Yonsei Med J.
2023 Aug;64(8):511-517. 10.3349/ymj.2023.0124.
Intramuscular Neural Distribution of the Gastrocnemius for Botulinum Neurotoxin Injection: Application to Cosmetic Calf Shaping
- Affiliations
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- 1Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea
- 2Department of Anatomy, Daegu Catholic University School of Medicine, Daegu, Korea
- 3Maylin Clinic, Goyang, Korea
- 4Aura Clinic, Seoul, Korea
- 5Maylin Clinic (Pangyo), Seoungnam, Korea
- 6Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea
- 7Department of Anatomy, Catholic Institute for Applied Anatomy, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 8Department of Anatomy and Acupoint, College of Korean Medicine, Gachon University, Seongnam, Korea
- KMID: 2544920
- DOI: http://doi.org/10.3349/ymj.2023.0124
Abstract
- Purpose
Anatomical landmarks can provide vital information on the distribution of nerves in the gastrocnemius muscle. We aimed to provide an anatomical perspective on appropriate locations for botulinum neurotoxin (BoNT) injections in the medial and lateral parts of the gastrocnemius for calf shaping.
Materials and Methods
A modified Sihler’s method was applied to both the medial and lateral parts of the gastrocnemius muscles (16 specimens). Intramuscular neural distributions were revealed by dissecting along a transverse line crossing the fibular head and superior margin of the calcaneal tuberosity.
Results
The intramuscular neural distribution for the medial and lateral parts of the gastrocnemius had the greatest arborized patterns in the 7/10–8/10 section of the medial head and 7.5/10–8.5/10 section of the lateral part of the gastrocnemius.
Conclusion
We propose that BoNT injections should be directed to the 7/10–8/10 section of the medial head and the 7.5/10– 8.5/10 section of the lateral part of the gastrocnemius. Following our guidelines, clinicians can ensure satisfactory results with the use of minimal doses to limit adverse effects, such as gait disturbance, antibody production, and bruising, due to multiple injections. The results can also be altered and applied to electromyography.
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