There are four phases: Preparation, Surgery, Lengthening and Strengthening.

1. Preparation
   The patient has his or her initial consultations with the physician during this phase. The physician should explain all aspects of the operation and recovery. X-Rays are taken of the legs so that a custom Ilizarov external fixator device can be built specially for the patient. Some centers may also perform a psychological evaluation to ensure that the patient will be able to endure the entire procedure, with the necessary positive attitude.
2. Surgery
   In the most common procedure, the tibia and fibula bones of both lower legs are broken and an external fixator device is attached to each half of each severed bone. The device is attached to the bones using pins or wires that go through small holes drilled through the patient’s skin.
3. Lengthening
   Also called Distraction, this phase begins about a week after surgery and continues over the next two to three months, depenmding on how much lengthening is desired. The fixator device is lengthened, increasing the distance between both halves of each bone. New bone growth occurs in the space in between. The lengthening is applied slowly, about 1mm a day. Typically a screw is turned four times a day to achieve the 1mm per day separation. External fixator devices may also be motorized to achieve continuous lengthening throughout the process. Patients should be scheduled for one to two hours of therapy each day during lengthening. By the end of this phase, the lower legs have been increased two to three inches.The patient is generally confined to a wheelchair during the Lengthening phase and must not bear any weight on the growing bone.
4. Strengthening
   This phase may also be called the Consolidation phase. For the following three to six months, the patient continues to use a wheelchair until the newly grown bone is strong enough to bear the patient’s weight. The external fixator device continues to be used to keep the two bones properly aligned, but is no longer lengthened. During bone Strengthening, physical therapy can be reduced to three times a week. At the end of the Strengthening phase, a simple operation is performed to remove the external fixator device, and the patients can usually walk on their own, no longer needing a wheelchair. However, they may require a cast for an additional month for protection of the legs.

Physical Therapy and Attitude
Two critical success factors for the procedure are extensive physical and occupational therapy and a positive attitude. Patients should be scheduled for one to two hours of therapy each day during the lengthening phase. This can be reduced to three times a week during the strengthening phase. Important: Some facilities have no formal program for physical therapy. The importance of physical therapy to the healing process can not be stressed strongly enough. Though very painful (PT is sometimes described as Pain and Torture), omitting it could lengthen recovery by two or three times the durations listed on this page. What should be a half year recovery can easily be extended to a one or two year recovery, without proper physical therapy.

A positive attitude is also important. The patient doesn’t just wait to be healed after the operation. He or she must actively work for it. The patient must also be prepared to be immobilized for half a year or more. In our busy day to day lives, it is difficult for most of us to appreciate what it means to be confined and have to depend on other people for basic daily activities.

Pain Management
The entire Leg Lengthening procedure is very painful so proper pain management is key. Chronic pain can significantly impair recovery. There are limitations to the types of pain management medications that can be used. Anti-inflammatory drugs have been shown to slow bone growth and will only be prescribed in emergencies. Narcotic drugs may cause the patient to become addicted and the doctor will probably want to keep away from them as well. Significant pain can also prevent the patient from doing physical therapy during the Lengthening and Strengthening phases. Getting enough sleep is also important for recovery and may be a problem when the pain is very bad. Sleeping pills can be taken for a short amount of time after surgery but eventually they may stop working.

Risks and Complications
As with any operation, there are risks of complications. There is a 25% risk of complications following cosmetic leg lengthening, which is relatively high. The greatest risk is infection at the sites where the pins enter the skin. Special care must be taken to ensure that these sites are kept clean. Anti-bacterial ointments must be applied on a regular schedule. Other risks include:

• Bone Infection (osteomyelitis) may result in bone destruction or stiffening of joints if the infection spreads. Acute osteomyelitis is caused by bacteria that enters the body through a wound. The onset may be sudden, with chills, high fever, and severe pain. Intravenous antibiotic treatment will usually clear up the infection.
• Injury to blood vessels can impair circulation and prevent proper bone growth.
• Poor bone healing. This includes delayed healing or failure of the new bone to form a union with the old bone. There is a one in 12 chance of the new bone breaking within weeks of completion of the Strengthening phase.
• Angulations can cause the leg to be angled inwards or outwards.
• Nerve injury could cause the patient to loose feelings in the lower leg or in extreme cases the loss of use of the leg.
• Unequal limb lengths. If one leg fails to heal properly, 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. While most people expect to achieve a full three inches in height after recovery, it is not uncommon for the final height to be a half inch or more shorter than that.

