Background: Different studies have been published over time for leg augmentation, but, to the best of our knowledge, no comprehensive literature review and complications analysis have been published.

Objectives: The aim of the study is to analyze the leg augmentation surgical procedures and complication rates associated with the investigated techniques, namely subfascial and submuscular implant placement, fat grafting or lipofilling, and Muscular Sculpting (MS).

Materials and methods: A literature review on the PubMed database was performed for clinical studies regarding leg augmentation surgical procedures. The authors selected and analyzed articles among the actual literature on this field and reported personal experience in leg augmentation surgery for an athletic look. Four different surgical techniques have been reviewed, excluding medical procedures: subfascial and submuscular implant augmentation (n patients = 166), fat grafting (n patients = 266) and MS (n patients = 6).

Results: Legs augmentation present complications compared to other implant techniques for body contouring such as gluteal augmentation, breast augmentation and pectoral implants for male chest enhancement. The submuscular implant placement complication rate was 5.7%. Fat grafting and MS complication rate are not statistically significant.

Conclusions: Legs augmentation, with all reviewed surgical techniques, has a low rate of complications, but a high rate of satisfaction among patients. Muscular Sculpting (MS) has no statistically significant complications. Fat grafting and MS have the lowest rate of complications, but for Fat Grafting multiple sessions are required. Specific complications of implants, such as capsular contracture, malposition or rupture, are less common compared to the use of implants for other cosmetic purposes. Procedures should always be performed by experienced plastic surgeons.

Body contouring, Sculpting, Liposuction, Legs, Muscle definition, Athletic body