ORIGINAL ARTICLE Laser-assisted lipolysis for cankle remodelling: a prospective study in 30 patients Franck Marie Leclère & Javier Moreno-Moraga & Serge Mordon & Pascal Servell & Frank Unglaub & Frédéric Kolb & Françoise Rimareix & Mario A Trelles Received: 23 June 2012 / Accepted: 28 January 2013 / Published online: 8 March 2013 # Springer-Verlag London 2013 Abstract Cankles refer to the area where the calf and ankle meet. Unaesthetic fat cankles, where definition between the calf and ankle is impossible, are a frustrating aesthetic deformity, which are exacerbated by their genetic condition- ing and special resistance to diet. This article reports our experience with laser-assisted lipolysis (LAL) in cankle remodelling. A total of 30 patients were treated for unaes- thetic fat cankles with LAL. The 924/975-nm diode laser used in this study consisted of two lasers, one emitting at 924 nm, and the other at 975 nm. According to our mathe- matical models, we assumed that to destroy 1 ml of fat, 0.1 kJ was required in dual emission mode at 924/975 nm. Patients were asked to file a satisfaction questionnaire. Ultra- sound was used to measure the fat thickness pre- and postop- eratively. Oedema in both lateral sulcus of the Achilles tendon was seen in all patients. It subsided after 4 weeks in nine cases and 6 weeks in 21 cases. Only two patients developed mild hyperpigmentation that disappeared, respectively, after 4 and 10 weeks. Pain during the anaesthesia and discomfort after the procedure were low with this technique. Mean down time was 1.0 day. Of the 30 patients, 29 would recommend this treat- ment. Overall, high patient and investigator satisfaction was confirmed by the sonography used to measure decrease in fat thickness. LAL in cankle remodelling is a safe and reproducible technique that is particularly appreciated by the patient. The procedure allows homogenous reduction of fatty tissue together with skin tightening. Keywords Cankles . Laser . Laser lipolysis . LAL Introduction Cankles refer to the area where the calf and ankle meet. Unsightly fat cankles, where definition between the calf and ankle is impossible, are a frustrating aesthetic deformity exacerbated by genetic predisposition and resistance to die- tary modification. Liposuction continues to be the most common cosmetic procedure for fat cankles [1–6]. Howev- er, this technique has the following limitations: increased blood loss, ecchymoses, long recovery times, increased postoperative discomfort, potential for pulmonary emboli, and seromas [2]. The search for and development of new liposuction technologies and techniques has grown steadily over the past decades in order to keep pace with patients’ requirements and expectations for greater efficacy and safe- ty. Recent decades have seen the introduction of internal ultrasound-assisted liposuction, external ultrasound-assisted F. M. Leclère : S. Mordon : P. Servell INSERM U703, Lille University Hospital, 152, rue du Dr. Yersin, 59120 Lille-Loos, France F. M. Leclère (*) : F. Kolb : F. Rimareix Department Plastic Surgery, Institut Gustave Roussy, Villejuif, France e-mail: franckleclere@yahoo.fr F. M. Leclère e-mail: franck.leclere@igr.fr F. M. Leclère e-mail: franck.leclere@inserm.fr F. M. Leclère e-mail: franck.leclere@insel.ch J. Moreno-Moraga Instituto Médico Laser, Madrid, Spain M. A. Trelles Instituto Médico Vilafortuny, Fundacion Antoni de Gimbernat, Cambrils, Tarragona, Spain F. Unglaub Medizinische Fakultät Mannheim, Universität Heidelberg, Heidelberg, Germany Lasers Med Sci (2014) 29:131–136 DOI 10.1007/s10103-013-1279-4