Work

Ultrasound-guided injection of ankle contouring with botulinum neurotoxin

Year: 2025

Type: article

Abstract: Background: A slim ankle is considered a hallmark of beauty in modern aesthetics. Excessive muscular hypertrophy, particularly of the deep calf muscle (soleus), can lead to a thick ankle appearance that detracts from an overall refined leg contour. Although surgical approaches have been used historically, they carry risks such as scarring, contracture, and unpredictable outcomes. Objective: This study aimed to evaluate the efficacy and safety of ultrasound-guided botulinum toxin type A (JETEMA THE TOXIN, JETEMA Co., Ltd. Korea) injections for improving ankle contour in patients with thick ankles. Methods: Three adult female patients with noticeably hypertrophic calf muscles underwent ultrasound-guided injection of 20 units of botulinum toxin into the soleus muscles. Needles were inserted with ultrasound guidance to ensure precise real-time visualization and accurate injection into the soleus muscles. Ankle circumference and soleus muscle thickness were measured pre-treatment and at 8 weeks post-treatment using standardized methods. Wilcoxon signed-rank test was applied to evaluate statistical significance.The manuscript was checked against the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist (Supplemental Appendix). Results: = 0.001) between pre- and post-treatment values. Visual assessment of photographic records further confirmed a noticeably slimmer and more refined ankle contour. Conclusion: Ultrasound-guided botulinum toxin injections appear to be a safe and effective minimally invasive approach for ankle contouring, achieving clinically meaningful reductions in muscle bulk with high patient satisfaction.

Source: JPRAS Open

DOI: 10.1016/j.jpra.2025.11.034