Capsular Contracture after Calf Augmentation with Silicone Implant Insertion

The legs are an aesthetically important part of the body, and an increasing number of patients desire calf-contouring procedures to improve the overall appearance of their legs. At one end of the spectrum, botulinum toxin injections are used to reduce the volume of hypertrophic calf muscles, and at the other end, silicone implants or autologous fat may be used to add volume. The shape of the calf is determined by a number of factors: the soleus and gastrocnemius musculature, the length and orientation of the bones, and the distribution of subcutaneous fat. Since Carlsen first performed calf augmentation with carved silastic foam implants inserted beneath the deep fascia of the calf in 1972, various methods of inserting silicone gel-filled implants and silicone rubber implants have been reported [[1]]. Inserting silicone implants into the calf has disadvantages; early postoperative complications include hematoma, seroma, wound disruption and infection, and later complications include capsular contracture, extrusion, rupture, and palpability. However, it is generally a safe procedure with a low incidence of complications [[2]]. Given the infrequent occurrence of complications, it is not surprising that few reports containing radiological or pathological images documenting capsular contracture have been published [[3]].