As in the case of square faces, this is due to hypertrophy of the muscles, in this case the Gastrocnemius and Soleus. This hypertrophy in the lower legs is more common in the Asian, and can be cosmetically so unacceptable that make ladies unwilling to wear skirts.

In the past, plastic surgeons can treat this by:

  • Cut some of the nerve supply to the muscles there and make them shrink. This is relatively simple but there is high chance of recurrence. Satisfaction is not too great either.
  • Cut away part of the muscles. This is a more permanent correction with high satisfaction, but the scar from the operation is a cosmetic problem in itself.

Because of the effect of Botox / Dysport on the muscles, causing partial weakness and some shrinkage, it can be used to alter the shape of the lower legs. This use of Botox / Dysport is popular in Korea and Taiwan.


The first course of treatment usually requires 2 sessions separated by 2 - 3 months. The achieved effect lasts for about 6 - 9 months and requires a repeat injection. Overall the improvement is moderate.

Side effects include temporary pain, which normally does not interfere with walking. However, there is a small chance that the walking balance may be affected and it is better not to wear high heals for a while.

Although the dosage used is a lot more than that used in treating expression lines or square faces, so far there is no reported problems in general. This higher dosage means that the cost for having this treatment is quite expensive and it is up to the individual to see if this is worth the money or not.

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