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Author Topic: Lengthening Amount Recommended  (Read 88338 times)

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Muse

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Lengthening Amount Recommended
« on: March 04, 2015, 03:42:44 PM »

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.
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endomorphisme

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Re: Lengthening Amount Recommended
« Reply #1 on: March 04, 2015, 03:57:24 PM »

great post,there is no general consensus, but 5 cm per segment seems to be the safe limit.
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ItsMyLife

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Re: Lengthening Amount Recommended
« Reply #2 on: March 04, 2015, 04:26:57 PM »

Seems like 7-8 cm is fine for tibia if your bone length is longer (22.5% in my case)
But I think I will err on the side of caution and do 7-7.5 cm only because worried too tall in my country and greater chance of athletic abilities recovery
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Uppland

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Re: Lengthening Amount Recommended
« Reply #3 on: March 04, 2015, 04:49:57 PM »

Maybe stick this post as a general info thread?

In general it seems like 4CM should be "safe" while 7-8CM is pushing it.
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YellowSpike

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Re: Lengthening Amount Recommended
« Reply #4 on: March 04, 2015, 04:53:57 PM »

I would say 5cm is pretty good estimate of the "safe" limit. In my experience, and in other diaries I have read, it seems that soft tissue/nerve pain often starts to escalate around the 5cm mark. I know that's when things got bad for me.

Only patients who are extremely naturally flexible and/or just straight up lucky can hope to do 7.5cm+ in one surgery. At least, that's my opinion, having struggled a good amount to get to around 7cm (and I worked hard and did all my PT). Then again, I didn't get any soft tissue releases, so that made my experience that much harder.
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ItsMyLife

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Re: Lengthening Amount Recommended
« Reply #5 on: March 04, 2015, 05:01:38 PM »

I would say 5cm is pretty good estimate of the "safe" limit. In my experience, and in other diaries I have read, it seems that soft tissue/nerve pain often starts to escalate around the 5cm mark. I know that's when things got bad for me.

Only patients who are extremely naturally flexible and/or just straight up lucky can hope to do 7.5cm+ in one surgery. At least, that's my opinion, having struggled a good amount to get to around 7cm (and I worked hard and did all my PT). Then again, I didn't get any soft tissue releases, so that made my experience that much harder.
Im at 5.5 cm and still no nerve pains. Im only on paracetamol and lyrica 75 mg (stopped tramadol for a week). I will listen to my body and stop if it gets too pain..
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YellowSpike

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Re: Lengthening Amount Recommended
« Reply #6 on: March 04, 2015, 05:02:57 PM »

Im at 5.5 cm and still no nerve pains. Im only on paracetamol and lyrica 75 mg (stopped tramadol for a week). I will listen to my body and stop if it gets too pain..

Yeah I"m going to see if I can get another prescription for Lyrica, although Dr. Guichet said there are better medicines for nerve pain that comes from LL. Right now, if it weren't for the nerve pain, I'd feel a lot better.
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ItsMyLife

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Re: Lengthening Amount Recommended
« Reply #7 on: March 04, 2015, 05:10:58 PM »

Yeah I"m going to see if I can get another prescription for Lyrica, although Dr. Guichet said there are better medicines for nerve pain that comes from LL. Right now, if it weren't for the nerve pain, I'd feel a lot better.

Pregabalin and its sister (I cant remember the name) are best for nerve pains. they are first-line agent and med students all know them..
Even when I stop Lyrica, I don't feel any pains... But I take LYrica 75 mg at night to sleep. It makes you feel calm and relaxed.
I could have stopped Lyrica, but I get breathless when I reduce it to zero.
So now I am taking 75 mg and next week I drop to 50 mg/day.
I take lyrica now not for pain  :'(
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YellowSpike

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Re: Lengthening Amount Recommended
« Reply #8 on: March 04, 2015, 05:16:30 PM »

Pregabalin and its sister (I cant remember the name) are best for nerve pains. they are first-line agent and med students all know them..
Even when I stop Lyrica, I don't feel any pains... But I take LYrica 75 mg at night to sleep. It makes you feel calm and relaxed.
I could have stopped Lyrica, but I get breathless when I reduce it to zero.
So now I am taking 75 mg and next week I drop to 50 mg/day.
I take lyrica now not for pain  :'(

