Your Questions

Q: Dr. Eppley, I need calf augmentation for club foot. I just read about Stem cell fat muscle augmentation. I would prefer that because its more natural and fat would be taken from the same body. Besides, I learnt that with age implants would have to be removed because of blood circulation. I want something permanent for the rest of my life. I am a size 8-10 and hoping you would find some fat in my thighs (though small) and other areas to work with. Kindly advice.

A: Unfortunately you have numerous misconceptions about fat grafting and calf implants. While fat grafting is an option for calf augmentation, you do not have enough fat to harvest to make the procedure worthwhile. Small thigh areas are not going to cut it for adequate fat donor sites. Besides the donor fat issue, there is also the variability of how well fat will take and persist. In thin people this is usually very poor. Tight tissues, like a small calf in clubfoot, also work against fat graft survival and ‘squeeze’ out most of the injected fat. Fat grafting still may work if one is willing to do two or three fat grafting sessions to bypass these issues, but again there has to be enough fat to repeatedly harvest for the procedure. Lastly anytime you see the phrase ‘Stem Cell’ associated with any plastic surgery procedure, that is all hype and marketing. There is no proven science that demonstrates the role that stem cells have in fat transplantation. It sounds good but, in the end, it is just fat grafting.

The only proven procedure for calf augmentation for clubfoot is an implant. That is the only way to assure a visible volume result that will be permanent. I have never heard or seen the issue of ‘implants having to be removed because of blood circulation’. If that have any validity every breast implant would eventually have to be removed because of it. This implant contention has no scientific basis.

Dr. Barry Eppley

Indianapolis, Indiana