Height lengthening surgery, also known as limb lengthening, is a complex orthopedic procedure that increases the length of a bone, typically in the femur (thigh) or tibia (shin). Height lengthening is a well-established technique with a history of helping individuals with significant limb length discrepancies and certain growth-related conditions.

We understand that you, as parents, might be exploring this option for your child. Perhaps your child has a limb length discrepancy due to a congenital condition or injury. 

Or maybe you're considering it for reasons related to short stature and its potential impact on your child's self-esteem. The decision to pursue height lengthening surgery is not to be taken lightly, so it's naturally appropriate to have many questions. 

This comprehensive guide will explain what height lengthening surgery is, when it's appropriate, and what you can expect throughout the process. We'll also touch on how to find the most qualified surgeons for limb lengthening in your area. 

What Is Height Lengthening Surgery?

Limb lengthening is a gradual process that leverages the body's natural ability to regenerate bone. It involves surgically separating the bone and then slowly pulling the two ends apart. This separation stimulates the growth of new bone tissue in the gap, increasing the bone's length.

The bones most commonly targeted in height increase procedures are the femur (thighbone) and the tibia (shinbone). The choice depends on the specific condition and desired outcome.

There are two primary techniques used in height lengthening surgery:

External Fixators: These devices are attached to the limb with pins or wires that extend through the skin. A classic example is the Ilizarov apparatus, a circular frame that surrounds the limb. The patient (or caregiver) adjusts the device daily to gradually separate bone segments.

Internal Lengthening Systems: These newer systems are implanted inside the bone, eliminating the need for external frames. A common example is the PRECICE system, which uses a magnetically driven rod that is lengthened externally with a remote control.

When Is It Medically Necessary?

Height lengthening surgery is often considered medically necessary to correct the underlying problem, improve function, and reduce pain. Here are a few situations that may require medical intervention:

Limb length discrepancies 

These can result from congenital conditions, such as fibular hemimelia (absence or shortening of the fibula), or from injuries, such as fractures that heal improperly. A significant difference in limb length can cause gait abnormalities, postural problems, and back pain.

Skeletal dysplasia

These are genetic conditions that affect bone growth, such as achondroplasia. Limb lengthening can help improve overall body proportions and function in individuals with these conditions.

Growth plate abnormalities

Damage to the growth plates (areas of cartilage at the ends of long bones where growth occurs) due to injury or infection can lead to uneven growth and limb length discrepancies.

What About Cosmetic Height Concerns?

In addition to its medical applications, some families consider height lengthening surgery for purely cosmetic reasons, driven by concerns about short stature and the potential psychological impact. 

Short stature can sometimes lead to lower self-esteem, social anxiety, and/or perceived difficulties in professional situations. However, before your child is ready for this life-changing surgery, consider the following: 

First, a thorough psychological evaluation is essential to assess the child's emotional maturity, motivations, and understanding of the procedure.

Also, it's vital to have realistic expectations about the outcome of the surgery. While it can increase height, it's a lengthy and demanding process with potential risks.

Mental health support before, during, and after the procedure is necessary to help the child cope with the physical and emotional challenges.

Remember that elective height lengthening surgery is a complex decision that should involve a multidisciplinary team, including orthopedic surgeons, psychologists, and the family.

The Height Increase Procedure: Step-by-Step

• Initial consultation and screening

This involves a comprehensive evaluation by an orthopedic surgeon specializing in limb lengthening.

• X-rays and growth plate evaluation

X-rays are taken to assess bone structure and growth potential. If the patient is still growing, the surgeon will evaluate the growth plates.

• Psychological screening

A mental health professional may evaluate the patient's emotional readiness and understanding of the procedure.

• Surgery

The surgeon makes an incision and performs an osteotomy, a surgical cut in the bone that needs to be lengthened. The lengthening device (external fixator or internal system) is then attached or inserted.

• Distraction phase

This is the gradual lengthening of the bone. With external fixators, the patient or caregiver adjusts the device daily, typically at a rate of about 1 mm per day.

With internal systems like PRECICE, the lengthening is regulated with a remote control that interacts with a magnetic rod inside the implant.

• Consolidation phase

During this phase, the newly formed bone hardens and stabilizes, while the lengthening device remains in place to support the bone.

• Rehabilitation

Physical therapy starts shortly after surgery and continues until full recovery to maintain joint mobility, strengthen muscles, and promote bone healing.

Recovery and Lifestyle Adjustments

The recovery process for height lengthening surgery is lengthy and demanding, typically lasting anywhere from 6 to 12 months or even longer, depending on the amount of lengthening and healing rate. Here are some key aspects of the recovery process:

• Assistive devices: The child will likely need to use crutches or a walker for an extended period to protect the healing bone and reduce weight-bearing.
• Impact on school and activities: Surgery and recovery can significantly impact school attendance, participation in sports, and other activities. Careful planning and coordination with school officials and therapists are essential.
• Physical therapy: Regular, intensive physical therapy prevents stiffness, maintains range of motion, and strengthens muscles surrounding the lengthened bone.
• Follow-up appointments: Frequent follow-up appointments with the surgeon are necessary to monitor bone healing, adjust the lengthening device (if applicable), and address any complications.

Benefits of the Procedure

When performed correctly and for appropriate indications, height lengthening surgery offers life-changing benefits, including:

• Improved limb symmetry and body proportion
• Increased self-esteem
• Corrected posture and gait
• Long-term functional and psychological improvement

Risks and Considerations

Like any surgical procedure, height lengthening surgery carries potential risks and complications. These can include infection, nerve irritation, delayed bone healing, nonunion (failure of the bone to heal), and joint stiffness.

The lengthy recovery process can be emotionally challenging for both the child and the family, and the child will need significant parental and emotional support throughout the process.

Finally, this surgery can be expensive, and insurance coverage may vary depending on whether it's considered medically necessary or elective.

How to Support Your Child Through the Process

Supporting your child throughout the height lengthening surgery process is crucial for their physical and emotional well-being. Here are some ways you can help:

• Encourage realistic expectations and patience
• Coordinate care with surgeons, therapists, and school staff
• Monitor for problems
• Celebrate milestones

Is Height Surgery Right for Your Child?

Height lengthening surgery is a complex but potentially positive, life-changing procedure that can address limb length discrepancies, skeletal deformities, and, in some cases, concerns about short stature. 

For parents considering this option, finding the best doctors for height surgery and building a strong support system are crucial for a successful outcome.

Are you located in the Burbank area and interested in height lengthening for your child? Schedule a consultation today with Dr. Shahab Mahboubian, D.O., MPH to learn more.