Objective      Calf reduction is one of the new topic in the plastic and aesthetic domain. Now there are two methods: neurectomy of the nerve to the medial gastrocnemius muscle and botulinum toxin A injection.  To observe and compare the clinic effect of two different methods for calf reduction.        Methods      During the period of 2011 January to 2012 October

40 female patients with calf hypertrophy were chosen from the plastic and aesthetic outpatient in southwest hospital

and the average age was 28.4 years. Twenty patients were chosen for the neurectomy of the nerve to the medial gastrocnemius muscle. Twenty patients were chosen for botulinum toxin A injection. The maximum calf perimeter and the shape were measured and observed per-operation

3 months，6 months and 12 months after operation.       Results      In the neurectomy group，the maximum calf perimeter was reduced for 10.73% in 6 months after operation and the muscle shape was smooth.The daily activities were not affected. The effect lasts for 12 months at least. In the botulinum toxin A group， the maximum calf perimeter was reduced for 4.58% in 3 months after operation. The calf hypertrpphy relapses 6 months after operation and the effect disappears in 12 months after operation. There was significant difference between the maximum calf perimeter in two methods（P0.05）.       Conclusion      The effect of the neurectomy of the nerve to the medial gastrocnemius muscle is better than that of botulinum toxin A injection，and the former is recommended. But the surgical skill is highly requested with more complications and the operation must be carried out carefully.