Have your patients been complaining to you about their "cankles"?

I haven't heard this new term but apparently it is a new description that has made it into the vocabulary and into some popular women's magazines. This has women heading into their podiatrists' offices complaining about cankles, a condition defined as, well, fat ankles.

Dr. Kathya Darmos-Zinszer, from the Temple School of Podiatric Medicine, appeared on Headline News today, describing the condition that apparently has patients streaming into offices asking for liposuction. Dr. Zinszer does NOT recommend that procedure due to the proliferation of neurovascular structures in the area.

She recommends a medical workup to see if there are issues that may be causing fluid buildup first. And in the end, a patient just might have to live with it!

Cankles, a new medical entity or a marketing tool for a liposuction tool designed for the ankle??

If the surgeon can do the liposuction and satisfy the patient, then great.  However, a person vain enough to want the surgery will not be satisfied easily.  That is what lawyers are for.  Bates

My practice partner is a cosmetic/reconstructive plastic surgeon.

There is nothing technically difficult about liposuction. If you have the right tools, you can learn how to do it in a day.

The bigger problem with cosmetic practice is the patient selections & how to gauge/manage the patients expectations. If a patient is looking for "perfection," you are doomed for a failure, because there is no such thing as "perfect" face, ankle, feet etc.

Another problem with cosmetic practice? It is very economy sensitive. My partner is doing fine with his reconstruction cases, but all the cosmetic plastic surgeons tell me they are having problems, as you can imagine. Since the recession started, in Los Angeles, I know of two plastic surgeons who closed their offices, and one doctor who committed suicide from his financial difficulty.

As for me, if I see "Cankles" in a new patient, I would make sure the patient does not have congestive heart failure.

Just my 2 cents... 

I agree with all of the above statements.  In this situation, patient selection must be extremely careful, and the patient must be made to understand the difference between "better" and "perfect." (which is an important distinction to make to the patient anyway).

Perhaps in right patient, after ruling out other potential systemic issues (like Congeste heart failure), and with realistic expectation of the outcome, liposuction for cankles may become a viable service to offer.  In my practice in rural Virginia, however, i can't imagine my patients offering to pay cash for such a service.

Wow.  Cankles.   ICD anyone??

Has anyone really looked at these patients and have evaluated for secondary lymphedema/chronic venous insufficiency?  I find that most of these women have the following:

a)  history of breast cancer
b)  history of lack of exercise and gastroc atrophy
c)  genetic predisposition
d) venous congestion

Try looking at compression therapy and manual decongestive therapies before lipo!!!

 

In the Tampa, FL market they had a plastic surgeon on a morning radio show discussing, yes - cankles and surgical treatment this week.

Karr 

Interesting!

Did he or she have any unique wisdom to offer that we, as podiatrists, don't offer our own patients?

Liposuction for "cankles."  I can't wait to hear about the podiatrist who starts doing this.  Maybe they can add this on to the aesthetic foot and CANKLE society!  Another procedure to do.  I agree with Eric: compression therapy.  Just because we can do a thing doesn't mean we should do that thing!

Kathleen,

The next day on Bay News 9 there was piece on lipo for cankles.  No wisdom......just remove and remodel.  Only a matter of time until we see a cankle's table at  a conference.  Does not intererst me at all.

karr