title: Safety and Efficacy of Subfascial Calf Augmentation.
abstract: BACKGROUND
  Calf augmentation surgery is one of the least popular procedures among plastic surgeons; in contrast, it is by far one of the most gratifying procedures among patients. In this article, the authors present a retrospective analysis of a surgeon's extensive experience with calf implants.
  
  
  METHODS
  The authors retrospectively analyzed 134 patients having calf augmentation for cosmetic and reconstructive surgery in their practice from 2003 to 2015. All patients were divided into two groups: primary cases and patients who had previously been operated on and who were referred to our service as patients who had complications after calf augmentation surgery. The subfascial approach was the preferred approach by authors for all primary cases. The authors analyzed indications, complication rates, results, and pitfalls. Secondary cases were further divided into three groups according to the origin of the problem and some possible solutions.
  
  
  RESULTS
  Subfascial calf augmentation surgery is safe and easy to reproduce, with a short recovery period and a low complication rate (<1 percent). To achieve the best aesthetic results, surgeons should choose appropriate implants for each case. In secondary cases, fat grafting is a powerful tool and can be used alone or in combination with calf implants.
  
  
  CONCLUSIONS
  There are several groups of patients seeking calf augmentation surgery (e.g., bodybuilders, women, those with reconstructive problems). Therefore, treatment should be planned individually. The development of a new implant is necessary and should be based on detailed anatomical findings and in accordance with surgical techniques. The process is intriguing and rewarding.
  
  
  METHODS
  Therapeutic, V.
authors.affiliation: Belgrade, Serbia; Ponte-Nova, Brazil; and Leeds, United Kingdom.|From the BelPrime Clinic, the Faculty of Medicine, University of Belgrade, and the Institute of Forensic Medicine; Faculdade Dinamica; and the University of Leeds.
authors.forename: Katarina
authors.initials: K
authors.lastname: Andjelkov
authors.affiliation: Belgrade, Serbia; Ponte-Nova, Brazil; and Leeds, United Kingdom.|From the BelPrime Clinic, the Faculty of Medicine, University of Belgrade, and the Institute of Forensic Medicine; Faculdade Dinamica; and the University of Leeds.
authors.forename: Marcos
authors.initials: M
authors.lastname: Sforza
authors.affiliation: Belgrade, Serbia; Ponte-Nova, Brazil; and Leeds, United Kingdom.|From the BelPrime Clinic, the Faculty of Medicine, University of Belgrade, and the Institute of Forensic Medicine; Faculdade Dinamica; and the University of Leeds.
authors.forename: Rodwan
authors.initials: R
authors.lastname: Husein
authors.affiliation: Belgrade, Serbia; Ponte-Nova, Brazil; and Leeds, United Kingdom.|From the BelPrime Clinic, the Faculty of Medicine, University of Belgrade, and the Institute of Forensic Medicine; Faculdade Dinamica; and the University of Leeds.
authors.forename: Tatjana C
authors.initials: TC
authors.lastname: Atanasijevic
authors.affiliation: Belgrade, Serbia; Ponte-Nova, Brazil; and Leeds, United Kingdom.|From the BelPrime Clinic, the Faculty of Medicine, University of Belgrade, and the Institute of Forensic Medicine; Faculdade Dinamica; and the University of Leeds.
authors.forename: Vesna M
authors.initials: VM
authors.lastname: Popovic
mesh_terms: D000328:Adult; D005205:Fascia; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D019736:Prostheses and Implants / Q000009:adverse effects; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult