London - The setting is a plush, private treatment room in London’s Harley Street, where Zara Marchant is about to be injected with Botox.
To her right is a brightly lit clinical bed and a trolley piled with needles and vials. So far, so normal.
But what happens next is far from standard. “Take off your tights,” instructs Dr Carolyn Berry, snapping on a pair of white, latex gloves, while Zara, 30, a marketing manager from South-West London, peels off her hosiery.
Because it’s not her frown lines she’s having frozen, or her crow’s feet that are being smoothed — instead, Zara is unhappy with her calves and is about to have them slimmed with an extraordinary new treatment, costing £300 (about R5 400).
Calf Botox, as it’s been dubbed, is now one of the fastest-growing areas of the multi-million-pound Botox market.
While Botox, the brand that has become synonymous with botulinum toxins, is cosmetically injected to iron out wrinkles, it’s also used by the NHS to treat cerebral palsy, facial tics, writer’s cramp and even long-term hiccups, thanks to its ability to paralyse nerves, thus preventing muscle contractions.
With this treatment, the toxin is injected into the calf muscle, paralysing certain nerves, and preventing it from contracting fully. This forced relaxation of muscle contours and slims the appearance of the leg.
It may sound dramatic, but the procedure is designed to affect only a small proportion of the outer muscle fibres, so that you’re still able to walk normally afterwards.
For those with a genetic predisposition to large calf muscles, or for women who exercise or wear high heels a lot and subsequently develop them, the treatment can knock more than 2cm off the circumference of each calf for up to six months. And this winter’s trend for knee-high boots has caused a stampede for the treatment.
As with facial Botox, the treatment, which can cost from £200 to £1 450, is non-surgical and non-invasive, requires little to no downtime and takes just minutes. Because the calf is a large muscle, a high dose of Botox is needed to have an effect — more than ten times what you would put into your face: 20 units versus 250 units.
Some physicians are concerned that such a large dose could not only cause your muscles to waste away, but also change the way you walk — potentially causing knock-on effects on the knees, hips and back.
The treatment could even potentially prove fatal if it hampers the muscle’s ability to pump blood from the legs towards the heart.
None of this bothers Zara as she climbs onto the bed, lies face down and jokes that if there’s some left over, could Dr Berry do her face, too?
It’s Zara’s first Botox treatment. She’s having it because she desperately wants to fit into a pair of trendy, black, knee-high River Island boots — a gift from a friend two years ago. Despite numerous attempts, she’s never managed to get the zip up higher than halfway.
“It’s so annoying,” says Zara. “I’m not a large person, but I can’t fit into them or any other boots. My calves are just too big and I’ve always been self-conscious of them.
“I’m a size 10, but my upper calf looks out of proportion to the rest of my body. Day-to-day, I don’t mind because they’re hidden underneath jeans or tights, but I’ve been desperate to wear these boots for years, and I’d love to wear them to the work Christmas party.”
Zara, who found out about the treatment while searching online, hasn’t told her friends she is having it done, but plans to reveal all later.
Within half-an-hour, the consultation and procedure are over. Dr Berry, who has been offering calf Botox for a year, since clients began requesting it, made six marks on the gastrocnemius muscle, the thickest part of the calf, on each leg, then injected each mark with Botox. The needle shouldn’t go in too deeply, or it could hit the soleus muscle — the long, inner muscle that runs down the length of the lower leg — which would affect walking. Zara says she only feels a slight pinprick as 100 units are injected into each leg.
Dr Berry says she might inject up to 125 units for someone with bigger calves. While just one unit could prove lethal to a mouse, experts estimate it would take at least 3 000 units to kill a human.
She warns that results take at least a week to show and up to 14 days for the full effect to be seen. She expects Zara to lose at least 1cm from each leg.
“Calf Botox is especially big business in Asia, where women have muscular legs but want delicate, bird-like limbs. But it is now also increasingly popular in the UK,” says Dr Berry.
“I see mothers-of-the-bride who are self conscious about their lower legs, or women coming to me before holidays. But many just want to fit into a pair of winter boots.”
So what are the downsides?
Jane Olver is the founder of Clinica London and specialises in cosmetic surgery. Before treatment, she asks everyone to sign a consent form acknowledging that “possible side-effects include initial weakness and risk of change of gait which is temporary”.
“There’s also a chance of bruising,” says Jane, who has been injecting Botox since 1990, when it was first used cosmetically.
In the five years she has had calf Botox on the menu, Jane has injected almost 100 people, but she says she’s seen a spike in the past year, as the UK becomes more aware of the procedure.
“We haven’t come across anyone who had a problem walking yet,” says Jane. “They might notice it very minimally, but no one has complained to us. Most of the women I see come to me because, when they put on high heels, they don’t like their calves looking too muscly. They want to look elegant and streamlined.”
Despite its calf-altering properties, some doctors and surgeons are worried about the implications of using Botox unnecessarily in large quantities. Cosmetic surgeon and British Association of Aesthetic Plastic Surgeons member (BAAPS) Naveen Cavale believes calf Botox is foolhardy and potentially dangerous.
“By preventing muscles from contracting properly, Botox weakens them and causes muscle wastage,” he says. “We use our calf muscles every time we take a step; why would you want to weaken something that helps you walk, just for the sake of your appearance?
“What’s more, calf muscles pump blood up the legs and towards the heart. If you weaken that pump mechanism, it could put you at risk of blood clots.
“That’s massively dangerous, and can lead to a clot travelling to the lungs — which could prove fatal.”
Mr Cavale also says that, if Botox is incorrectly injected, it could enter a vein or artery, potentially causing a stroke or heart attack. “I would strongly advise against something like this,” he adds.
Yet among women desperate for slimmer calves, some believe it’s worth the risk.
Gillian Higgin, 49, from Lee-on-the-Solent, Hants, who works in mental health and is a mother-of-two, has no regrets about her calf Botox treatment. Quite the opposite, in fact. Gillian had the treatment for the first time more than a month ago at Firvale Clinic in Southampton — and has lost 2cm from each calf.
“There was only a tiny amount of bruising. After two weeks, my calves looked tighter and less obvious,” she says. “They’ve stayed like that and I feel great. I’m hooked.”
Like Zara, Gillian was motivated by a desire to fit into a pair of long, winter boots. “Boots have always been a problem,” she says.
“I’ve looked everywhere, from Evans to M&S and online, and tried pairs with stretchy, elastic side panels, as well as with zips, but they either pinch, tear, or don’t do up.
“Even when I was a dress size 8 before my wedding, my calves were huge. It’s how I’m made.
“I wanted to be able to wear comfortable, long boots for work, as I walk long distances in all weathers.”
For those who think exercise might pose an alternative, slimming and toning the muscle naturally, it only made matters worse for Gillian.
“The more I worked out, the bigger my calves got,” she says. “They’ve never been wobbly or fat — muscle is the problem.”
Now Gillian can wear her favourite brown M&S riding boots — and there’s even room to tuck her jeans in around the sides. “I love my new legs,” she says. “It was painless, quick and cheaper than many treatments.”
Gillian’s husband Max, 43, a lecturer, was less enthusiastic. “He laughed and thought it was a strange thing to have done,’” says Gillian. “He says my calves look slimmer, but, then again, he doesn’t notice when I get my hair cut, so he might be saying what he thinks I want to hear.”
Susan Richardson, 45, a beauty therapist, also visited the Firvale Clinic to contour her calves with Botox.
The mother-of-two from Southampton has been twice this year — most recently last month to shape her legs in time for a Caribbean holiday with friends in January.
She first had the treatment in March to restore confidence. “I’ve had quite a tough couple of years,” she says. “My son was very ill for a while and I’ve recently divorced and moved house. With so much stress, I put on weight and stopped looking after myself. This was to reclaim my body and make me feel better.”
And has it? “Definitely,” she says. “I can really see a difference in my calves and friends have been saying how nice I look — even if they don’t know about the Botox.
“With Christmas coming up, I wanted to be able to fit into long boots so I can wear shorter dresses. But they seem to be making boots smaller and smaller. It’s hard to squeeze them on.
“I’ve got my eye on a sparkly Monsoon dress that I would never have been able to buy before, as it comes to the knee, but now I can wear it with long boots.”
Susan has lost 2cm from each calf and heard about the treatment after having her thread veins lasered at the clinic. She says the calf Botox treatment wasn’t painful, and she hasn’t noticed any difference with her walking.
“I was worried calf Botox might make my legs feel tight, or make it harder to walk, but I haven’t noticed any difference at all,” says Susan.
“I’m definitely going to keep having it done. It’s not like I’ve gone under the knife, and the Botox will eventually wear off. As a beauty therapist, it’s important to look my best. Why shouldn’t I treat myself?”
As for Zara, one week after treatment she’s lost just over 1½ cm from her calves. “I’m really pleased,” she says. “My calves look better and more defined. While it’s only a small change, it makes a big difference. I can fit the boots on now.”
Zara’s philosophy is simple: “I feel pretty fabulous on the inside and I want to look fabulous on the outside, too. It’s all about looks.
“People say it’s not, but it is. If you look good, you are treated differently, so I’ll always be interested in strange cosmetic treatments.”
And Dr Berry agrees: ‘”’d hang upside down like a bat if I thought it would make me look better.” - Daily Mail