FAQ (A Guide to Cosmetic Leg Lengthening)

There are many resources on leg lengthening surgery, but most are confusing or don’t answer questions in a clear and concise manner.

For this reason, we consolidated the most frequently asked questions in one area and linked out to relevant resources. So if you’re considering leg lengthening surgery or simply fascinated by the topic, let this FAQ serve as a starting point for your research.

What Exactly is Leg (Limb) Lengthening Surgery?

Limb or leg lengthening surgery allows individuals to gain inches in height by breaking the shin and/or thigh bones before implanting an internal (internal nail) or external fixator (circular fixation device among others). The fixator or nail slowly pulls apart the bones for months (distraction), and the bones fill in the gaps in a process called consolidation.

After distraction, patients are a few inches taller, and the majority of the process is over. From there, the bones are allowed to heal (consolidate). Although it’s a long and painful process, some have deemed leg lengthening surgery worth it due to the difficulties they face about their height.

For more details, check out our limb lengthening surgery article here.

Can Anyone Get Taller Through Surgery?

Yes, nearly anyone can get height surgery if they’re healthy and sane. 

However, the list below are disqualifications for those who seek height increasing surgery: 

• History of smoking
• Poor health or vitamin deficiencies 
• Under 18 years of age (growth plates must be closed)
• Mentally unstable (some doctors may perform or outsource a psychological evaluation)
• Not enough time between work, school, and family
• Unable to afford the surgery

Is There a Maximum Age Limit for Limb Lengthening?

While the minimum age for this surgery is generally 18 or once the growth plates have fused, there’s no maximum age limit for limb lengthening surgery. Even the elderly can get leg lengthening performed with excellent results [1]. Ultimately, even for young people, qualifying for surgery depends on the individual’s health.

Surgeons will assess all patients’ physical strength/frailty, underlying health conditions, bone density, etc., before approving the surgery. Since people below the age of 50 are more likely to have higher quality bones and better health in general, some surgeons may recommend getting this surgery before 50.

However, people can offset worse bone quality with dietary and supplementary changes under the guidance of their doctor, so there’s no actual limit for height surgery.  

Is it Possible to Get Taller Naturally?

Unfortunately, healthy adults are not able to get through natural means. But in rare cases such as those with humpback or kyphosis (rounded shoulders), adults can gain a few millimeters by improving their posture. So there’s no evidence that stretches can help you gain height, but some exercises can improve posture and help you appear taller. 

Note, young children going through puberty can potentially facilitate the growth of their legs by eating a nutritious diet, exercising regularly, and maintaining excellent posture. 

Are There Any Alternatives to Leg Lengthening Surgery?

If patients don’t want to go the surgical route or want to find out how they’d feel being taller, they can try methods like heel lifts, different clothing choices, and posture exercises.

Heel lifts insert into the heels of shoes and are unnoticeable unless they add a lot of height. People can look 3-5 inches with heel inserts. Similarly, monochromatic clothing – wearing clothes of the same color all over – can create the illusion of long legs since it forms a continuous silhouette without separating the legs from the torso.

Finally, most people don’t have perfect posture, which can make them appear shorter than they are. Regular stretching and posture exercises can help them make themselves taller.

How Much Taller Can I Get With Surgery?

With the newest nails such as PRECICE and STRYDE, it’s possible to safely gain 8 – 16 centimeters or 3.1 – 6.3 inches in height. 

The more you stretch pre and post-surgery, the more likely you’ll reach your desired height. The main thing that stops patients from lengthening is the soft tissues getting tight from the distraction (lengthening) process.

What Are Some Modern Fixation Devices Used for The Surgery?

Modern devices used for limb lengthening include both external and internal fixation devices, for example:

• PRECICE STRYDE: The STRYDE nail is an intramedullary nail placed in the patient’s bone marrow and can gradually lengthen the bone with an external remote controller. It’s stainless steel and allows patients to walk throughout the lengthening process [2].
• PRECICE 2.2: The PRECICE 2.2 is similar in functionality to the STRYDE nail, but it’s made of titanium and is only partially weight-bearing. However, it costs less than the STRYDE.
• Ilizarov Apparatus and Taylor Spatial Frame: These are both external fixators attached to the bone via wires and screws, which patients turn to lengthen the bone. They have a visible cumbersome external apparatus and are not weight-bearing.

Can You Get Height Increasing Surgery Two or Three Times (2-3x)?

Patients can get limb lengthening surgery two times if they want to gain the maximum height possible, extending both the tibias and the femurs twice. The first surgery can safely provide a height gain of up to 8 cm (about 3 inches), but a second or third one can extend this to 13 cm (about 5 inches) [3][4].

