|No recurrence in calf reduction ?|
Partial resection of Gastrocnemius muscle has no risk of recurrence .
1. How does muscle resection work ?
Partial resection of Gastrocnemius muscle removes muscle directly and reduce
the number of muscle fibers in Gastrocnemius muscle.
Surgical removal is the only way to reduce the number of muscle fibers.
Because the number of muscle fiber doesn't change after adolescent, the result
of surgery is permanent.
In calf reduction, about 70 % of Gastrocnemius muscle is removed and only 30%
remains to maintain the shape of natural calf.
The remained 30 % of muscle fiber can become bigger in volume with excessive
exercise like body building, the change is minimal after surgery because there
are few remained.
So, patients can do any exercise after calf muscle resection without fear of
2. The other muscles in calf
How about the other muscles in calf ?
Can it grow more after calf muscle resection ?
The other muscles in calf can grow bigger with exercise of course.
But the other muscles in calf are deep muscle which is encircled in strong muscle
So, growing of other muscles in calf is not noticeable.
Because Gastrocnemius muscle is superficial muscle, slight volume change in
Gastrocnemius muscle is noticeable and makes calf look awful.
In other words, reducing Gastrocnemius muscle effectively change the shape of
calf and makes calf look much thinner and longer.
3. Recurrence in nerve ablation and radiofrequency
Nerve block to muscles in calf can make the muscle atrophied.
Why is nerve block recurred so frequently ?
Even though muscle can't be regenerated, nerve can be regenerated very easily.
Nerve is the most easily regenerating structure in our body.
As you can see in below picture, nerve injury can make the distal muscle atrophied
in 2 weeks.
After 3 weeks of nerve injury, the atrophy of muscle becomes peak.
That's the reason why most calf nerve block pictures are taken after 3 to 4
After 3 weeks, nerve can grow and innervate distal muscle easily and muscle
can become normal again.
This means nerve block is destined to be recurred.
During this atrophy and regeneration of nerve, the distal muscle loose some
But the change is so inntoceable that most patients can't be satisfied with
the result of calf nerve block.
In the second nerve block, the effect is less noticeable than the first trial.
This means repeated nerve block has little meaning.
Most patients seek muscle resection after disappointing and being tired of repetition
of nerve block.
What a waste of time, money, and pain !
In addition, this patients may have less satisfactory result with muscle resection
because of the scarring from nerve block.
Even though most people know nerve block is ineffective, many patients still
undergo this because it is less scary, cheaper, and simpler.
But that is not wise choice for calf surgery.
The more you know, the better you can choose.
4. 2 years after surgery
One of my patients visited me after 2 years of calf reduction because of other
Not only her upper calf but also her lower calf looked slimmer.
Before surgery, she had muscular and heavy looking calf with circumference of
After 2 year of surgery, she still had slimmer and longer looking calf with
circumference of 32 cm.
Her Achilles tendon in lower calf was reduced also in size because it was atrophied
with smaller Gastrocnemius muscle.
In addition, she is no longer afraid of recurrence and is actively participating
in her extreme sports.
What a surprise !
She asked me to advertise this calf muscle resection more because many patients
are still wasting their time, money, and pain for ineffective calf nerve ablation.
If she knew this procedure earlier, she should have been happier in her younger
days and didn't have to undergo many times of nerve block.
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Hyuncheol Park MD