Correcting of Calf Atrophy With a Custom-Made Silicone Implant: Contribution of Three-Dimensional Computer-Aided Design Reconstruction: A Pilot Study

Abstract

Abstract Background Calf shape is an essential aesthetic parameter of the leg, and calf atrophy can lead to complex problems. The functional consequences of calf atrophy are generally moderate. Prefilled silicone gel implants represent the vast majority of currently placed prostheses, but this technique does not ensure optimal adaptation of the implant shape due to loss of volume. Objectives The aim of this study was to describe an innovative procedure for correcting acquired calf atrophy based on 3-dimensional (3D) modeling. Methods The study involved 22 patients treated for calf atrophy caused by illness. Implants were made with solid rubber silicone, and 3D reconstructions were created by computer-aided design based on computed tomography scans. The implants were introduced through a horizontal popliteal incision. Results Forty-one implants were placed. No cases of infection, hematoma, or compartment syndrome were encountered. We experienced 1 case of skin necrosis and 1 case of periprosthetic seroma. In addition, lipofilling was performed in 5 cases. Two patients sought to benefit from a surgical reduction in implant size. Conclusions Our innovative procedure to correct calf atrophy with custom solid rubber silicone implants produces a calf shape that better adapts to volume loss than prefilled silicone gel implants. The material maintains its shape and facilitates retrofitting of the prosthesis. There is no risk of hull formation or breakage, and the life span of the implants is limitless. This 3D computer-aided design approach has optimized our reconstructions. Level of Evidence: 4