Calf augmentation is performed by placing soft solid silicone implants in “pockets” created between the gastrocnemius muscles and their tough outer connective tissue fascia. The gastrocnemius calf muscle is comprised of two heads on the back of the lower leg; with one head medial (inside) and one head lateral. Most often, only one implant is needed on the medial side to enhance and proportion the calves. However, for body builders, or those with more pronounced deficiencies, calf implants may be used to enhance both the medial and lateral gastrocnemius muscles. After healing, there is no impairment of normal muscular function because no muscles are cut or detached.

Calf implants can also be placed under the gastrocnemius muscles (submuscular placement); this procedure has a higher incidence of complications and has a substantially more difficult and painful recovery. The new generation of extra-soft contoured silicone implants makes submuscular placement unnecessary and affords natural results with the subfascial placement, as well as an easier recovery. Fat augmentation can also be used to modestly enhance the shape and contour of the calves.