Patients can also combine multiple surgeries into a quadrilateral limb lengthening procedure, where the femurs and the tibias distract simultaneously. They can also repeat this surgery a year later. However, the risk of complications and the recovery time go up along with the difficulty and number of surgeries – a factor patients should keep in mind.

Is it Best to Lengthen Femurs or Tibias First?

Whether patients should lengthen femurs or tibias first depends on how much time and money they have and what surgery option they’re getting.

Tibias take double the time to heal than femurs and are approximately $10,000 more expensive to operate on [5]. Femur lengthening is also safer, so most patients prefer to lengthen their femurs first if they’re getting bilateral (either both femurs or both tibias) lengthening surgery.

However, if getting quadrilateral (both femurs and tibias simultaneously) lengthening surgery, surgeons will operate on the tibia first to give them a head-start on healing. 

Otherwise, surgeons generally only perform tibia lengthening first if patients want to correct the femur-to-tibia ratio.

How Much Does Limb (Leg) Lengthening Surgery Cost?

Surgery to increase your height ranges from country to country, doctor to doctor, and even more so for various lengthening methods. 

For example, a surgery using a classic but outdated method such as lengthening over nail (LON) in India will be significantly cheaper and inherently riskier than going with the newest STRYDE nail in the same country. Additionally, it’s much more expensive to have the surgery in the USA or European countries, no matter the nailing method used. 

With that said, cosmetic limb lengthening surgery costs anywhere from $15,000 – $300,000. 

As always, it’s advised to prioritize your safety over the cost of surgery. You can read more about the costs of limb lengthening here. 

Is Limb Lengthening Surgery Dangerous?

Limb lengthening surgery is very safe, but just as with any invasive procedure, it comes with it’s own set or risks. 

There’s only 5-6% chances of severe complications like bow-leggedness or knock knees, even with the old-fashioned Ilizarov technique [6]. Overall, there’s only a 1% chance of complications that require unplanned surgery, according to the world renowned Dr. Paley [7].

The general complication rate may go up to 37% with external fixators like the Ilizarov, but surgeons can resolve most issues before complete consolidation (healing of the bone) occurs.

Like every cosmetic surgery, patients can minimize the risk of complications if patients diligently follow the physical therapy and take the medications prescribed to them. Besides that, they should also make sure to attend their regular check-ups with the doctor to catch unexpected complications before they can do much damage.

What Are the Success Rates of Limb Lengthening Surgery?

Limb lengthening surgery success rates are pretty high at 95% [1]. Most complications that occur during the process can be diagnosed and treated if the patient visits their surgeon regularly.

Most patients are highly satisfied with the surgery. They would do it again and recommend it to others, which indicates that height surgery may mitigate height dysphoria to some extent. However, this isn’t a guaranteed outcome and depends on the patient’s mindset going into surgery.

Who is The Best Limb Lengthening Surgeon or Top Doctors?

Dr. Dror Paley at the Paley Orthopedic & Spine Institute, West Palm Beach, and Dr. S. Robert Rozbruch at the Hospital for Special Surgery, New York, are the two most renowned and respected surgeons in the field of limb lengthening. With them, you can count on a safe leg lengthening surgery – although complications can arise with skilled surgeons too.

However, if patients aren’t in the US, there are other talented surgeons worldwide. Use our Doctor Finder to find a qualified height surgeon near you.

How Do You Pick the Right Surgeon?

Some tips on picking the right leg lengthening surgeon include ensuring that they keep the patient’s safety first, have a record of previous successful surgeries, and are active in following up with patients and providing after-care.

Potential patients can find scholarly articles by most surgeons online, proving their credentials and activity within the orthopedic community. Potential patients can also look up surgeons on YouTube, blogs, and communities such as the Limb Lengthening Forum, where many patients post their leg lengthening diaries with various doctors.

Lastly, potential patients should look at their own funds, location, and mindset to determine which surgeon they should go to, but keep in mind that choosing the wrong surgeon based solely on a smaller price tag may add significantly to complications and recovery time.

What Are The Potential Risks of Limb Lengthening Surgery?

By picking a top-notch surgeon and a dedication towards physical therapy, you can mitigate many of the risks associated with surgery. 

However, just as with any surgery, there are always risks, side effects, and potential complications. Some minor side effects are pain, weakness, difficulty sleeping, and mental fog due to the constant dull pain. 

More serious side effects include a fat embolism, deep vein thrombosis, pulmonary embolism, nerve damage, and more. Check out our article about risks, complications, and side effects to better understand what can go wrong.

Can You Run After Limb Lengthening Surgery?

Patients can run after limb lengthening surgery, but only once the bones are fully consolidated or healed. Running before the healing process is complete may cause fractures and other complications.

