Cankles?

[Shireiqiang]

http://www.cnn.com/2009/HEALTH/08/24/chubby.ankles.cankles/index.html?iref=allsearch

Have any of you had patients come to you to treat their cankles? I am curious to know how you would handle a question like this, or how you have dealt with it in the past.

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[PADPM]

The idea of liposuction for this problem was started by a DPM in Philadelphia, though it hasn't been extremely well accetped. It isn't a very popular or highly respected procedure in the medical field.

My recommendation........wear long pants.

 

[Feli]

You can't spot reduce. Gravity will win every time, and the fat and edema from the rest of the leg will just gradually re-occupy any dead space where you do lipo.

I agree with wearing long pants... or better yet, exercising to lower overall body fat.

 

[sideways]

You can't spot reduce. Gravity will win every time, and the fat and edema from the rest of the leg will just gradually re-occupy any dead space where you do lipo.

Why not just remove the excess skin and thereby remove the dead space?

And just in case Hillary Clinton stumbles on this thread: hi Mrs. Secretary!

 

[Feli]

Why not just remove the excess skin and thereby remove the dead space?..

Skin can just expand right back. Have you ever seen someone with venous stasis or lymphedema? You could take out groups of the fat cells in the "cankle" ankle or the skin/fascia that contains them, but that means you are also bagging veins and lymphatics that drain that foot/ankle. It might look ok in the recovery room, but good luck on the results lasting.

Just look at a patient with a total knee, fracture, bypass vein harvest, or other major surgery on one leg... almost universally more edematous for the rest of their life than the opposite non-operative extremity. Gravity is a mother.

 

[sideways]

Skin can just expand right back. Have you ever seen someone with venous stasis or lymphedema? You could take out groups of the fat cells in the "cankle" ankle or the skin/fascia that contains them, but that means you are also bagging veins and lymphatics that drain that foot/ankle. It might look ok in the recovery room, but good luck on the results lasting.

Just look at a patient with a total knee, fracture, bypass vein harvest, or other major surgery on one leg... almost universally more edematous for the rest of their life than the opposite non-operative extremity. Gravity is a mother.

Interesting. It seems like such a mechanical limitation, I'm surprised the egghead collective can't overcome it.

I'm telling you, once we figure out skin, holy crap. A whole new world.

 

[NatCh]

Interesting. It seems like such a mechanical limitation, I'm surprised the egghead collective can't overcome it.

I'm telling you, once we figure out skin, holy crap. A whole new world.

One could always go old-school: exercise, not eat the world...

 

[sideways]

One could always go old-school: exercise, not eat the world...

I've seen plenty of fit people with big ass ankles. I'd personally jump off a building if I had that problem. But it definitely exists.

 

[krabmas]

Some people that have cankles do have excess fat just in their ankles, some are just fat all over, then there are those that have low lying soleus and peroneal muscle bellies.

I agree with Feli that LE surgery leads to destruction of the lymphatics and edema for a long time after surgery if not forever especially after a long day of standing.

I do not agree with Lipo of the lower leg, this probably destroys tons of lymphatics not to mention the blood supply to the skin. In order to make the ankle thin enough to appear to not have cankles more fat than is possible would need to be removed. IMO.


There is a procedure that some plastic surgeons perform expecially for the asian population that have thicker calves/ankles than they would like. Part of the low lying soleus muscle belly is removed thinning and shaping the calves.

 

[Substance]

Cankles are unfortunate. The most svelte, shapely woman would have her physical attractiveness severely reduced if she had cankles.

The thing is, cankles are generally not adipose. As far as I know they are either a low-lying soleus muscle belly, as krabmas has described above, or they are the result of a thicker achilles tendon thah desired. Either way, they make legs look stumpy and ugly.

If there was a PRS out there who could devise a way to eliminate cankles with few to no side effects, he'd have an extremely lucrative practice.

 

[NatCh]

The thing is, cankles are generally not adipose. As far as I know they are either a low-lying soleus muscle belly, as krabmas has described above, or they are the result of a thicker achilles tendon thah desired. Either way, they make legs look stumpy and ugly.

I love it! "I'm not fat; I have big muscles!"

 

[215353]

Why can't you just insert calf implants? An extra insert that would lay over the upper part of the gastrocnemius. Therefore you can get some kind of distrinction in the lower leg and eliminate the cankle appearance.

 

[krabmas]

Why can't you just insert calf implants? An extra insert that would lay over the upper part of the gastrocnemius. Therefore you can get some kind of distrinction in the lower leg and eliminate the cankle appearance.

It is not just the lck of definition between the calf and ankle, it is the lack of definition around the achilles tendon. Sexy ankles are typically bony and tendonous.