Cosmetic covers and silicone finishing
Under the clothing, a modern artificial leg is a tube and some joints. A cosmetic cover gives it the shape of a leg. Some people would not leave the house without one. Others never bother. Both are reasonable, and the choice has practical consequences worth knowing.
What is a cosmetic cover for an artificial leg?
A cosmetic cover, or cosmesis, is a shaped outer layer fitted over the structural parts of a prosthesis to give it the form of a natural leg. The usual type is soft foam carved to match the other leg and finished with a skin toned stocking. Custom silicone covers copy skin detail closely at far higher cost. Rigid printed fairings give shape with a deliberate, modern look.
Five finishes compared
| Finish | What it is | Looks | Trade offs | Indicative PKR, 2026 |
|---|---|---|---|---|
| No cover | Bare pylon and joints, perhaps a knee protector | Openly prosthetic. Hidden by trousers or shalwar. | Lightest, coolest, easiest to service | Nil |
| Foam cover with stocking | Soft foam carved to your other leg, under a nylon skin stocking | Natural outline under clothes. Plain close up. | Adds 200 to 500 grams, tears at the knee, must be cut open for adjustments | 12,000 to 40,000 |
| Foam with sprayed or PVC skin | Foam sealed under a painted flexible skin | Better colour match, wipes clean | Stiffer at the knee, heavier, repairs show | 30,000 to 90,000 |
| Custom silicone | Hand sculpted and painted silicone over a copy of your other leg | Veins, hair, freckles, nails. Convincing at conversation distance. | Costly, heavy, easily torn, stains from dye and ink | 150,000 to 600,000 |
| Printed or moulded fairing | A rigid shaped shell clipped over the pylon, in any colour or pattern | Deliberately visible and stylish | No skin likeness. Below knee mainly. | 25,000 to 120,000 |
Four things a cover changes
Weight
Foam adds a few hundred grams, silicone up to a kilo. Frail users feel it. Strong users do not.
Knee bend
A one piece above knee cover resists bending and wears through at the knee within a year. A two piece cover, split at the knee, moves freely and lasts longer.
Heat
Foam insulates. In a Karachi summer the covered leg is warmer and the stocking holds sweat and dust.
Servicing
Every alignment change means cutting the cover open and gluing it back. This is why it is added a few months after fitting, once adjustments have settled.
Shaping a cover to match your other leg
- Circumferences of your other leg are measured every few centimetres from ankle to knee, and thigh if needed.
- A tracing or photographs from the front and side record the line of the shin and the fullness of the calf.
- A foam block is fitted over the aligned leg and carved down by hand against those measurements.
- The ankle is kept slim enough for your shoes, and the top blends into the socket with no step.
- A stocking is matched to your skin in daylight, against your own leg. Two are supplied, as they ladder.
- For sandals, a foot shell with separated toes is chosen to match.
Who usually chooses what
A cover is usually worth it if
- you wear fitted trousers, shalwar in light fabric, or clothing where the outline shows
- meeting people is part of your work, and you would rather the leg was not the first topic
- a child is the patient, and school is approaching
- it simply makes you more willing to go out. That is reason enough.
You may be happier without one if
- you are frail and every gram matters
- your work is dusty, oily or wet. A cover will be ruined in weeks.
- your leg is still being adjusted in its first months
- you like the look of the engineering. Many younger users do.
Looking after a cover
Keep it dry. Foam soaks up water, smells and crumbles. Wipe a stocking with a damp cloth and change it when it ladders. Keep sharp furniture edges, motorcycle exhausts and cigarette ends away from it.
Silicone stains permanently from newsprint, ballpoint ink, henna, hair dye and the dye in new dark denim. Wash it with mild soap only, and dust with a little talc so clothes slide over it.
Expect a foam cover to last one to two years at the knee, longer below the knee. Replacing it is a routine job.
Is the cover included in the price of a leg?
It is listed as its own line on the quotation, so you can include it, leave it out, or add it later. Most basic builds omit it to keep the figure down.
Can it be added later?
Yes, at any time, and later is usually better. Once the alignment has stopped changing, the cover will not need to be cut open again.
Can the skin colour be matched to mine?
Stockings and sprayed skins come in a range of tones suited to South Asian skin. We match against your own leg in daylight. Only custom silicone matches fine detail such as freckles and veins.
Is a silicone leg worth the money?
For a few people it changes how they feel in public, and then it is. It does nothing for walking, adds weight and needs careful handling. We suggest living with a foam cover first.
Will a cover stop my knee bending fully?
A one piece cover limits the last part of the bend, which matters for floor sitting. A two piece cover split at the knee avoids this. Tell us if you sit on the floor daily.
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