Ankle carry isn't for everyone however it works very well as a deep concealment holster for many, including myself. I can't see the butt down carry as a good idea, it puts the pistol in an awkward position for the draw. There certainly is opportunity to put hand/fingers where they don't belong with an unnatural drawing position. I don't want to sweep any parts of my body to bring the weapon to bear.
I've seen people that have tried ankle carry come up with all kinds of things. One of the most common mistakes I see people that try this form of carry is using the holster on the outside of the ankle. They then complain about hitting the pistol on everything.
Get a good manufactured holster that is designed to stay in place, i.e. Renegade or one of the Galco offerings. Do this and you won't have anything to worry about. It allows you to carry a servicable caliber where it isn't likely to print or be noticed. With a little practice on the draw it can be brought into service reasonably fast.
Cheers,
Sam