Additional Lengthening
To achieve a greater height, some patients opt for a second operation. Once the lower legs are strong enough, the femur bones of the thighs are broken and lengthened using a similar procedure. However, an additional six inches in the legs will make a person appear significantly disproportional. Add to that the additional expenses and recovery time of almost a year and it becomes obvious why the second operation is rarely performed.

At no time should you ever consider having both lower and upper legs lengthened at the same time. While some international facilities perform this variation, recovery is very difficult and physical therapy nearly impossible because of the pain. We spoke to one person who opted for this. A year after the operation he was still bedridden.

There have been many developments in recent years that improve upon the Ilizarov External Fixator device. Most of these developments involve internal devices that either provide more support during lengthening and strengthening, or eliminate completely the need for the cumbersome Ilizarov device. The alternatives are listed below in alphabetical order.

• Albizzia
  Albizzia is also call GEN for Gradual Elongation over intramedullary Nail and is a variation of Internal Lengthening Over Nails. It was developed in France by Dr Jean-Marc Guichet at the University Center (CHU) of Dijon in 1986. The device is sping loaded. The rotation of the patient’s lower extremity creates the distraction with an audible “click.” It appears to be similar to, or perhaps a precursor of the ISKD. Dr Guichet is continuing his research with the development of a new 3D-Reconstruction nail (3D-Albizzia) allowing for lengthening and axial corrections at the same time.
• Bliskunov’s method
  Bliskunov’s method was pioneered in the ex-USSR by Professor Alexander Bliskunov, now deceased. It is another example of an internal lengthening device and is now practiced in the Ukraine.

  

• Fitbone®
  The Fitbone® device is being used by Prof. Augustin Betz in Germany and appears to be the only device that uses a powered system to lengthen the legs. The bones of the leg (Tibia and/or Femur) are cut and the intramedullary telescoping nail is implanted in the bone marrow of each bone. Each end of the telescope nail is attached to each end of the cut bone. The nail is connected to an induction receiver that is placed just under the skin. An external control unit powers the telescope nail though the induction plate. A similar technique has been used to power artificial hearts.Additional information is available from the The Fitbone® site.

  

  Dr. Betz’s Therapiezentrum Martinsmühle site also provides good information about the procedure. See especially the “Implantation technique” link on the left side of the home page.

• Intramedullary Skeletal Kinetic Distractor (ISKD)
  The Intramedullary Skeletal Kinetic Distractor (ISKD) device uses a kinetic clutch mechanism to lengthen the leg. One segment of a rod is screwed onto another and the whole rod is inserted into the patient’s bone. When the patient rotates his or her leg, the lower segment rotates over the upper one, like screwing a bolt out of a nut, and the rod lengthens, expanding the leg. The clutch ensures that the rod can rotate only in one direction. A monitor is included to track how much the leg has separated at any point in time.The ISKD was invented by Dr. J. Dean Cole, an orthopedic surgeon and President of Orthodyne Inc. Dr. Cole is Medical Director of the Florida Hospital, Orthopaedic Institute, Fracture Care Center. This is one of the few facilities in the U.S. that performs Cosmetic Leg Lengthening. Orthofix manufactures this device. Drs. Paley and Herzenberg at the LifeBridge International Center for Limb Lengthening (ICLL) also use ISKD for Cosmetic Leg Lengthening.
• Lengthening Over Nails (LON)
  The use of Lengthening Over Nails was pioneered in 1990, by Drs. Paley and Herzenberg while they practiced at the Maryland Center for Limb Lengthening & Reconstruction (MCLLR). They are now at the LifeBridge International Center for Limb Lengthening (ICLL). During the initial surgery, a metal rod is inserted into the central cavity (intramedullary) of the lower legs (the tibia bone), and then the external fixator device is attached to the bone. As the limb is lengthened, one end of the bone slides over the rod and new bone is grown around it. When the bone is fully lengthened, the external device is removed and the rod is surgically attached to each bone segment. During bone strengthening, the rod provides support instead of the more uncomfortable and unwieldy External Fixator Device. At the end of the Strengthening phase, a second operation is performed to remove the metal rod. Lengthening Over Nails decreases the duration of the Strengthening phase by two to three months.
• Micro-wound
  Dr. Helong Bai at the The 8th Hospital in Chongqing, China developed a micro-wound operation for leg lengthening. This procedure uses a fixative clip instead of an Ilizarov fixator. The fixator clip covers just one side of the leg and appears to be more comfortable than the Ilizarov fixator which completely surrounds the leg.