Some patients indicate better running ability after surgery – however, most report high mile times or a decrease in running feel. This effect likely occurs due to a change in biomechanics (the way the patient moves after gaining inches of height) and is largely due to new femur-to-tibia ratios. 

Patients may also face difficulties in running if they go outside ideal femur-to-tibia ratios, which they can get tibia lengthening surgery to correct afterward. Other than that, it’s essential to keep up with physical therapy to ensure better running ability post-lengthening.

How Soon Can You Walk After Leg Lengthening?

How soon after limb lengthening surgery patients can walk depends on the method used and the recovery time. Using the STRYDE nail (which has been recalled), patients can start walking with crutches and walkers right after surgery.

If patients get the PRECICE 2.2, patients can lengthen 0.75 mm-1 mm per day, along with a recovery lasting one week for a 1 cm increase in height with the femurs and 1.5 weeks with the tibia.

With lengthening over nail (LON), patients can walk throughout the lengthening period. Lastly, with the Ilizarov apparatus, distraction is 3-4 months, and healing takes 45 days for every 1 cm increase in height, and patients can only walk once the bone completely consolidates (heals).

How Long After Limb Lengthening Can You Drive Again?

Patients can drive after limb lengthening surgery after fulfilling specific requirements – about 1-3 months post-surgery.

Depending on the height gained and bone lengthened (femur, tibia or both), patients will be under the influence of narcotics for 1-3 months, making them incapable of driving until then [8]. Afterward, people with weight-bearing nails like STRYDE can begin to drive, though it may take longer for people with non-weight-bearing nails.

People with external fixators may not be able to drive until healing is complete due to the bulkiness of the fixator. Also, people who get unilateral surgery (on one leg) will be able to drive much quicker than those with bilateral (both legs) or quadrilateral (both femurs and tibias) surgery.

How to Tell if You Have Long Legs for Your Height? Or Have Ideal Proportions?

Body proportions and ratios vary significantly from person to person. Two common ways to measure your leg to body ratio is with the perineum to floor or ankle to hip measurement. 

Then compare these measurements to your total height or upper body height to gauge your ratios. Some people go as far as measuring the proportions between their tibias and femurs for a more aesthetic look. Normally tibia to femur lengths are .8 + / -.02

What is an Ideal Arm to Height Ratio?

The ideal ape index or arm-to-height ratio is 1:1 [8]. People can calculate this ratio by dividing the wingspan (the distance between the fingertips of both hands with the arms outstretched) by height.

For example, if a person has a wingspan of 180 cm and their height is also 180 cm, the ape index will be 180/180 or 1:1.

However, even if the wingspan and height have a difference of 2-3 cm, it’s practically indistinguishable from 1:1. In fact, people aren’t considered disproportionate up to a difference of about 10 cm.

How Many Inches Do People Grow in a Year?

If you’re under 18 and contemplating surgery, we suggest waiting to see if you hit a growth spurt before committing or fantasizing about such a procedure. On average, young children grow 2.25-3.33 inches per year between the ages of 12-18.  

When it comes to limb lengthening, it’s possible to grow about 4+ inches in a year, or approximately 6 inches in two years.

Can I Get Shorter in Height?

Yes, you can get shorter through height reduction surgery or, even though the procedure is quite rare. Many of the same doctors who perform cosmetic limb lengthening know how to perform surgery to reduce your height too.

Both men and women undergo height reduction and increasing surgery for various reasons and everyone experiences height loss with age at some point too. 

Does Insurance Cover Limb Lengthening?

If someone has a significant limb length discrepancy or deformity, insurance may cover all or a portion of the procedure. However, leg lengthening surgery is considered an elective cosmetic procedure to increase your height, so insurance does not cover any costs. 

What is Heightism, Height Dysphoria, and Height Neurosis?

• Heightism – is the discrimination or prejudice towards a person because of their stature or height 
• Height Dysphoria – means that someone is unhappy with their height
• Height Neurosis – is often used as a synonym for height dysphoria and Dr. Dror Paley coined the term. Neurosis differs in that it denotes any one of a variety of mental disorders characterized by significant anxiety or other distressing emotional symptoms. 

Note, Body dysmorphic disorder is a related but separate term that means one is obsessed with or over-emphasizes certain flaws or characteristics. See dysmorphia vs dysphoria for more information.

What Height is Considered Short? Or Tall?

What height is tall and what height is considered short depends on the individual’s ethnicity, gender, geographic location, etc. Technically, people would regard a person one standard deviation shorter or taller than the average in their country or group as short or tall, respectively.

The average man in the US is 5’6”. Since statisticians consider 3 inches to be a standard deviation in male height, we can safely say that people would see men below 5’6” as short and men above 5’11 as tall – generally.

However, the technical answer isn’t enough as height perception is subjective. If one is generally shorter or taller than one’s peers in group settings, that’s a more holistic method of determining if they’re short or tall.

