On your initial consultation with your plastic surgeon, your leg will be measured to determine the right size of implant for your calves. You may also choose the implant material you want: silicone-gel implants or solid silicone implant.
Before the actual procedure, you will be given intravenous sedation and local anesthesia or general anesthesia. In some cases, an epidural blockade may be used instead. You will have to lie face down on the operating table.
During the procedure, your plastic surgeon will create an incision at the back of the knee, through the skin and fascia (a sheet of connective tissue) that covers the gastrocnemius muscle. Your surgeon will then create a snug pocket just beneath the fascia (subfascial), or within the calf muscle (submuscular). The snug pocket is made large enough only for the implant. The silicone implant will be inserted through the incision to the sung pocket. Depending on the result you want to achieve, your surgeon may place a second silicone implant alongside the first to give your calf greater shape.
Once your surgeon is done placing the implant, they will examine the leg and close the incision with sutures. You will then be positioned to lie flat on your back, facing up, and taken to recovery.