The effect of calf subcutaneous fat thickness on patient satisfaction after calf contouring with botulinum toxin A

Xiangwen Xu; Dandan Liu; Mengfan Wu; Lin Luo; Jun Feng; Yanting Ou; Yixing Kang; Adriana C Panayi; Yun Long; Yongyan Cui

doi:10.1097/PRS.0000000000010721

The effect of calf subcutaneous fat thickness on patient satisfaction after calf contouring with botulinum toxin A

Plast Reconstr Surg. 2023 May 23. doi: 10.1097/PRS.0000000000010721. Online ahead of print.

Authors

Xiangwen Xu¹, Dandan Liu¹, Mengfan Wu¹, Lin Luo¹, Jun Feng¹, Yanting Ou¹, Yixing Kang¹, Adriana C Panayi², Yun Long¹, Yongyan Cui¹

Affiliations

¹ Department of Plastic and Reconstructive Surgery, Peking university Shenzhen hospital, Shenzhen, Guangdong, China, 518036.
² . Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA.

PMID: 37220391
DOI: 10.1097/PRS.0000000000010721

Abstract

Background: As a minimally invasive therapy, botulinum toxin A (BTXA) treatment effectively reduces the hypertrophy of the gastrocnemius muscle (GM). Patient satisfaction is, however, reported to be low after treatment with a possible correlation between high satisfaction and thinner subcutaneous fat. The goal of this study was to classify the subcutaneous fat of calves to understand the relation between fat thickness and patient satisfaction after BTXA treatment.

Methods: The maximal leg circumference was measured and B-mode ultrasound was used to measure the thickness of the medial head of the GM and of the subcutaneous fat. Patients were followed up at one and six months post-BTXA treatment.

Results: A total of 50 cases were classified into three levels of fat thickness, slim (< 0.55 cm), moderate (0.55 cm to 0.85 cm) and bulge (> 0.85 cm). All patients were treated with 300 units of BTXA (HengLi, China). Patients in the slim and bulge groups reported higher satisfaction rate than patients in the moderate group, with patients in the slim and bulge groups reporting complete satisfaction (100%) with calf contour at the 6-month follow-up. The satisfaction rate with the improvement in total leg circumference was low in all three groups. No severe complications were encountered in this study.

Conclusions: This study identified a U-shaped correlation between calf subcutaneous fat thickness and patient satisfaction rate after treatment. Our results provide a theoretical basis for BTXA treatment and suggest the importance of pre-procedure conversations in GM hypertrophy treatment.