Calf implant surgery consists of the placement of solid silastic implants in pockets overlying the patient's own muscles. Pectorial implants are placed beneath the pectorial muscle through an incision in the armpit. The implants come in several sizes so that the appropriate one can be chosen to give the degree of enlargement that is in balance with the rest of the body.

The surgery is performed on an ambulatory out-patient basis, with the patient returning home upon recoveryfrom anesthesia. Anesthesia can either be sedation or full general anesthesia. For the calf implants small incisions are made in the crease behind the knee and the appropriate sized pockets are formed beneath the muscle fascia. Depending upon the extent of enlargement, either tissue expanders or the actual implants are placed within these pockets. If a large degree of enlargement is desired, the tissue expanders, which are balloon-like devices, can be slowly increased in size over the course of several weeks. This gradual expansion allows the area to slowly stretch to a size not possible at the time of the original surgery. Once the proper size is achieved, the expanders can be replaced by the correct sized implants. If the degree of enlargement is not excessive, the permanent implants can be inserted in one stage. Usually, two implants are placed in each leg over each head of the gastrocnemius. Recuperation and Restrictions: There is a certain amount of pain and discomfort following the procedure caused by the pressure of the implant until the body adjusts to it. Most patients find walking on their toes or in built-up heels the most comfortable during this adjustment stage. Bed rest is advisable for the first few days with a gradual increase in walking. Upper body workouts can be resumed in one week. Light leg workouts can begin in three weeks, increasing to full workouts in six weeks. The scars behind the knees will be pink at first but will eventually fade.

Possible complications: Shifting of the implants, infection, bruising and, in rare cases, muscle weakness. If activity is resumed too quickly, before the implant is solidly healed in place, it may shift position or even come to the surface. In such cases, healing is allowed to occur and the implant can be replaced in the proper position. If infection should occur, it may be necessary to temporarily remove the implant to allow the infection to be treated; the implant is then replaced. While cases of muscle weakness have been reported they are extremely rare and are usually due to too rapid an increase in size.