Calf implants may be required in cases where the calves are underdeveloped due to malformations, trauma (such as during childhood), or without any apparent cause. In many cases, gym exercises or cycling may actually worsen the situation. Both men and women affected are often self-conscious about their appearance, avoiding exposing their legs in the summer or during physical activities. Correction and reshaping of the calves often improves self-esteem, with results generally being very satisfactory.