Introduction
Fat accumulation in different body parts can make a person obese. Obesity is a widespread health problem that negatively affects the health and well-being of people. The arms, stomach, legs, and hands are a few areas in the human body where fat accumulates. Furthermore, the lower leg (calf muscle) and ankle joint are common areas, especially in women. The calf muscle of the leg is contoured in a tapering shape as it merges with the ankle joint. Due to the excess fat deposition, the calf loses its tapering shape and appears thick and cylindrical. However, the overall appearance of the calf muscle differs from one person to another.
What Are Cankles?
Cankles is a term formed by combining two words “calf” and “ankle.” The cankle is an area in the lower leg where the calf muscle and ankle joint meet. Fatty cankles are an aesthetic deformity. The fat in the swollen ankle joint gives an illusion of the absence of an ankle joint. Cankles are commonly known as fat cankles, cankles feet, pregnancy cankles, and swollen cankles. Hence, cankle is slang given to the swollen ankle joint that merges with the calf muscle without demarcation.
What Causes Cankles?
Mentioned below are the various conditions that may cause cankles.
1. Lipedema:
It is a long-standing disease that results in fat deposition in different parts of the body, such as the arms, legs, feet, and hips. It mostly occurs due to hormonal imbalances among women. There are five types of lipedema.
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Type I - Fat deposits around the hips and butt.
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Type II - Fat deposits between hips to knees.
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Type III - Fat deposits between hips to ankle.
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Type IV - Fat deposits between hips to ankle and around arms, which is most commonly seen.
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Type V - Fat deposits in the calf region only, which is rarely seen.
2. Lymphedema:
It is also known as lymphatic dysfunction, a chronic swelling (edema) in different parts of the body. The most common areas of swelling are the legs and feet.
3. Other Health Conditions:
Other associated conditions, such as kidney or liver disease, may result in cankles.
4. Pregnancy:
During the third trimester, ankle and foot swelling may occur. Various factors contribute to cankles during pregnancy. The growing uterus puts pressure on veins, impairing blood return to the heart. Furthermore, hormonal changes also play a role.
5. Genetics:
Sometimes, genes are associated with fat deposition. Some women may be prone to obesity, which could be hereditary-genetic cankles.
6. Natural Appearance:
Some people may have big ankles since birth, which includes their natural appearance.
How to Know If One Has Cankles?
Generally, the calf muscle has a long tapering shape that merges with the ankle joint. Someone with cankles may have swollen ankles with a cylindrical shape without taper. Moreover, the junction where the calf muscle and ankle joint meet may not be visible.
How to Prevent Cankles?
Cankles can lead to chronic ankle instability. It comprises lingering pain, instability, recurring injury, and continued functional disability. Although it is difficult to get rid of cankles, a few steps may help.
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Weight Loss: If the patient is obese, it is essential to lose weight. As cankles may occur because of fat deposition, losing weight may help to reduce the fat from the body and cankles.
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Diet: Taking a good and healthy diet may help to reduce fat and cankles. Sometimes, cankles are diet-related. For example, a high-sodium diet retains more water in the body, including the ankle area. Excess dietary fat and sodium are linked with obesity and metabolic dysfunction.
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Exercises: Calf-reducing exercises may help to reduce fat deposition and reshape the calf muscle. A few are stair calf raises, weighted calf raises, jogging, and brisk walking.
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Liposuction: It is a surgical treatment that helps reduce extra fat from the body. As a result, it improves the shape or contour of the body. Nowadays, it is the most widely performed surgery. Calf liposuction consists of removing excess fat from the calf muscles and ankles. Calf and ankle liposuction refines the lower legs and harmonizes their volumes.
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Laser-Assisted Lipolysis (LAL): It is a more recent technique adjunct to liposuction that melts the underlying fats through a laser. It also results in skin tightening after fat removal. A recent study included 30 patients for treatment of unaesthetic fat cankles with LAL. Ultrasound imaging was used to measure the fat thickness before and after the surgery. Of the 30 patients, 29 recommended LAL. The authors concluded that LAL in cankle remodeling is a safe and reproducible technique. Further, the procedure allows the uniform reduction of fatty tissue and skin tightening.
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Tumescent Liposuction: It is a fat-removing technique performed under local anesthesia (LA), called tumescent anesthesia. This technique is the gold standard of liposuction procedures. High awareness of health and beauty in India has led to increasing demand for aesthetic procedures. Hence, many dermatologists are performing this technique. LAL has safety, no hospital admission, and a rapid postoperative recovery. However, the procedure is slow (three to four hours). Further, the amount of fat extracted is limited to about four to five liters.
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Ultrasound-Assisted Liposuction: Another method of fat removal from the calves and ankles is ultrasound-assisted liposuction (UAL). UAL was introduced to damage the fat cells and facilitate their removal. However, the method has side effects such as skin burns. The damaged fat also leads to seromas (small cysts containing fluid). UAL can also cause skin bruising and prolonged postoperative swelling. Besides, the UAL machines are expensive (increasing the procedure cost).
What Are the Risks and Complications of Cankles Surgery?
Liposuction is the most widely performed and safe surgery to remove fat. However, it also has minor risks and complications. The complications include postoperative swelling (which can last up to six months), longer recovery time, increased blood loss, ecchymoses (discoloration due to bleeding under the skin), discomfort after surgery, damage to deeper structures (blood vessels and organs), bruising, surgical site infection, and scar formation.
Conclusion
Cankles are formed by the abnormal merging of the calf muscle with the ankle joint of the leg that may occur due to swelling or fat deposition. A healthy diet, exercise, and safe surgical procedures may reduce the fat and re-contour the shape. However, surgery should only be performed by experienced surgeons with proper training. Subsequently, follow-up of the calf muscles and ankle joint after surgery is warranted
