Dr. Saber’s Blog

Leg Lengthening Surgery: Too Good to Be True?

As the old saying goes: if something seems too good to be true, it probably is. The current manifestation of this wisdom is the bourgeoning medical segment urging men to become taller through cosmetic limb lengthening surgery.

Leg lengthening surgery — most recently championed in an edition of Gentleman’s Quarterly — is sold as minimal discomfort outweighed by gigantic leaps in confidence. But look a little deeper at lengthening surgery, and a minefield of possible tragedies appears.

“This is a bad idea and can’t be compared to cosmetic surgeries,” says noted plastic surgeon Dr. Sepideh Saber, MD, FACS. “With a limb lengthening procedure, one must break the tibia and fibula on both sides. These are our weight-bearing bones. Potential complications could be nonunion (bones don’t heal), malunion (bones heal in poor position/slightly off), re-fracture, and osteomyelitis (an infection in the bone).”

Leg lengthening surgery to compensate for short stature is performed by orthopedic surgeons and is a multi-hour, traumatic operation involving breaking a bone in two places.

Limb lengthening is medically valid to preserve a child’s limb function and mobility. Limb length discrepancies — one leg shorter than the other — can occur for several reasons. First, a child may be born with a leg length discrepancy that causes one limb to grow slower. Second, a leg may stop growing after a complex fracture or a fracture that heals incorrectly. Third, some children have birth defects and dwarfism or may require a deformity correction.

Leg Lengthening Surgery Risks

How is leg lengthening done?

During cosmetic height surgery, the lengthening device — an expandable rod — is inserted after the tibia (shin) is cut. One commonly used lengthening rod is a Precice nail. X-rays guide the surgeon as they move the internal device into position. The rod is later lengthened with a magnetic controller outside the limb.

An older method of leg lengthening used the Ilizarov unit — an external fixator. The external device attaches around the lower leg and slowly stretches the bone to lengthen it.

In the weeks after surgery, the two parts of the bone are slowly (with a rate of around 1 mm per day) pushed away from each other by the internal lengthening device. New bone tissue — identical to healthy tissue — gradually forms in the developing gap. The procedure is essentially growing new bone using the body’s natural healing response.

In some subsequent surgeries, the femur is broken to add two additional inches.

The surgical procedure is done under general anesthesia, epidural anesthesia, or a combination of both. After the osteotomy (cutting of the bone), the bone is held in place with orthopedic implants or devices that provide stability for the patient.

How long is leg lengthening recovery?

Even uneventful leg surgeries take at least a year to even out. Depending on the patient, the first 24-48 hours following surgery can be quite painful. Most people stay in the hospital for about three days after surgery. Then, have a friend or family member take them home.

Using a remote control, the leg bones must be pulled apart slowly each day of the lengthening process to allow the muscles, tendons, and bone enough time to grow. Most doctors advise patients to forgo working for at least three months after surgery — or not undergo the surgery.

While new bone growth expands at a rate of more than 1 mm per day, the soft tissues of the legs (muscles, tendons, ligaments, nerves) cannot grow as quickly. For this reason, if the leg muscles become too tight, the surgeon may not allow you to lengthen at the maximum daily expansion rate.

Leg Lengthening Surgery Risks
Ilizarov unit

Daily physical therapy is a crucial component for healing and maintaining a range of motion. You will also have to go in for multiple follow-up appointments so your healthcare provider can monitor your growth and healing.

One day, the bone formation will reach the desired length and your doctor will remove the rods. Rod removal is an outpatient procedure that should be done within 1-2 years of the last surgery. Most patients can walk out of the hospital but may need assistance such as a walker or cane for about a week afterward. 

The screw holes take around 10-12 weeks to heal. Patients should not do any heavy lifting until the holes are healed.

Patients can begin light sports anywhere from 6-18 months after the last surgery or about three to six months after rod removal.

Common risks of bone lengthening procedures

The short-term side effect of surgery is that patients must spend 8-12 weeks in bed until they have healed enough to walk.

According to the University of Florida Health Department, the most common risks of this surgery include:

  • allergic reaction to medicines injected during surgery
  • bleeding problems or infection
  • bone infection
  • nerve damage
  • blood clots
  • poor healing, causing you to require extensive rehabilitation
  • muscle pain, stiffness, or weakness
  • difficulty falling and/or staying asleep
  • difficulty concentrating
  • injury to blood vessels

Is leg lengthening worth it?

Leg lengthening surgery should not be pursued for strictly cosmetic reasons. While many people (commonly men) have insecurities about their height, self-confidence can be improved in other ways — ideally ways that don’t risk permanent disability.

