Surgical removal of the entire medial gastrocnemius muscle causes full loss of function, is painful, and can lead to trouble walking.

As with nerve resection (neurectomy), the remaining lateral gastrocnemius and soleus muscles will enlarge to try to compensate for lost muscle function.

• Partial Muscle Resection (M, L, •S•)

Selective muscular resection can result in significant reduction in calf circumference from between 3 and 7 cm. Both gastrocnemius muscles (medial and lateral) and the soleus muscle beneath them are thinned not by total removal but rather by sculpting them down piece by piece. While most resection is done on the medial gastrocnemius muscle, the lateral gastrocnemius and soleus muscle may also be slimmed to achieve the best result.

Although many experienced surgeons feel this is the procedure of choice for Asian calf reduction, the operation is far from risk-free.

In contrast to neurectomy, partial muscle resection allows for more precision since the location and amount of reduction is more controllable. It is the only treatment that can help bowing of the legs (other treatments may worsen bowing).

Endoscopic-assisted surgery is performed under either spinal or general anesthesia and takes about 2-3 hours.

Scarring from the incision behind the knee (•••) is slightly greater than with other methods and healing can be slower. Normal calf strength may not be regained for up to a year.

Risks include asymmetry, permanent nerve injury, and pain during walking. Compensatory hypertrophy is not usually much of a problem.

Partial muscle resection does not need to be repeated. In comparison, BOTOX injections may cost significantly more in the long run while producing little change.

Western doctors have essentially no experience with this procedure.