These are the recommended lengthening amount by Limb Lengthening Doctors worldwide, from their response in the Doctor's Directory. Note that they are recommending based on their own specialized LL techniques.

**Dr Leonid N.Solomin**:

- On average, 3-6 cm for femur and lower leg: depends on the initial extremity length: the longer the initial length, the greater the elongation possible.

**Dr. Barinov**:

- Surgeons worldwide recommend to grow 5-7 cm, which is considered physiological. On an average patients grow 0.75 - 1 mm a day. growing 8-9 cm requires up to 9-10 months of treatment. I must say that the process of growing is very individual, some patients stop at 3-4 cm, others grow 9 cm and it's impossible to predict how the body will react to growing.

**Dr Janet Conway** :

- The total recommended lengthening is 2 inches (5 cm) in the thigh bone (femur). Lengthening more than 2 inches in one bone is associated with higher complication rates. If desired, another entirely separate lengthening procedure can be performed one year later in the shin bones (tibiae) to gain an additional 2 inches (5 cm) of height.

**Dr Dror Paley**:

- 8cms femur and 6-7 cms tibia. 1 mm daily femur and .75 tibias

**Dr Shahab Mahboubian**:

- If the PRECICE lengthening device is used, the current limitation is 6.5cm. If the LATN or LON technique is used, patients can gain 8 cm or more, if their body accommodates the lengthening well.

**Dr Saurabh Khakharia**:

- 1mm daily rate of lengthening. Amount of lengthening will depend on how your body takes it.

**Dr Suhas Shah** :

- Cosmetic lengthening of the tibias is recommended a maximum of 7.5 cm with external fixation, LON, or LATP

**Dr Manish Dhawan**:

- Lengthening of 5 to 8 cm will require 5.5 to 6.5 months.

**Dr Mangal Parihar**:

- Max 6 cms. daily rate 0.75 to 1 mm, depending on pain and muscle tightness.

**Dr Amar Sarin**:

-Safely can increase 22 5 of leg length. Lengthening depends on person to person may be 1.25mm to .5 MM

**Dr Guichet**:

-It depends on your body, and that must be evaluated. Some patients stop at a 5 cm gain, while others may go to 9 or 10 cm. All patients do not have the same body or psychological capacities. In Dr. Guichet’s practice, the average gain is 68 mm in cosmetic lengthening (115 cases).

**Dr Alex Monegal**:

-I recommend to use intramedullar devices. We can lengthen up to 8cm in fémur and 6 in tibia. It depends on your current height and the tibio-femoral proportion What i might advice you to lengthen.

**Dr Jamal Nemer**:

- Optimum value of the lengthening: 6,5-7,0 cms for femurs and 4,5 - 5,0 cms for tibias. Maximum "hard" program: 10-11 cms for femurs and 6-7 cms for tibias. There is a big resistance of Achilles tendon after 4,5-5,0 cm of tibias lengthening. And there is a big resistance of hip's muscles after 6,0 - 7,0 cm of femurs lengthening .

**Dr Milorad Mitkovic**:

- the recommended maximal lengthening is 5-7.5cm or 2-3 inches.

**Dr Maurizio Catagni** :

-At the level of the leg, with 2 level of osteotomy, with Ilizarov ring fixator, for an amount of 5-8cm, depending from the patient

**Dr Alexander Kirienko**:

-Recomendent amount of lengthening 6-8 cm of both legs.

**Dr Rainer Baumgart** :

-In normal proportioned people lengthening of more than 5cm (2 inches) only at the femur or at the tibia creates disproportions, which is not advantageous. If you want to get more than 5cm (2 inches), it is normally necessary to lengthen femur and tibia simultaneously. With this procedure you can reach 10-15cm (4-6 inches) or even more, but in most cases the relationship to the frame becomes disadvantageous if you lengthen more than about 10cm (4 inches).

**Dr Augustin Betz**:

- Our patients can gain up to 4-5 inches (10-12 cm) in one operation on upper legs (femurs) or lower legs (tibias). Patients may also gain a total of 8-9 inches (20-22 cm) in 2 operations. 1st operation on femur for 4-5 inches (10-12 cm). 2nd operation on tibias for 4 inches (10 cm). The amount of gain in tibias may vary from patient to patient. In many cases it is advised by Prof. Dr. Betz to lengthen up to 6-8 cm in tibias. Patients gain an average of 7-10 cm in one bone region at the Betz institute. The rate of lengthening is 1 millimetre per day

**Dr. Ghassan Salameh**:

- 8 cm , 0.8 mm per day

**Drs Wiebking/Krettek/Jagodzinski/Liodakis**:

- ISKD and Precice nail. Lengthening up to 8cm possible.