Cosmetic surgery has been growing among men in recent years. Body contouring, facelifts, and rhinoplasty have all helped patients feel more self-confident without putting their ability to walk at risk.

The possible complications of leg lengthening are too severe for it to be recommended as a cosmetic, elective procedure.

Severe limb lengthening surgery side effects & complications

The following are serious complications that can occur from leg-lengthening surgery:

Nerve injury

Patients who feel pain on the top of their foot or find themselves frequently needing a foot massage may have entrapment of the tibia’s peroneal nerve. The trapped nerve can lead to increased sensitivity (hyperesthesia) or lessened sensitivity (hypoesthesia).

In some cases, the immediate post-surgical nerve pain following leg lengthening surgery can reach an 8/10 or above on the pain scale.

Fat embolism

A fat embolism (FE) is the scariest risk associated with leg lengthening.

Before inserting the lengthening pin into your leg, they must first cut the bone. Reaming involves cutting bone with a rotational cutting tool (a reamer). This process builds up pressure in the bone and causes bone marrow to be compressed.

This compression creates a possibility for fat from the bone marrow to make its way into your bloodstream. These chunks of fat can block blood flow and cause major complications. A pulmonary embolism can occur if the fat clot travels all the way into the lungs.

Large amounts of fat can lead to:

  • shortness of breath
  • lower oxygen levels
  • intubation and ventilation treatment
  • death

Deep vein thrombosis

Deep vein thrombosis (DVT) can occur after orthopedic surgery or bone damage, such as a fracture. It occurs when a blood clot (thrombus) occurs in one of your body’s deep veins (such as in the legs). These blood clots can form as a side effect of surgery, or if you go a long time without moving — for example, while on bed rest after surgery.

Fibular complications

During leg lengthening surgery, a rod is only inserted into one of your lower leg bones — the tibia, not the fibula. The fibula bone is too thin to place an internal nail.

The tibia and the fibula must therefore be screwed together so that when one is lengthened, the other is as well. If not, the tibia will extend more than the fibula, causing a severe bone misalignment.

The consequences can be disastrous as the fibula can dislocate at the top or end up smaller than the tibia. Unevenness in these bones can lead to ankle arthritis and the inability to fully flex the knee.

Considering cosmetic surgery? Talk to Dr. Saber

Dr. Sepideh Saber, MD, FACS, offers a more sensitive, female perspective for patients of all ages, genders, and orientations. With training in cosmetic and reconstructive surgery — including the highly delicate field of hand surgery — Dr. Saber is a skilled expert in the field.

Whether you know what procedure you want, or are just exploring your cosmetic options, Dr. Saber can help. After evaluating your goals and lifestyle, she can recommend the best procedure for you (even if the best option is not to go forward with surgery).

To request a free consultation, call (877) 205-4100 or schedule a consultation online.

Dr. Saber takes her patients’ safety very seriously. Her facility’s Covid-19 patient safety procedures exceed all CDC and World Health Organization recommendations. Masks are required in our office at all times during the coronavirus pandemic.

The practice of Dr. Saber is located in Encino, CA for patients throughout the Los Angeles area. We are also convenient to Encino, Woodland Hills, Sherman Oaks, Calabasas, Burbank, Glendale, Hidden Hills, Agoura Hills, Northridge, North Hollywood, Malibu, Topanga, Canoga Park, Reseda, Valley Glen, Chatsworth, West Hills, Winnetka, Universal City, Bel Air, Beverly Hills, Downtown Los Angeles, Silverlake, and Echo Park.

Dr. Saber graduated from Stanford University’s world-renowned medical school and did her plastic and reconstructive surgery residency at the equally lauded University of Southern California. She then completed a fellowship at New York University in the extremely challenging and delicate disciplines of hand surgery and microsurgery.

Dr. Saber offers a more sensitive, female perspective for patients of all ages, genders, and orientations. Former patients from all walks of life have praised not only their treatment outcomes but her caring, thoughtful approach to a wide array of appearance and health-related matters.
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    Dr. Sepideh Saber, MD, FACS

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    I was fortunate to find Dr. Saber after researching board-certified surgeons who specialize in breast cancer reconstruction revision surgery. I knew I was in good hands from the moment I spoke with the lovely and efficient Marlene, Dr Saber's office manager. Dr Saber patiently listened to my concerns and, after examining me, explained what I could realistically expect the outcome to be from another surgery. She also explained to me that she would need to review my previous surgery notes before we could discuss a possible further surgery, which I found comforting and highly ethical. I also discussed a couple of other procedures that I would like done, including fat removal from my large upper arms that had caused me great embarrassment for several years. Dr. Saber is an excellent surgeon who is incredibly kind and genuine. She truly understands the female body and the emotional aspect of body insecurities yet, she is transparent about what can and cannot be done and takes time to discuss realistic expectations and outcomes. My breast reconstruction revision surgery will take place in the New Year, but in the meantime, I have the most fabulous upper arms that I recently flaunted in a strapless dress (something I have not done in years). Dr Saber is truly one of a kind, and I still cannot believe how fortunate I am to have found her. I highly recommend Dr Saber.

