 times.

② Visit after 1 to 2 weeks; for areas with clots, the clot is removed with a needle, and then the compression stockings are put on again. - Additional treatment may be performed on areas that were not sufficiently treated.

③ Second follow-up after the procedure - 1 to 2 weeks after the second treatment

The hematoma in the treated vessel area can be removed, and additional treatment may be performed in areas that were not sufficiently treated.

④ Third follow-up after the procedure - 1 to 2 weeks after the third treatment

The hematoma in the treated vessel area is removed.

The number of times hematoma removal is needed varies by person, usually about 2 to 4 times.

♥ Precautions regarding calf procedures ♥

Calf plastic surgery selects the appropriate method according to the desired shape or the cause.

Muscle recession surgery uses a nerve block procedure.

In cases of obesity, liposuction is performed.

For vascular dilation, scarless surgery or sclerotherapy is performed.

The procedure should be effective, have no side effects, and allow immediate return to daily life.

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