Imagine being able to permanently increase your height—highlight and improve your appearance—throughout your adult years. This is the aim of height extension surgery, a type of cosmetic or aesthetic surgery with the working title “leg lengthening” or “stature surgery.” This relatively new process has a long and controversial history and has been in consistent development since 1953, and has grown significantly in recent years.
A combination of psychological and social factors can make it difficult to accept a small stature. The use of this period in our expectations of beauty is one such variable, but history offers us certain reflections. Some new data reveal an increase in mental health issues across various age ranges, with adult males being the most important demographic. Patients are believed to be obsessed with their low stature, believe it is too little for them and does not fit with their personality, character, or frame. Any other offerings from other specialists to discuss can be ignored. Physiologically, these patients are proportionately small and do not show any signs of dwarfism. They have undergone orthopedic treatment for their tibiofibular length. They have undergone bone density assessment and metabolic evaluation in order to determine if they are appropriate candidates for stature surgery.
In theory, height increase surgery is feasible based on the principles of human anatomy and physiology, i.e., the occurrence of endochondral ossification, and is achieved using bone linear growth. The reason patients cannot achieve a permanent height increase (about 10 cm) in a single surgery is that bone lengthening by wire is slow, about 1 mm/day, and the bone-healing process is an equally slow physiological phenomenon. Several techniques have been adopted and developed to perform bone lengthening at various anatomical locations in patients with normal or achondroplasia. However, the backbone of permanent height increase surgery is the “distraction osteogenesis.”
At present, five main techniques are used to cut the bone during growing taller with surgery: metaphyseal corticotomy, osteotomy, and corticotomy in mature individuals; percutaneous epiphysiodesis (patients aged 12–13 years); and open prophylactic or post-fracture epiphysial-physeal injury in younger children under hospital admission. In relation to the different timing and anatomy of the surgery, the best technique for patients is selected to promote limb lengthening. External fixators are used to support this slow and progressive and permanent height increase. This progressive distraction plays several functions in addition to lengthening the skeleton: formation of a neojoint mechanism, guiding the new bone, muscles, and nerves to an improved anatomic position, and progressively adapting the soft tissue to the new length of the skeleton. In the appropriate patient, adult bone will form after surgery and after a gradual clockwise or counterclockwise turn of the pins in the fixator or nails to maintain the correct alignment of the new bone until complete skeletal development. Finally, after removing the external fixator, patients can gain approximately 8–10 cm. Numerous external fixators and different metal internal nails have been developed, evolving with the use of progressive access to the bone and new substances that stimulate bone healing and vascularity at the lengthening site. Complications include numerous adverse effects due to bone lengthening and fracture healing, including soft tissue contractures, possible fractures during bone lengthening, and many orthopedic diseases due to the conservative goal of lengthening or risks during the procedure.
Height extension surgery is often performed for cosmetic purposes, and unlike invasive cosmetic surgery, its results and advantages can be clearly measured. The primary motivations for the procedures were to enhance self-esteem and add physical appeal by making individuals growing taller with surgery. Similarly, people treated with height surgery will have access to a greater range of jobs and earn more money than shorter individuals. Taller people, on average, make more money. Furthermore, centered on the heights of U.S.-born CEOs and adult men, it was concluded that businesses are more likely to hire taller males for leadership compared to shorter men.
Height increase surgery, on the other hand, requires a great deal of foresight. Most visits to the surgery initially considered all readings and received consultation and evaluative X-rays. Nonetheless, there may be risks to the surgery, such as the need for medication during the surgical process, as well as the potential for infections, deep vein thrombosis, nonunion, and nerve damage following the surgery. While the surgery has become more acceptable in terms of variables, it is unclear whether individuals who are able to undergo the surgeries completely understand their ramifications. Nonetheless, millions of people around the world often travel for height surgery, working with orthopedic surgeons to give them the inches in height they crave.
Height enhancement through how height extension works has been a better understood, albeit niche, field in medicine for many years. However, recent advancements in the techniques and technology have resulted in potential new markets. In particular, demand from those who cannot yet afford height extension surgery may drive the development of the next generation of technologies. New research has led to the development of implant applications that release biological factors to stimulate bone growth, tissue engineering and regeneration applications, and the use of on-site stem cells to increase bone growth. Stem cell applications have been a more recent subject of low-impact research but have shown promising results so far.
For now, any limb lengthening surgery remains a growing taller with surgery or bone-stretching surgery, and as such requires significant incisions throughout bleeding procedures to access and cut the bone. With improvements in research and technology, it is possible in the future that there may be less cutting of the bone, or demand for less invasive surgery, leading to new patient markets. In recent years, the idea of cosmetic limb lengthening and other high-invasive elective surgeries has been raised within the media and popular press. Reasons have been given as to why this is unethical, mainly surrounding the well-documented issues of limb lengthening (pain, secondary surgeries to remove implants, re-fracture rates, limb weakness). However, large social demographics, influenced by social media and wider societal norms, may be interested in such surgeries in the future. It is important to consider the attitudes of wider society when future technological advancements in how height extension works may open new markets, whether they are perceived as ethical or unacceptable. In recent years, we have become more aware that we are living in a world of increasing interest in biohacking and transhumanism. However, more education is still required, be it a future enhancement, a radical body modification, or within current practices. A full psychological assessment is required within all current procedures, but is entered into voluntarily and at a cost. In the future, caution should apply to the ethical and moral implications of any surgical innovation, be it technological, implantable, injectable, or a more physical manifestation of ambitious desires. The practice or future use of these emerging technologies may lead to a shift in societal norms surrounding what is considered natural and what is artificial in the future, and what is beautiful and what is acceptable or unacceptable on a global scale.
Our goal is to improve the quality of life of patients by managing the process of limb lengthening and boot lengthening in a healthy and safe manner.
Our doctors are ready to make a treatment plan tailored to your needs within 24 hours.
