The size and shape of the ankles and calves vary from person to person. Genetics certainly play a role in the dimensions of your lower legs, but muscle, fluid balance, and fat mass also influence how ankles look in relation to your calves.

For some people, their ankles end up looking a bit bigger than they think they should be — and no amount of dieting, running, or weightlifting ever seems to make a difference.

When diet and exercise aren’t enough, getting rid of what some people refer to as “cankles” could mean surgery. Of course, the decision to undergo surgery shouldn’t be taken lightly.

Read on to learn when surgery for ankles is appropriate, as well as what you can expect from the procedure.

The term “cankles” is slang — it isn’t a real medical term. The word is used to describe the lower part of the leg when the calf and ankle appear to be one continuous body part.

Cankles might occur when a person doesn’t have well-defined calf muscles or if they have a lot of fat tissue or fluid surrounding their lower leg.

Weight training and weight loss can sometimes help you tone and change the shape of the calves and ankles, but calves and ankles in particular are more resistant to diet and exercise.

Cankle causes

There are multiple reasons for excess fat storage in the ankles. For example, foot and ankle swelling are common during pregnancy, especially in the third trimester.

A number of other health conditions can also cause swollen ankles and feet, including diseases of the liver and kidneys.

A condition known as lipedema causes fat to be stored beneath the skin on your legs. Lipedema is often a painful condition affecting up to 11 percent of women. It can be triggered by hormones.

In some cases, a buildup of lymphatic fluid in the lower leg can also make the ankles look larger. This is referred to as lymphedema.

For lymphedema, you can try massage techniques or compression stockings or bandages to reduce swelling. Cutting down on sodium in your diet can also help with excess fluid retention.

For some people, ankle liposuction is done purely for cosmetic reasons. These patients just don’t like how their ankles and calves look and want to quickly reduce their size.

But for people with other health conditions, excess ankle fat can affect quality of life. Lipedema, for example, can be painful and is often resistant to weight loss strategies.

If the extra fat tissue in your ankle is causing pain or keeping you from walking safely, your doctor may advise surgically removing the fat deposits. This is referred to as ankle liposuction.

Keep in mind that liposuction isn’t a treatment for obesity or a substitute for proper diet and exercise. It’s also not an effective way to remove cellulite or loose skin.

Liposuction is a cosmetic procedure that removes excess fat deposits in specific areas of the body. It’s a relatively simple and minimally invasive procedure that works by removing the fat cells that are resistant to diet and exercise.

The best candidates for liposuction are adults within 30 percent of their ideal body weight who have firm, elastic skin.

Here’s what to expect from an ankle liposuction:

  1. First, your doctor will inject a local anesthetic solution into the fatty tissue so you won’t feel pain.
  2. Your doctor will then make small horizontal incisions around the calf or ankle.
  3. Next, they’ll insert a small tube called a cannula to loosen the fatty deposits. The goal is to reduce the size of the calf and make the lower leg look more slender.
  4. The excess fat is then suctioned with a vacuum-like device.
  5. Your doctor will close up the incisions and cover the area with compression bandages.

Additional steps for those with lipedema

If you have lipedema, ankle liposuction may involve additional steps.

Specialized techniques for lipedema may include water jet-assisted liposuction. This involves a doctor injecting large amounts of fluid under the skin to help dislodge some of the fat tissue so it can be more easily removed.


Most people will find the recovery easy. You can return home the same day and will be encouraged to walk around the next day. No overnight stay is required after ankle liposuction, but you’ll need a ride to and from your procedure.

Swelling of the leg is normal following the procedure. You may need to wear a compression garment during the first week to minimize swelling. Pain resolves relatively quickly and can be treated with over-the-counter pain relievers like acetaminophen (Tylenol).

The results of an ankle liposuction procedure are considered permanent — as long as you maintain your weight and fitness level.

Despite its potential benefits, there are various downsides to ankle liposuction.

Side effects

Ankle liposuction is generally considered very safe. But as with any surgery, there are risks. Possible side effects or complications of liposuction may include:

Swelling will likely occur in the ankles for a few months post-surgery. You may have to wait 3 or 4 months in order to see the final results.


Another drawback of ankle liposuction is the cost, which according to the American Society of Plastic Surgeons is around $3,500 — not including anesthesia, facility expenses, and other fees.

The total cost can range from $4,000 to $7,000, depending on your location. As with other cosmetic procedures, ankle liposuction isn’t considered to be medically necessary and isn’t covered by insurance.

If you’re apprehensive about surgery, another option for to consider is a newer procedure known as CoolSculpting.

CoolSculpting is a noninvasive medical procedure that helps eliminate fat cells from underneath the skin without surgery. It’s also known as cryolipolysis.

A trained physician will use a tool that cools the fat to freezing temperature. After a few weeks, the body naturally removes these frozen dead fat cells through your liver.

CoolSculpting is a nonsurgical, outpatient procedure. There’s no cutting, no anesthesia, and no recovery time needed. It only takes about an hour, but you may need to go in for a few treatments to achieve your desired results.

Deciding to reshape your calves or ankles through liposuction is a big decision. If fat deposits in your ankles are causing pain or making it difficult to walk, surgery may be necessary to improve your quality of life.

If you’re not happy with the way your calves and ankles look, liposuction could be a solution. But it’s important to have a positive outlook and realistic goals in mind for cosmetic procedures.

If you’re considering ankle liposuction surgery, meet with a board certified plastic surgeon to discuss the risks, benefits, and costs associated with this procedure.