Leg-Lengthening Surgery: What Is It?

Medically Reviewed by Neha Pathak, MD on September 16, 2022
Written by Shishira Sreenivas
6 min read

Leg lengthening is a type of surgery you might get if one of your legs is shorter than the other. This condition is also known as anisomelia.

Often, it’s a medically necessary procedure to correct the difference. This helps to equally distribute the weight across your hips. But lately, some people are having cosmetic leg lengthening to add a few inches to their height.

This procedure is done slowly, usually over many weeks. This gives your leg bones – like the femur (thigh bone) and tibia (shinbone) – and soft tissues like muscles, skin, and nerves the time to increase in length gradually.

You can decide to lengthen either the tibia or the femur. Another option is to lengthen both bones. The two bones are lengthened at different times, usually a few weeks or up to a year apart. Ask your doctor which choice is right for you.

If you’re trying to bridge the length difference between two legs, your doctor will suggest which bone to lengthen.

The entire procedure from start to finish can take several months. It often depends on how much length is being added.

The leg-lengthening procedure usually happens in four stages:

  • Surgery – called osteotomy
  • Latency period – a period of rest
  • Distraction – the pulling apart of the bones
  • Consolidation – healing, bone growth, and hardening of the new bone

Surgery. During your surgery, the doctor will the cut the bone into two pieces. They may also do certain procedures to soften your muscle fibers and prep the nerves for new bone growth. For example, if you’re having your shinbone lengthened, your doctor might lengthen the Achilles tendon to make the next step easier.

They’ll also insert an orthopedic limb-lengthening device during the surgery. There are two types:

Internal device. This type is inserted into the bone. Precice nail is a commonly used internal device.

External fixator. This stays on the outside of your leg. Metal pins and screws will hold the contraption in place.

Over a few months, screws and pins will be tightened, using a metal device attached to it. This slowly pulls the bones apart. Commonly used external fixators include Taylor Spatial Frame or the Ilizarov device.

You’ll be under general anesthesia during the surgery. You’ll mostly feel nothing and sleep through the procedure.

Latency period. Once the surgery is done, your bones will be allowed to rest for 5-7 days. During this time, your doctor won’t manually lengthen the bones.

Distraction. Also known as “pulling apart,” during this stage, you or an instructed family member will adjust the external or internal orthopedic lengthening device to slowly pull apart the two bone segments.

You’ll need regular physical therapy and daily exercises during the lengthening phase to keep your range of motion and bone strength. You might need up to five physical therapy sessions per week. Check with your doctor to see what they recommend for you.

The adjustment is very small. Usually, it’s between .75 millimeter and 1 millimeter (0.04 inches) a day. Typically, you can lengthen the bone by 1 inch each month.

The bones are adjusted daily until they extend to the desired length. New bone, called regenerate bone, will slowly grow to bridge the gap between the two separated pieces.

Consolidation. This is the last stage when the new bone begins to get harder, thicker, and solid. This happens when calcium deposits itself into the new bone (calcification).

During this phase, you doctor may encourage you to put weight on your leg (with the help of a walker or crutches). That helps strengthen the new bone. You’ll need to eat lots of protein and take vitamin and mineral supplements to boost bone strength.

If you’re wondering how much your leg can grow, it can add up to 6 inches to your height. Generally, during one lengthening cycle, the bone may grow up 2 inches.

If you’re trying to make the bone longer, you might need more surgeries. Talk to your doctor to find out if it’s feasible and what it might involve.

Traditionally, the leg lengthening has been done for people who have limbs that are unequal in length. But today, many decide to have the surgery to become taller.

The surgery might be suggested for:

  • Children whose bones are still growing
  • Children whose growth plates have issues
  • Adults who are short and want to add a few inches to their height
  • People who have had a physical injury that has shorted or lengthened their limbs

In some cases, certain medical conditions may cause your limbs to be unequal in length, such as:

  • Polio
  • Cerebral palsy, a condition that affects posture and your ability to move properly
  • Birth defects of bones, joints, muscles, tendons, or ligaments
  • Hip conditions, such as Legg-Perthes disease
  • Small, weak muscles or short, tight (spastic) muscles. This may cause issues with normal bone growth.
  • Injuries or broken bones

Before you get this surgery, it’s important to understand that it requires several complex procedures and has a long recovery period. There are some serious risks involved, such as:

  • Pin-site infection
  • Joint dislocation
  • Blood vessel injury
  • Bone infection
  • Muscle contractions
  • Nerve damage
  • Bone forms too soon or it’s delayed
  • Bone doesn’t attach

If you or your child is getting this surgery, the doctor will check for any side effects regularly during the lengthening process. Keep a close eye on the skin color, temperature, and sensation on your foot and toes. If you notice any questionable changes, tell your doctor right away.

The rate of healing may also be different for each person. For example, the new bone growth might be slow for those who have diabetes or smoke. In other cases, the bone may harden too fast. If this is the case, your doctor may work on the daily adjusting to find the right pace for your bone growth goals.

Before you choose to lengthen your leg, discuss with you doctor if this is right for you.

The recovery time will depend on how much you want to lengthen the bone or if you’re lengthening multiple bones. Most people are able to walk around without crutches within 2-3 months after surgery.

Recovery usually speeds up after the bone grows to your desired length. The bone typically heals faster for children than adults.

Leg-lengthening procedures are complex, and you might need several surgeries. The risk and complications are often high, and recovery might be long, too. According to research, 4 out 10 surgeries are completely successful in reaching the lengthening goal.

If the leg-lengthening procedure is medically necessary for you or your child, your health insurance may cover most or part of your expenses.

This will depend on the type of coverage you have. You’ll also need several physical therapy sessions a week after you finish your surgery. Check with your doctor and insurance company about your coverage. Be prepared to pay the copayment and any deductible if your insurance and doctor’s office require it.

If you’re choosing to get this surgery as a cosmetic procedure to add a few inches to your height, your insurance might cover some part of it, if it’s within your plan. Often you might have to self-pay.

Leg-lengthening procedures can be costly, and the price might depend on your location and the doctor you choose. They may cost between $90,000 and $300,000.