    Linda DeCarlo November 29, 2023

    I don’t have enough wonderful words to describe Dr Saber and Marlene! I had a tummy tuck done this year and from start to finish the entire experience was amazing. Marlene is always so helpful and works so hard to make every detail a breeze for you. When I had my consultation with Dr Saber I was at a point of complete agony with my body. She instantly took that stress and frustration off my shoulders! As a woman not being heard by doctors for years I left that consultation with happy tears knowing I had finally found my Dr. It was a major surgery and I felt completely zen and at peace going in because she really does make you feel that safe. I didn’t think I would ever look the way I do now! She gave me the gift of having the body I kept fighting for. I will never stop recommending her.

    Monica Prusa October 9, 2023

    I saw Dr. Saber when I broke my wrist. I ended up having to have surgery. She did an excellent job and I am healing nicely. She was very professional, but was also very kind and compassionate. I would highly recommend her!!

    Sandy Schaupp September 13, 2022

    I LOVED DR SABER!!! There are a few reasons why I chose her. One was because she’s a female Doctor that was my goal who also did a good job (which I was able to confirm with all her before and after photos) and what sold me was my safety in mind. She made me feel like I was in the best hands ever along with Marlene who coordinated everything THANK YOU LADIES! Dr Saber helped me get back the body I have always desired. I had a lot of stomach fat from weight gain and I lost weight so a lot of my weight was in my front lower and upper abdomen. Now I have a super beautiful curvy body like an hourglass after a tummy tuck and lipo she did. She understood the assignment hahaha . I’m 32 years old no kids just wanted to enjoy my younger body looking and feeling beautiful and she really took good care of me. Even after hours I had an emergency due to my fault but she was there and got back to me very quickly and I’m very grateful. I also think her work says a lot because I stopped taking pain medication on the 3rd day after surgery and was fine with very minimal pain I was able to tolerate the healing process. Highly recommend going with her I just had a wonderful experience and would do it all over again if I had too. Maybe after I have kids. Thanks Dr Saber and team <3

    STEPHANIE d July 15, 2022

    Dr.Saber is by far one of the best plastic surgeons. I love how she takes her time to explain any procedure to the patients understanding. She always makes sure to answers any and all questions.From fillers to body contours she’s the one you want.

    Katherine Melara February 15, 2022

    Dr Saber is amazing! She is caring and very informative. I went in for fillers and she explained procedure step by step. I highly recommend her and look forward to future visits.

    Amanda Vazquez December 18, 2020

    Dr. Saber was friendly, knowledgeable and professional. She took time to listen, answer all my questions and was forthright in her recommendations. Her staff was friendly and helpful. I was very happy with the results and plan on going back. If you are looking for a first rate professional experience look no further she is the doctor for you!

    T R December 18, 2020

    Dr. Saber is one of a kind plastic surgeon with a heart of gold. She is a well verse plastic surgeon that puts her patient's needs before anything else. She genuinely cares about every single patient, and her work speaks for itself. I notice every post-operative result on her Instagram (@saberplasticsurgery) the patients have this glow that radiates through. I have been going to Dr. Saber for my Botox for the past 3 years, and love the results every time. I know who I will be going to for any future plastic surgery needs, and will confidently refer family and friends to Dr. Saber for any Botox, fillers, and plastic surgery consultations.

    Rudy Garcia December 16, 2020

    I have nothing but great things to say about Dr. Saber! I am so pleased with my results from a breast augmentation she performed on me back in late June! She answered all my questions and concerns before and after my surgery. She’s very easy to get in contact with and she’s so nice. She made feel so comfortable throughout the whole process. 100/10 Lover her work!!

    Amanda Villegas October 15, 2020

    Dr Saber is hands down the best surgeon! She took her time answering my questions and explained procedure in detail. After doing liposuction six months ago, I am extremely happy with my results and I appreciate her so much.

    Marlene Cosentino October 15, 2020

    Dr. Saber is so kind and thorough with her patients! She is an amazing doctor and genuinely cars about everyone she comes in contact with. I would recommend her to anyone for any hand surgery or cosmetic procedure.

    Rachel Meach October 15, 2020