Injection of BOTOX ® Cosmetic works by paralyzing the nerves supplying the calf muscles and causing the gastrocnemius muscles to shrink, or atrophy.

To effect even a tiny reduction in calf diameter requires that a large amount of BOTOX be injected repeatedly at intervals of three months.

After the initial three treatments, most patients note a slight improvement that lasts 6-9 months.

Reduction in calf circumference may be hard to measure but the weakened muscle appears less prominent.

Although recommended by some American surgeons, many Asian doctors feel BOTOX reduction is ineffective and mostly abandoned the procedure years ago.

Some doctors suggest that continued use will eventually lead to longer lasting effects and even permanent reduction.

Unfortunately, this claim makes little medical sense and is not backed up by scientific studies.

The only advantage of BOTOX calf reduction is that it is minimally invasive. Initial and recurring costs are high.