Once the proper size is achieved, the expanders can be replaced by the correct sized implants. If the degree of enlargement is not excessive, the permanent implants can be inserted in one stage. Usually, two implants are placed in each leg over each head of the gastrocnemius. There is a certain amount of pain and discomfort following the procedure caused by the pressure of the implant until the body adjusts to it. Most patients find walking on their toes or in built-up heels the most comfortable during this adjustment stage.
Bed rest is advisable for the first few days with a gradual increase in walking.
Upper body workouts can be resumed in one week. Light leg workouts can begin in three weeks, increasing to full workouts in six weeks. The scars behind the knees will be pink at first but will eventually fade. Shifting of the implants, infection, bruising and, in rare cases, muscle weakness. If activity is resumed too quickly, before the implant is solidly healed in place, it may shift position or even come to the surface.