Limb Lengthening a Rare Wonder

New York Post—April 3, 2007

Undergoing cosmetic limb lengthening is a miracle, but simple? No way. To get those 2 to 3 inches, patients submit to a surgery wherein both tibiae and fibulae—those are the bones of the lower leg—are cut. A mechanical device is then inserted in the new gap, which gradually pulls the bones apart. Very gradually.

"You can't just go in there, cut the bone and pull it apart 2 inches," says S. Robert Rozbruch, M.D., director and chief of service at Hospital for Special Surgery's Limb Lengthening and Reconstruction Program in New York City. "That doesn't work—it's a very slow process of stretching, 1 millimeter per day."

The patient's own bones regenerate to fill the gap.

"By gradually pulling the bones apart, we are stretching the soft tissue in the nerves, the blood vessels and the muscles, all of which create stimulus for growth," Dr. Rozbruch explains. "That's exactly how it works with a growth spurt—the bone is what grows, and all the soft tissue responds to the stretch and grows, as well."

Dr. Rozbruch emphasizes that elective limb lengthening is not for everyone. "Most surgeries we do are for reconstruction—equalization of leg length, correction of deformities. We are not running a cosmetic chop shop here."

Patients who wish to undergo limb lengthening must first submit to an intensive psychological evaluation, to determine whether they in fact suffer from "short stature dysphoria”—meaning they are consistently unhappy with their height, while being well-adjusted and happy in other aspects of their lives.

"The patients who do this are not people who are like, 'Oh, wow, it would be really cool to be 3 inches taller,'" Dr. Rozbruch says. "They are in severe psychological distress over their short stature. This is a complex procedure—it's just not as simple as doing a nose job."

Not as cheap, either. The psych consult alone costs $440, while surgery and lengthening run from $80,000 to $100,000—and must be paid upfront.

The author of this piece, Rock Positano, DPM, M.Sc., MPH, is the director of the Non-surgical Foot and Ankle Service at Hospital for Special Surgery in New York. His column appears every Tuesday in the New York Post.

Read this article at NYPost.com.