Teen height surgery, specifically adolescent limb lengthening, is a complex-yet-life-changing procedure that offers the potential for significant height gain. Interest in this highly specialized surgery is driven by both medical necessity and increasingly, by cosmetic motivations.

As a parent or guardian, understanding the intricacies of this procedure is crucial. This life-altering decision requires deliberate consideration, weighing the potential benefits against inherent risks and the lengthy recovery process. 

Read on to find out more about height lengthening surgery in adolescents, including its risks, benefits, and realistic expectations for your teen. 

FYI - This decision should always be made in close consultation with qualified orthopedic surgeons and mental health professionals. To learn more from orthopedic specialists in height lengthening surgery in Burbank, get in touch with Dr. Shahab Mahboubian, D.O., MPH today. 

What Exactly Is Height Lengthening Surgery?

Height lengthening or limb lengthening surgery is a surgical procedure that increases the length of a bone: the femur, aka the thigh bone, or tibia aka the shinbone. The process relies on a biological principle called distraction osteogenesis. Here's how it works:

The surgeon makes a precise cut called an osteotomy in the bone to be lengthened. Next is distraction, where two segments of the bone are gradually separated over time. 

Finally, osteogenesis occurs as this separation stimulates new bone cell growth, leading to a permanent increase in bone length. The body naturally generates new bone tissue to fill the gap.

For height lengthening, this process is carefully controlled using either external or internal devices:

External fixators are devices attached to the bone with pins or wires through the skin. For example, the Ilizarov apparatus is an external fixator with a circular frame that surrounds the limb. The patient or caregiver must adjust the device each day to control lengthening.

Internal lengthening systems are newer systems implanted inside the actual bone. An example is the PRECICE system that uses a magnetic rod lengthened with an external remote control operated by the patient or caregiver. 

The choice between external and internal fixators depends on the patient's age, the amount of lengthening desired, and the surgeon's preference. Typically, a height increase of 2 to 6 inches is achievable, though this varies from case to case.

When Is Adolescent Limb Lengthening Medically Necessary vs. Cosmetic?

Medical Reasons

In adolescents, growth surgery for teens is often necessary to improve function, reduce pain, and correct deformities. It can effectively address specific medical conditions, like:

• Limb length discrepancies - Significant differences in the length of the legs or arms can result from congenital conditions present at birth, injuries, or diseases.
• Skeletal dysplasia - These are genetic conditions that affect bone growth, such as achondroplasia.
• Post-traumatic growth issues - Injuries or infections that damage the growth plates in bones can lead to uneven growth.

Cosmetic Motivations

In some cases, adolescents and their families consider surgery for purely cosmetic reasons, driven by concerns about short stature. Height can be a factor in self-image, especially during adolescence, so it’s crucial for parents to proceed with caution. 

Firstly, a thorough psychological evaluation is essential to assess the adolescent's motivations, emotional maturity level, and whether or not they understand what the procedure entails. 

It's important for parents and healthcare professionals to differentiate between a genuine desire for improved self-esteem and external pressures or unrealistic expectations.

What Are the Benefits of Height Lengthening in Adolescents?

• Improved limb symmetry and function
• Enhanced self-esteem and social confidence
• Higher bone healing capacity
• Long-term correction

What Are the Potential Risks and Complications?

It's essential to be fully aware of the potential risks and well-documented complications of height surgery in adolescents. This is a major surgical undertaking with a lengthy recovery. Surgical risks include infection at the pin sites or within the surgical site, bleeding, and device malfunction.

Risks of the mechanical lengthening process include joint stiffness and contractures, nerve irritation or damage, which can cause numbness or weakness, and delayed bone healing or nonunion (failure of the bone to heal)

Stress is another potential risk factor. The lengthy and sometimes painful recovery can be emotionally and psychologically challenging for adolescents, which is why it’s so important that they are evaluated beforehand to show they truly understand the consequences. 

Costs and insurance complications are another component to be keenly aware of. Cosmetic teen height surgery is typically not covered by insurance, and costs can be substantial. Even for medically necessary cases, there may be out-of-pocket expenses.

Recovery and What to Expect Post-Surgery

The recovery process after adolescent limb lengthening is lengthy and will require substantial commitment. Here’s a breakdown of the recovery phases: 

• Surgery: The initial operation to perform the osteotomy and apply the lengthening device.
• Distraction (Lengthening): The gradual separation of the bone segments, typically at a rate of about 1 mm per day. This phase can last for several weeks or months, depending on the desired length gain.
• Consolidation (Bone Hardening): The period during which the new bone hardens and strengthens. The lengthening device remains in place during this phase to provide support.
• Rehabilitation: Patients need physical therapy throughout the entire process, starting shortly after surgery and continuing until full recovery. Physical rehabilitation helps maintain range of motion, strengthen muscles, and promote bone healing.

The adolescent will likely need to use crutches or a walker for several weeks or months, and full recovery can take 6 to 12 months or even longer, depending on the extent of the lengthening.

Psychological and Emotional Considerations

Teen height surgery can have a significant impact on an adolescent's psychological and emotional well-being. Adolescents considering this surgery may already struggle with body image issues related to their height.

Strong family support is required to help adolescents cope with the physical and emotional challenges of the surgery and recovery. Additionally, pre- and post-operative counseling will help the adolescent:

• Manage expectations
• Cope with pain and discomfort
• Address emotional distress

Again, it's important for adolescents and their parents to recognize that the recovery process is long and can be challenging, and the final result may not meet all expectations.

Are There Alternatives to Consider First?

Before considering height lengthening surgery, consider non-surgical alternatives, especially for adolescents. 

These can include hormone therapy for growth-related conditions, shoe lifts or orthotics, and counseling to address self-esteem and body image issues. Emphasizing self-confidence and resilience-building in therapy can be beneficial, regardless of the surgical decision.

In some cases, it may be advisable to delay surgery until the adolescent has reached full physical and emotional maturity.

Is It the Right Choice for Your Teen?

Height lengthening surgery in adolescents is a complex decision with life-altering implications. This complex procedure offers substantial benefits, particularly in cases of medical necessity, but it also carries considerable risks and requires a lengthy, demanding recovery.

To close, remember to:

• Seek out orthopedic surgeons specializing in limb lengthening.
• Involve mental health professionals in the decision-making process.
• Thoroughly weigh the risks and benefits.
• Consider non-surgical alternatives.
• Make sure your teen has a strong support system.

Ultimately, the decision should be made in the best interests of your teen's overall health and well-being, both physical and psychological.

Dr. Shahab Mahboubian, D.O., MPH is a world-renowned orthopedic surgeon who specializes in height lengthening surgery in Burbank, CA. Schedule a consultation today for more information.