What has helped you the most with nerve pain? I texted ChrisIsaak to ask him, but he says Tramadol, but that didn't do much for my nerve pain. I'm going to ask Dr. Guichet to contact my personal doctor here at home to give me another Rx, because pharmacies near me all won't take international prescriptions. So damn annoying.
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ItsMyLife

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Re: Lengthening Amount Recommended
« Reply #9 on: March 04, 2015, 05:19:40 PM »

I was experiencing some bad pains at about 4 cm.  Tramadol + Lyrica, really helps..... Did it work for you?
Why do I experience zero pain now at 5.5 cm? According to my docs, the pain drops off mid-way, so I can expect more pain soon??  :-X
Now I can even stop paracetamol and be totally pain-free......
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ppatient

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Re: Lengthening Amount Recommended
« Reply #10 on: March 07, 2016, 04:55:28 PM »

Some doctors agree to do the number of cm you want to do and then you get problems. 5 or 6 cm is the maximum limit for tibiae and 6 or 7 for femurs... and its risky. I would advise 4 + 6 as a maximum, and that's a lot. You won't be the same after all that lenghtening
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applesandoranges

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Re: Lengthening Amount Recommended
« Reply #11 on: March 07, 2016, 08:29:43 PM »

I think 1.5cm internal femurs + 2.5cm external tibias is the safest way for me. And 4cm is the amount I would be satisfied with.
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Knik

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Re: Lengthening Amount Recommended
« Reply #12 on: March 07, 2016, 08:53:12 PM »

I think 1.5cm internal femurs + 2.5cm external tibias is the safest way for me. And 4cm is the amount I would be satisfied with.

1,5 cm. Are you crazy ? Any doctor will accept you
do 4 cm in one operation, more simply and no more risky than 2 operations
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ppatient

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Re: Lengthening Amount Recommended
« Reply #13 on: March 07, 2016, 09:00:21 PM »

1.5 + 2.5 isn't reasonable. Your soft tissues will recover better than if you lengthen more but what about the trauma of doing both tibias and femurs? not reasonable
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applesandoranges

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Re: Lengthening Amount Recommended
« Reply #14 on: March 08, 2016, 02:58:51 AM »

1.5 + 2.5 isn't reasonable. Your soft tissues will recover better than if you lengthen more but what about the trauma of doing both tibias and femurs? not reasonable

Yes, I'm aiming for long-term recovery as top priority. How I would do it is do 2.5cm external tibia first, and then after 3-4 years do 1.5cm internal femur. All from top doctors. Money and time is not really an issue.
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texasbruce

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Re: Lengthening Amount Recommended
« Reply #15 on: March 08, 2016, 03:19:32 AM »

Yes, I'm aiming for long-term recovery as top priority. How I would do it is do 2.5cm external tibia first, and then after 3-4 years do 1.5cm internal femur. All from top doctors. Money and time is not really an issue.

Apparently this guy has no idea what he's talking about
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applesandoranges

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Re: Lengthening Amount Recommended
« Reply #16 on: March 08, 2016, 01:32:57 PM »

Apparently this guy has no idea what he's talking about

Don't comment if you have nothing useful to say. Mod plz ban this guy. Thanks
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Alittletooshort

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Re: Lengthening Amount Recommended
« Reply #17 on: March 08, 2016, 01:55:50 PM »

Don't comment if you have nothing useful to say. Mod plz ban this guy. Thanks
You want to ban him because he has a different oppinipon than you? ;D
Doing 1,5cm´s with an internal device is stupid (not only money wise), you didn´t really consider the fact that the surgery alone is pretty scary. The anesthetics and painkillers are pretty harmful for your system and the x-rays increase your chance of cancer in the long run. So doing this procedure twice for only 4cm´s in total is not smart.
Do 4-5cm´s with an internal nail and call it a day.
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applesandoranges

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Re: Lengthening Amount Recommended
« Reply #18 on: March 08, 2016, 02:23:16 PM »

You want to ban him because he has a different oppinipon than you? ;D
Doing 1,5cm´s with an internal device is stupid (not only money wise), you didn´t really consider the fact that the surgery alone is pretty scary. The anesthetics and painkillers are pretty harmful for your system and the x-rays increase your chance of cancer in the long run. So doing this procedure twice for only 4cm´s in total is not smart.
Do 4-5cm´s with an internal nail and call it a day.