**Dr Muharrem Inan**:

- The ideal lengthening amount is 1/5th of the original length of the bone. The maximum tolerable amounts of lengthening we advise is 8 cm for femurs and 6 cm for tibiae.

**Dr.Mehmet Kocaoglu**:

- Eight and seven cms. My average amount of lengthening for cosmetic lengthening patients is 8-10 cms.

**Dr Hae-Ryong Song**:

- complication rates was increased in cases with lengthening of more than 30% of initial length. So, usually, for tibia, we lengthened about 7 - 8 cm. and for femur we lengthened about 5-7cm.

**Dr Donghoon Lee**:

- To minimize various complications resulting from limb lengthening, it is recommended that lengthening is performed under 20% of the original bone length, and by an experienced surgeon. Since the femur is longer than the tibia, generally speaking it is possible to lengthen more when lengthening the femur. However, since the muscles surrounding the femur are very strong, too much lengthening could lead to joint contracture in the hip joint or knee joint, so caution must be taken. According to Park's report (Park HW et al, JBJS,2008 ) , 25% of the people who lengthen the tibia(6cm in average) was found to have some difficulties in persuing vigorous activity If both Tibia and Femur are lengthened sequentially, the maximum to be 10cm in total. But, one more important thing is to consider body ratio. So, I recommend to decide the target considering the safety, recovery of sports activity and body ratio.

**Dr Aimin Peng**:

- 6-8 cm lengthening for cosmetic purpose Dr. Peng always recommends. The rate of lengthening daily is 0.66-0.67mm as average.

**Dr Xia/Dr Li**:

-In regard to the lengthening surgery, we usually lengthen the tibiae for cosmetic purposes, as most of people with short stature have relatively short tibiae, and the lengthening of tibiae will make them look more even. The surgery on tibiae is also relatively easy and risk free comparing to femurs (as there are a lot of muscles around it and special cares are needed to keep the patients comfortable during the lengthening). In most of cases, 8-10 (3-4 inches) cm tibial lengthening is sufficient to satisfy the needs.

**Dr Bai Helong**:

-6 一7cm is the maximum lengthening amount we recommend for safety in tibia . Sorry we do not do femur.

**Dr Lyall Ashberg** :

-Maximum lengthening that I would consider safe at this stage, would be about 5cm to 6cm of each segment (femur or tibia). Thus 10cm is realistic to achieve safely (~4 inches) but only in a staged fashion. It is possible to continue lengthening if there are no complications, given that the current Precise nails distract up to 6.5cm (another 3cm or 1.2 inches). This can be decided upon as the process continues.

**Dr Franz Birkholtz**:

-Functional recovery is multifactorial but we expect high levels of recovery in lengthenings between 5 and 10 cm. Cosmetically 10cm still keeps people in proportion. I would aim for 5-6 cm on femur and 4-5 cm on tibia. Arthritis is probably due to malalignment, but also increased joint pressures. This seems to be related to the extent of the lengthening as well.

**Dr. Richard Luzzi** :

- Safety reasons: 5cm tibias, 6cm femurs;

**Dr Mirzoyan**:

- In our practice we have increased length 14 cm (5.5 inches)for cosmetic reasons. This was indicated because of obvious disproportion between the patient’s body and legs. Theoretically, there is no limit. The problem is to estimate comprehensively how much any particular patient ultimately needs to make him proportional. Proportion between the tibia (lower leg) and the femur (upper leg) is also very important. With some frequency, potential patients ask us to lengthen tibias only by 8 or 10cm. We never do this. Priority №1 for us is the final esthetic result, and beyond that, biomechanical correctness

**Dr. Khaqan Jahangir Janjua**:

-We can increase your height by 5 to 12 cm (in stages).

**Dr Porn-A-nke Tardthong**:

- The height that you may get will be about 5 - 8 centimeters depending on your anatomical structure. One important caution about this procedure is you should follow our instructions strictly; absolute bed rest and a good understanding why you need to use the wheelchair and restrict strenuous activities. *Please note that this limit may vary a bit, depending on your individual anatomical structures. If your legs are rather short compared to your upper body, you are a suitable candidate for limblengthening or height increase surgery. However, the maximum length somebody can gain is about 12 cm or more.