  

My name is Jack and I had been thinking about leg lengthening surgery for a very long time before I actually had the operation done. I was 5′ 6″ (168 cm) tall and I wanted to be about 5’9″ (175 cm). I thought that after all the researching and reading about leg lengthening I was ready for this operation. I decided that I would like my operation done at the Beijing Institute of Technology. The reason I choose this hospital was because of a forum I found that was very supportive of this hospital. To my surprise the creators of this forum were ex-patients of the actual hospitial. They made it sound very easy and fun.

Let me tell you now leg lengthening is no joke. After going through the operation in Beijing, knowing that it was 100% what I wanted, I was wrong. After the operation I had nightmares for the first week about me having big external fixator objects on my legs. I was in unbearable pain, and much discomfort. It was like I had made the biggest mistake in my life, and I prayed to God that it was only a dream, but it wasn’t. It was real, and I was living in a total nightmare, with painful days and more painful nights. I was very disappointment. It was nothing like anyone had told me about.

The doctors did not tell me that it would be this painful. All they told me was that pain is different for every patient. What gets more scary is that my days seem much longer once I had the operation performed, which is exactly what I didn’t want. Everyday is a drag. Now I regret ever doing this operation. It doesn’t matter if you’re going to become 3 inch’s taller. It is not nearly worth the pain.

Please, anyone who is thinking about this operation, please give it a second thought. My mind was so consumed with the idea that I wanted to be taller that there was no other choice, and I ended up doing something that I now wouldn’t have done for a million dollars. It is not worth it. Enjoy your freedom to walk, live in peace, and enjoy life. This operation is very senseless and I hate to see myself everyday in pain. Forget about leg lengthening. It is the worst decision I made in my life, don’t let it be yours too.

We do not have enough specific knowledge about the other facilities but have received some input from readers who have had the procedure.

* Four people reported good to excellent experiences following surgery by Dr. Yasser Elbatrawy in Egypt. They report that the procedure was performed in an operating theatre with modern medical equipment and that staff are friendly and helpful.
* Two people reported moderate experiences by Dr. Maurizio A. Catagni in Italy.
* Two people reported catastrophic experiences and serious complications by Dr. Veklich Vitaliy in Ukraine

# Is there a hospital in my country that performs Cosmetic Leg Lengthening?
A list of all hospitals that perform Cosmetic Leg Lengthening is available. This list is organized by country. Costs are included where they are known.

# How much taller can I become?
The maximum amount of height increase is about 3 inches or 7 to 8cm with surgery on the lower legs. Additional surgery on the upper legs is highly discouraged because it makes the patient appear significantly disproportional.

# Am I too tall for this operation?
Because of the controversy surrounding the need for this drastic procedure, in the United States, Cosmetic Leg Lengthening surgery is typically available for men 5′ 9″ and under and women 5′ 3″ and under. Facilities in countries other than the United States will operate on taller people.

# Is surgery covered by health insurance?
In the United States, Cosmetic Leg Lengthening is never covered by health insurance companies. The patient usually must pay the full amount in advance for the surgery. The surgery may be covered in other countries but only for citizens of that country. Leg lengthening is typically covered by insurance to correct leg length differences of 6cm or more.

for vitamins and supplements, you can try multivitamin, calcium, cod liver oil/fish oil, glucosamine chondoitrin

sleep 8-10 hours a day, and sleep on firm mattress and a small pillow

have positive mind

The Golden rule holds : Stretching + Exercise + Nutrition + Sleep = Growth.

Nutrition is pretty self explanatory, if you eat normally, a typical diet which consist of meat, vegetables, rice and fruits would do the job. Drink 1.5-2.5 litres of water a day according to your needs. Get supplements if needed. Oh, and drink milk too.

As for the stretching and exercise part, its pretty simple.  Follow their directions and you would have exercised your spine, throw in another leg lengthening exercise for the day ( E.G. Sprinting, Cycling, Swimming etc. ) and you would be fine.

So … The simplest and effective routine would look something like that.

30 mins of stretching EVERYDAY.
100 jumps on Monday, 125 jumps on Tuesday, 150 jumps on Wednesday, 175 jumps on Thursday, 200 jumps on Friday, 225 jumps on Saturday, 50 jumps on Sunday and back to 100 jumps on Monday, repeat.

OR

30 mins of stretching EVERYDAY.
Cycle for an hour, max intensity when possible 6 out of 7 days.

Something like that, as you can see, the stretches work your spine while the jumps and stuff like that work your legs, add that with 7 hours of sleep and a good nutrition, you could be looking at a couple of inches.