He didn't state an opinion, he just insulted me for no reason. Useless, negative posters need to get banned  ;D

I'm not worried about using anesthetics and x-rays. There are no studies that show anesthetics are harmful to the body and that x-rays cause cancer. Even if it was a little toxic to your body, you can recover from it easily over time. What you cannot recover from is mechanical deviation and stretched out muscles/tendons and other soft tissue and nerve damage in your legs that is inevitable if you do large amounts of lengthening. 1.5cm is enough that I can get a significant height increase while minimizing mechanical deviation and soft tissue damage. Also, I can get back to regular life a lot more easily if I do 1.5cm.

Also I think doing femurs 3-4 years after I do tibia is better since I can have a long time to recover from the first surgery. 2.5cm in tibia is about 5 months total recovery. 1.5cm internal femur is about 2 months for lengthening/consolidation time.
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Alittletooshort

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Re: Lengthening Amount Recommended
« Reply #19 on: March 08, 2016, 02:45:55 PM »

He didn't state an opinion, he just insulted me for no reason. Useless, negative posters need to get banned  ;D

I'm not worried about using anesthetics and x-rays. There are no studies that show anesthetics are harmful to the body and that x-rays cause cancer. Even if it was a little toxic to your body, you can recover from it easily over time. What you cannot recover from is mechanical deviation and stretched out muscles/tendons and other soft tissue and nerve damage in your legs that is inevitable if you do large amounts of lengthening. 1.5cm is enough that I can get a significant height increase while minimizing mechanical deviation and soft tissue damage. Also, I can get back to regular life a lot more easily if I do 1.5cm.

Also I think doing femurs 3-4 years after I do tibia is better since I can have a long time to recover from the first surgery. 2.5cm in tibia is about 5 months total recovery. 1.5cm internal femur is about 2 months for lengthening/consolidation time.
What? Did you just say that there is no evidence that x-rays increase the chance of getting cancer?  :o Dude, please inform yourself a little about the subject, it's for your own good.
Edit:
 Anesthetics are related to brain damage btw. Saying there are no dangers involved by the x-rays , anestaethics, the pin killers and the stress that is caused by the surgery is just wrong. Every decent doctor will tell you that.
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applesandoranges

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Re: Lengthening Amount Recommended
« Reply #20 on: March 08, 2016, 03:15:07 PM »

What? Did you just say that there is no evidence that x-rays increase the chance of getting cancer?  :o Dude, please inform yourself a little about the subject, it's for your own good.

No I did not say that. I said there are no studies that show x-rays cause cancer. The human body repairs low-dose radiation damage.

http://www.medicalnewstoday.com/articles/306067.php
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Alittletooshort

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Re: Lengthening Amount Recommended
« Reply #21 on: March 08, 2016, 03:58:20 PM »

No I did not say that. I said there are no studies that show x-rays cause cancer. The human body repairs low-dose radiation damage.

http://www.medicalnewstoday.com/articles/306067.php
http://ukhealthcare.uky.edu/CT-risks/
They used fruit to test this, so it's not necessarily the most accurate studie for humans. Non the less it's known that radiologists do have an increased risk to develop cancer.

To get back to the original topic, 1.5cm's can easily accieved by using lifts. Spending so much money and time for a very similar result is probably not worth it.
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applesandoranges

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Re: Lengthening Amount Recommended
« Reply #22 on: March 08, 2016, 04:47:29 PM »

http://ukhealthcare.uky.edu/CT-risks/
They used fruit to test this, so it's not necessarily the most accurate studie for humans. Non the less it's known that radiologists do have an increased risk to develop cancer.

To get back to the original topic, 1.5cm's can easily accieved by using lifts. Spending so much money and time for a very similar result is probably not worth it.

Not to argue with you, but radiologists spend all day in that environment. Getting a few x-rays for LL poses a negligible amount of risk for cancer.

