Definition & Overview

Calf liposuction is a cosmetic surgical procedure that aims to reduce the size and improve the contour of the calves by suctioning out excess fat build-up. The procedure, which helps patients achieve toned and leaner legs, is typically considered as an option if diet and exercise have failed to provide the patient’s desired result.

Calf liposuction is also known as lipoplasty, or liposuction of the lower extremities, which also includes ankle liposuction. Its popularity has increased over the last two decades, as the techniques in performing the procedure have improved significantly and the rate of associated complications has declined considerably.

Who Should Undergo and Expected Results

Patients who should undergo calf liposuction are those who have fat and bulky calves, as well as thick and poorly defined ankles. More specifically, ideal candidates include:

  • Patients with circumferentially heavy legs or those whose entire legs are fat as a whole. This means that their entire leg has equal fat distributions all over.

  • Patients with localised thickness or have significant fat deposits in specific regions of the calves such as the lower lateral fibular, medial tibial, or the ankle area.

Surgeons usually determine where fat deposits are located through a simple pinch test, in which the patient is asked to stand flat-footed on a stool and while standing on their toes or while their legs are placed horizontally on a chair with the knee bent at 90 degrees. Patients are considered good candidates for the procedure if their pinch test results are higher than the minimum 2cm in the calves and 1cm in the ankles.

Patients undergoing liposuction, in general, should also be:

  • Aged between 20 and 30 years old
  • In good health
  • Has good skin tone

Some patients aged over 30 years old are still suitable candidates if they have good skin tone.

Expected results following the procedure are slimmer lower legs that taper down towards the ankles as well as well defined ankles. The size of the calf and the ankles should also be proportional.

However, not all patients with thick and large calves can benefit from a liposuction, as the procedure only works if the thickness is caused by excess fat. In cases wherein the cause is a combination of muscle tissue and fat, the procedure can still be performed as long as the patient's expectations are managed beforehand.

How is the Procedure Performed?

Prior to the operation, patients are subjected to a number of tests to ensure that they do not have existing contraindications that can make them unsuitable candidates for the procedure. These include active phlebitis and any history of hypercoagulability, including deep venous thrombosis and other thromboembolic events. They are also checked for vascular signs of lower extremity oedema and venous insufficiency. If patients suffer from severe varicosities, these should be treated at least three months prior to a calf liposuction.

The surgeon then begins by first marking out the portion of the calf where excess fat is located. At this point, the surgeon and the patient can discuss the parts that will be targeted to achieve the desired shape.

A pinhole incision is then made in the target area where a cannula (a thin steel tube) is inserted and moved back and forth through the fat layers to warm up the fat, causing them to break apart before they are suctioned out.

In some cases, the surgeon makes two separate incisions on either side of the calf to access all unwanted fats in the area to create a more balanced and more proportionate shape for the calf.

This procedure typically takes one to two hours, with patients under local anaesthesia the whole time, which means that they are awake but unable to feel anything in the lower extremities.

Possible Risks and Complications

Calf liposuction is considered as one of the least complicated of all types of liposuctions. However, it is not without complications.

Common side effects include swelling or oedema, which is a normal reaction of the body in response to the surgical trauma caused by the insertion of the cannula. The swelling, which is worse during the first two days and which may continue to slightly increase over the next two weeks, can be controlled by wearing compression stockings. By the end of two to three weeks, the swelling should start to dissipate.

Other complications include:

  • Seroma
  • Hematoma
  • Infection
  • Over-correction
  • Under-correction
  • Hyperpigmented scars
  • Hypertrophic or keloid scars
  • Skin necrosis
  • Blood loss
  • Hypothermia
  • DVT or thromboembolism
  • Visceral perforation
  • Fat embolism syndrome
  • Acute pulmonary oedema

In all liposuction procedures, there is also always a risk that patients will not be satisfied with the results. Studies show that the most common reasons for patient dissatisfaction are:

  • The legs are less slim than expected
  • Skin surface irregularities
  • Asymmetrical calf shape
  • Skin laxity
  • Skin hyperpigmentation
  • Severe post-operative pain
  • Hypesthesia


  • Dixit VV, Wagh MS. “Unfavorable outcomes of liposuction and their management.” Indian J Plast Surg. 2013 May-Aug; 46(2): 377-392.

  • Mladick RA. “Advances in liposuction contouring of calves and ankles.” Plastic & Reconstructive Surgery. 1999 Sept; 104(3).

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