Individualized Treatment of Botulinum Toxin Type A for Hypertrophic Muscular Calves With Different Bulging Units in Asian Women.

[BACKGROUND] Dermatologic surgeons have performed botulinum toxin type A injection to treat muscular calves, with different dosages and injection sites suggested.

[OBJECTIVE] We investigated the use of individualized botulinum toxin type A injection protocols to treat hypertrophic calves in Asian women.

[MATERIALS AND METHODS] A total of 294 calves were examined and their bulging areas divided into 4 units (Units 1, 2, 3, 4). The rare bulging area unit 5 was only seen in 1 case. Thirty-five cases were treated using botulinum toxin type A between September 2011 and May 2016, with the treatment protocol chosen according to the assessed bulging units. Standard photo documentation was performed at each clinical visit.

[RESULTS] The average injection dose was 187 ± 10 U per patient. The average maximum calf circumference was significantly reduced 3 months postinjection, with that of the right leg reduced from 36.48 ± 0.57 to 34.87 ± 0.44 cm, and that of the left leg from 36.26 ± 0.61 to 34.71 ± 0.53 cm (both p < .01). The overall patient satisfaction rate was 73.08%.

[CONCLUSION] A botulinum toxin type A injection protocol tailored to the shape of the hypertrophic calf muscle can effectively improve the contour of the lower leg.