I already wear shoe lifts, but there's a maximum amount of shoe lift I can wear comfortably on a daily basis. Currently my shoes+lifts give me 4cms in height, but if I try to increase that, it's not comfortable. For me, it's not sustainable after 4cm shoe+lifts.

Also, the total amount of LL I want is around 4cm and I think it's worth doing both segments because it's safer for the legs to do less amounts each.
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Knik

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Re: Lengthening Amount Recommended
« Reply #23 on: March 08, 2016, 06:20:12 PM »

why not do 4 km in one operation? It is not less risky
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Ozymandias

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Re: Lengthening Amount Recommended
« Reply #24 on: March 08, 2016, 08:56:10 PM »

Woah, I consider myself part of the "don't-lengthen-too-much" yihad, but both segments for just 4 cm is crazy.

And even more, why 2.5 cm in tibias and 1.5 in femurs? Unless your tibias are naturally longer than your femurs (is that possible?) you are changing your tibia-femur ratio for no reason (2.3 in femurs and 1.7 in tibias could be better, but whatever... it still sounds crazy)
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aspirant185

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Re: Lengthening Amount Recommended
« Reply #25 on: March 08, 2016, 10:15:17 PM »

4 cm in two surgeries :D what a nut job haha
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Current afternoon height: 175.5 cm
Wingspan - 182 cm
Target height 184 cm
Considering doing 4.3 cm Femurs and 4.2 cm Tibias with Dr. Milorad Mitkovic in Serbia.

TIBIKE200

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Re: Lengthening Amount Recommended
« Reply #26 on: March 08, 2016, 11:01:19 PM »

why not do 4 km in one operation? It is not less risky

 I completely agree. 4Km is indeed the best. You will be the tallest person in every situation :D
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Rubywoo

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Re: Lengthening Amount Recommended
« Reply #27 on: March 17, 2016, 02:36:32 AM »

Hello

I am experiencing really bad pain 6 years after my last leg lengthening operation in which I have had 3 in total . I am taking much more painkillers now than I ever did during my treatment !

I was wondering if anyone else Is having this trouble with arthritis and nerve damage I am now on morphine  continually and there is no sign of me coming off it !

I am so grateful of my surgeries and without them I wouldn't have been able to get about without crutches or a wheelchair .

I am 27 years old and am just a bit worried about what the future holds and wondering if there's anything that's anyone has came across to help ?
Thank you
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hamilton

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Re: Lengthening Amount Recommended
« Reply #28 on: March 17, 2016, 02:50:27 AM »

Hello

I am experiencing really bad pain 6 years after my last leg lengthening operation in which I have had 3 in total . I am taking much more painkillers now than I ever did during my treatment !

I was wondering if anyone else Is having this trouble with arthritis and nerve damage I am now on morphine  continually and there is no sign of me coming off it !

I am so grateful of my surgeries and without them I wouldn't have been able to get about without crutches or a wheelchair .

I am 27 years old and am just a bit worried about what the future holds and wondering if there's anything that's anyone has came across to help ?
Thank you

who is your Dr.? and What part did you have  leg lengthening operation? (femur or tibias? )
what method did you take?
good for you, but 6 years for recovery is too slow.
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TIBIKE200

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Re: Lengthening Amount Recommended
« Reply #29 on: March 17, 2016, 02:51:51 AM »

Hello

I am experiencing really bad pain 6 years after my last leg lengthening operation in which I have had 3 in total . I am taking much more painkillers now than I ever did during my treatment !

I was wondering if anyone else Is having this trouble with arthritis and nerve damage I am now on morphine  continually and there is no sign of me coming off it !

I am so grateful of my surgeries and without them I wouldn't have been able to get about without crutches or a wheelchair .

I am 27 years old and am just a bit worried about what the future holds and wondering if there's anything that's anyone has came across to help ?
Thank you

How much did you lengthen in each segment? what's your height now? Why did you do 3 surgeries? You had acondroplasia? Leg disperencies?
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Bruno Mars

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Re: Lengthening Amount Recommended
« Reply #30 on: March 26, 2016, 06:21:04 PM »

i just read on old forum, is it true that the bone will shrink, so if i lengthen 4 cm,   the actual will be like only 3 to 3.5cm?
How can bone shrink??? Please use your brain to think before asking such question.
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