Are There Disadvantages to Being Short?

Statistically, there is a stigma against short people in society, especially short men. People see their shorter peers as less capable, leading to lower self-confidence and lower salaries [9]. Shorter men have also been ridiculed about their negative emotions like sadness and anger than tall people [10].

In a UK study, women described their ideal male height as 5’11”, corroborating the notion that women see shorter men as less attractive. However, this discrepancy doesn’t reflect reality across the board [11].

Short people are also more likely to put on weight as their caloric expenditure, while taller people can eat more and still not gain weight. So, while there aren’t significant biological disadvantages to being short, the societal differences are pretty stark.

Are There Advantages to Being Tall?

CEOs are disproportionately tall – 60% of CEOs stand at 6+’ tall, compared to just 15% of the masses [12]. Height confers a confidence boost on tall people, making them more likely to earn more money and get promoted faster as they’re also perceived to be more capable than their short counterparts.

Even a 1-inch increase in height translates to a 4% wage increase [10]. This discrepancy leads to tall people being generally happier than short people, besides being seen as more desirable in general, especially when it comes to men.

So, there are advantages of being tall, but one doesn’t have to be tall to be confident – it’s just more likely that society will bolster a tall person’s confidence than a short person’s.

Is This Surgery Right for Me if I’m Always Comparing Myself to Others?

If you’re comparing yourself to others to the point of height dysphoria or height neurosis (extreme dissatisfaction and obsession with your height), no, this surgery is not suitable for you. It’s better to look into therapy to get into a healthier mindset before permanently altering your body.

However, if you’re generally happy with yourself but are just dissatisfied with your height and want to change it, height surgery may be your solution. There’s no guarantee that this surgery will treat height dysphoria, but it can give you a boost in self-confidence and freedom from heightism (height discrimination).

Instead of comparing yourself to others, it may be more productive to visualize how you would look at a certain height. You can do so using our height comparison and visualizer tool.

References

[1] Rozbruch, S. R. (n.d.). Limb lengthening: An overview by S. Robert Rozbruch: HSS. Hospital for Special Surgery. https://www.hss.edu/conditions_limb-lengthening-overview.asp

[2] Robbins, C., & Paley, D. (n.d.). Stryde Weight-bearing Internal Lengthening Nail. Techniques in Orthopaedics, 35(3), 201-208. https://paleyinstitute.org/wp-content/uploads/Stryde-Weight-bearing-Internal-Lengthening-Nail.pdf 

[3] Guerreschi, F., & Tsibidakis, H. (2016). Cosmetic lengthening: what are the limits?. Journal of children’s orthopaedics, 10(6), 597–604. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5145841/ 

[4] Paley Orthopedic & Spine Institute. (2018). Costs & Financial Considerations. Paley Orthopedic & Spine Institute. https://paleyinstitute.org/centers-of-excellence/stature-lengthening/costs-financial-considerations/#/ 

[5] Paley Orthopedic & Spine Institute. (2018). Consolidation Phase. Paley Orthopedic & Spine Institute. https://paleyinstitute.org/centers-of-excellence/stature-lengthening/the-paley-method/consolidation-phase/#/ 

[6] Paley D. (1990). Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clinical orthopaedics and related research, (250), 81–104. https://pubmed.ncbi.nlm.nih.gov/2403498/  

[7] Paley Orthopedic & Spine Institute. (2022). Stature Lengthening Guide Book [PDF]. https://paleyinstitute.org/wp-content/uploads/StatureLengtheningGuide-Website.pdf  

[8] Science Buddies & De Brabandere, S. (2017, March 16). Human Body Ratios. Scientific American. https://www.scientificamerican.com/article/human-body-ratios/ 

[9] Blaker, N. M., Rompa, I., Dessing, I. H., Vriend, A. F., Herschberg, C., & van Vugt, M. (2013). The height leadership advantage in men and women: Testing evolutionary psychology predictions about the perceptions of tall leaders. Group Processes & Intergroup Relations, 16(1), 17–27. https://psycnet.apa.org/record/2013-01284-002 

[10] Reuters Life! (2008, September 11). Taller people have the edge when it comes to happiness. Reuters. https://www.reuters.com/article/us-height-happiness-idUSSP35300020080911 

[11] Jordan, W. (2014, July 11). The ideal height: 5’6” for a woman, 5’11” for a man. YouGov. https://yougov.co.uk/topics/politics/articles-reports/2014/07/11/ideal-height-56-woman-511-man

[12] Lindqvist, E (2012); Height and Leadership. The Review of Economics and Statistics, 94(4): 1191–1196. https://direct.mit.edu/rest/article-abstract/94/4/1191/58060/Height-and-Leadership