Calf and thigh implants

Chapter 43 Calf and thigh implants






Background


In 1979 Carlsen1 showed the use of hard silicone implants for calf augmentation, but also emphasized the fact that they were not the best implants for this surgery, as there were many complications. In the same year, Glicenstein3 published an article where he used cigar-shaped silicone gel implants for calf augmentation, through a skin incision in the middle third of the leg. Then in 1985, Montellano5 presented his first cases of calf augmentation using anatomical silicone gel implants at the 22nd National Brazilian Meeting of Plastic Surgery.



Anatomy


The calf is composed of three major muscles:



These three muscles converge inferiorly at the heel, where they form the Achilles tendon, also known as triceps surae (Fig. 43.2).



The implants are placed under the aponeurosis of the medial gastrocnemius muscle, always preserving a thin muscular layer.


The thigh is composed of two muscular groups starting beneath the gluteal sulcus. The superficial group is formed by the biceps femoris, semitendinosus, semimembranous and adductor magnus. The deeper muscular group is composed of the adductor minimus, adductor brevis, adductor longus, vastus medialis and internal rectus muscles. An important structure, the sciatic nerve exits the pyramidal muscle through its inferior-medial part and travels between the two muscular groups mentioned above, reaching the popliteal fossa where it divides into two branches: the common fibular and tibial nerves.


The implant is placed in the medial-posterior region of the thigh, under the following muscles: internal rectus, adductor magnum, semimembranous and vastus medialis muscles (Fig. 43.3).




Jul 23, 2016 | Posted by in Aesthetic plastic surgery | Comments Off on Calf and thigh implants

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