Calf reduction by selective neurectomy

Calf reduction by selective neurectomy is also described.


A selective neurectomy (denervation, nerve transection) is the separation of the nerve trunk which innervates the gastrocnemius muscle. If your calf consists mainly of fat then a calf liposuction will be the solution.

After the neurectomy, the muscle atrophies, reducing the muscle’s volume. This effect, however, cannot be compared with that of removing the gastrocnemius muscle. A neurectomy can achieve a reduction in volume between 1.5 and 5cm depending on the volume of the gastrocnemius muscles. Only a small amount of the calf muscle’s volume remains. In very rare cases the calf muscle may be innervated from individual nerve branches which do not originate from the typical bundle in the hollow of the knee. These branches could partially replace the lost nerve trunk and in doing so prevent the desired muscle attrition.

Generally only a selective neurectomy is employed for calf reduction. The surgeon separates the nerve branch which connects to the inner head of the gastrocnemius muscle. The doctor does also separate the branch connecting the lateral muscle head, despite it’s close proximity to the nerve branch of the soleus muscle. This requires a lot of expierience in this operation and training in microsurgery.


  • If the nerves are not atypically placed then the intrusion is minimal.
  • Post operative recovery is very short.
  • The scar is hardly visible (often not visible) and only 2,5-3cm.
  • Depending on the anatomy of the lower leg and themuscles there can be some cavity on the upper third on the inner side if calf reduction by gastrocnemius resection is done. We never had such a cavity in selective neurectomy!
  • Smaller inner wound.


  • On occasion, the nerves are placed atypically; the results are hard to predict in such rare cases.
  • Slightly less calf reduction. We usually expect 2-4cm which is depending on the gastrocnemius muscle volume. We are talking about 0,5-1,5cm difference  compared to resection depending on the largeness of the gastrocnemius muscle.
  • A neurectomy is performed on a healthy muscle.


Despite selective neurectomy there are other options for reduction calfplasty. You can read about them in our articles about botulinum toxin and radio frequency.

FAQ for calf reduction by selective neurectomy

Is this procedure very painfull?

No, it isn’t. You will feel no pain because of the cutting of the nerve. But the suture in the hollow of you knee will hurt a bit. Slight pain killers are usually enaugh.

I have large calves because of fat and muscle. What can you do?

In such cases we combine two procedures!  We do selective neurectomy and liposuction of the lower leg in one session. We can also perform a liposuction of additional areas if desired.

When can I do sports after this operation?

You should be carefull for about 6-8 weeks. Not only because of wound healing, but also because of the healing of the scars. You can start with training of the upper part of your body right after about 1-2 weeks.

Do I have to wear compression garment after selective neurectomy?

Yes it is very important especially in the beginning to avoid hematoma, swelling and seroma production. We give the advice to wear surgical stockings for about 6 weeks.