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Leg Extension Surgery: A Legitimate Option?

by Maggie McGee

Leg lengthening is a cosmetic procedure designed to give patients a few extra inches of height. It was originally intended to correct childhood leg length abnormalities and to aid victims of dwarfism. Recently, physicians have been implementing the surgery to add height for individuals of Constitutional Short Stature (those who are in the bottom fifth percentile of height in their region and display no deformities common with dwarfism).

A leg lengthening surgery is much more complex, costly, and painful than most other cosmetic procedures. In fact, very few doctors offer this surgery, and those that do typically require that patients go through a psychological evaluation prior to the surgery as a means of determining whether or not the patient is capable of coping with the mental aspect of the recovery process.

The basic leg lengthening procedure is constituted of four stages:

Preparation - This is the stage during which the patient gets acquainted with the procedure, its demands, and the physician.
Surgery – The operation breaking the tibia and fibula bones both legs. An external fixator device (commonly known as an ilizarov), is attached to each half of each severed bone.
Lengthening – The fixator device is designed to stretch the halves of the bones further apart as new bone grows in the spaces between. Patients typically undergo 1-2 hours of physical therapy each day to ensure that bones don’t get stiff. Furthermore, individuals are cautioned from putting weight on the bones and are confined to a wheelchair for the duration of the lengthening process. The ending process yields approximately 2-3 inches of added height.
Strengthening – Following the lengthening process, the patient is confined to a wheelchair for an additional 3-6 months while the bones become strong enough to bear full body weight. Physical therapy is reduced to approximately three times a week. Once the bones have regained full strength, an operation is preformed to remove the fixator device (used to keep bones properly aligned after the lengthening process). A cast is recommended for the first month after the operation as an added protection to the bones.

Following the completion of these stages, the patient will begin to regain leg function.

Important Side notes:

Anti-inflammatory pain medication can disrupt the creation of new bone, so some doctors prescribe minimal pain management.
The recovery time ranges from six months to a one year.

Complications

The biggest concern for patients undergoing a leg lengthening procedure is the possibility of infection at the sites where the pins enter the skin. Regular cleaning is crucial; however, even with proper cleaning, a 25% chance of infection still exists. This percentage is relatively high when compared to other cosmetic procedures. Other risks may include:

If a skin infection is contracted, the bacteria can spread to the bones, impairing the body’s ability to produce new bone to fill the gap. Symptoms include, but are not limited to: chills, high fever, and severe pain. In the event of the spread of such infection, doctors will prescribe an antibiotic that will treat the ailment within a few weeks.
Injury to blood vessels can inhibit circulation and prevent proper bone growth.
Improper healing – there is a possibility of new bone failing to form a union with the old bone. Additionally, there is a one in twelve chance of the new bone breaking within weeks of completion of the strengthening process.
Angulations can cause the leg to be angled either inwards or outwards.
Nerve injury could cause the patient to lose feelings in the lower leg or in extreme cases, lose use of the leg entirely.
Unequal limb lengths – in the event of improper healing of one leg, the doctor may need to reverse the direction of the external fixator device to strengthen it, causing a slight differential between the two legs.
Final height may be less than expected - although most patients can expect to gain approximately three inches in height after recovery, it is not uncommon for the final height to be a half inch shorter than that and in some cases more.

With so many risks and chronic pain involved in this procedure, it’s easy to see why it would be controversial. Until further advances are made in the field, most prospective leg extension surgery patients are advised to consider this option with extreme caution. As of now, no surgeons in the Plastic Surgery Portal network offer leg extension surgery.