title: Calf contouring with endoscopic fascial release, calf implant, and structural fat grafting.
abstract: BACKGROUND
  Curved lower legs cause psychological stress for women. In evaluating the shape, if thickness is the main contributing factor of leg aesthetic, then lipoplasty or calf reducing procedures will be the option. If the legs are slender and have no muscle hypertrophy but still have some indentation or bulges on both sides and lack an aesthetic shape what will be the options? The answer to the question is discussed in detail in this article.
  
  
  METHODS
  Twenty-two patients, operated over a period of 5 years from 2007 to 2012, were included in the study. A novel technique has been introduced. This method requires release of fascia covering muscles of the inner leg bulge via endoscopic approach and simultaneous calf augmentation with calf implant, liposuction, and structural fat grafting to optimize the results.
  
  
  RESULTS
  Patients were followed on a regular basis with a mean follow-up of 31 months. The procedure was well tolerated with minimal discomfort during the postoperative period. Increase in diameter of proximal and distal lower legs was measured at least 6 months after surgery. Mean diameter change of proximal lower legs was 2.16 cm and 1.77 cm in distal lower legs.
  
  
  CONCLUSIONS
  A novel endoscopic approach for lower leg contouring is discussed. Endoscopic fasciotomy technique with calf implant and structural fat grafting for improved lower leg aesthetics is a simple, effective, reliable, and predictable technique for calf contouring.
authors.affiliation: Department of Plastic Surgery, Memorial Hospital Atasehir, Istanbul, Turkey; Division of Plastic Surgery, Brown University School of Medicine, Providence, R.I.; and Division of Plastic Surgery, Medpark International Hospital, Chisinau, Moldova.
authors.forename: Ercan
authors.initials: E
authors.lastname: Karacaoglu
authors.affiliation: Department of Plastic Surgery, Memorial Hospital Atasehir, Istanbul, Turkey; Division of Plastic Surgery, Brown University School of Medicine, Providence, R.I.; and Division of Plastic Surgery, Medpark International Hospital, Chisinau, Moldova.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Zienowicz
authors.affiliation: Department of Plastic Surgery, Memorial Hospital Atasehir, Istanbul, Turkey; Division of Plastic Surgery, Brown University School of Medicine, Providence, R.I.; and Division of Plastic Surgery, Medpark International Hospital, Chisinau, Moldova.
authors.forename: Iulian
authors.initials: I
authors.lastname: Balan