What is Lengthening Surgery?
- Congenital / acquired trauma originated single leg,
- Single arm or finger shortness,
- Dwarfism or
- After puberty after the growth plates are closed,
it is a surgical operation that covers an average of 6-12 months of treatment for aesthetic purposes.
Theoretically, 80% elongation is possible with lengthening surgery, but in practice the situation is a little different. After the operation, both the muscles and the nerve and vascular network are shortened, so the 80% expectation predicted in theory varies according to the target and current height ratio of the person in practice at lower percentages.
In cases of heightening diagnosed early in childhood, after surgical intervention that started at the age of 5-6 years, it is possible to grow up to 20-25 cm after planning surgery for 2-3 more sessions in advanced ages. In adults, 4-8 cm in one session surgery. In 2 sessions of surgery, an extension of up to 10-16 cm can be achieved.
Why Do People Want to Increase Height?
Today, active use of social media, changes in world trends, advancement of visual material and technology have significantly increased human interaction; This increased people’s desire to be liked more, to be accepted and their position in society.
The desire of people to be accepted as an individual increases their visual expectations over time.
Although the perception of aesthetics and beauty has changed over the centuries, the desire of self-admiration and acceptance by the society continues.
These expectations are independent of gender.
How Does Height Increase Hormone Work?
Growth hormone, which provides height growth, is a protein-structured hormone consisting of 191 amino acids. Growth hormone is secreted by factors such as exercise, healthy nutrition, regular sleep habits, and it is processed in the liver to repair damaged tissue, cell renewal, bone growth, and to form proteins such as height growth, muscle growth, and fat burning.
Growth hormone is an injection needle treatment formulated with the same goal as growth hormone and developed for external reinforcement at the stage where the growth hormones of the person are adequately produced and stored.
During the development phase, growth hormone treatment is started after the determination of growth hormone deficiency in hormone tests performed by your doctor before puberty before the growth plates are closed.
What are the ways to Increase Height?
In child development, hormones, genetic and environmental factors are effective on height growth.
If the child does not show the expected physical development despite regular sleep, healthy and adequate nutrition, and jump-supported exercises, the first step should be applied to the Endocrinology department to investigate whether there are any hormones or genetic obstacles in the development of the child and a treatment plan should be established accordingly.
Lack or excess of hormones such as growth hormone, cortisol, puberty hormones (estrogen and testosterone), thyroid hormones directly affect growth.
In addition, chronic diseases such as diabetes and kidney failure have a negative effect on child development. If the person develops below the percentile determined according to his peers without any health problems, then genetic predisposition is investigated.
All these checks should be performed by the relevant specialist with the tests requested and the ways of lengthening should be determined with an appropriate treatment program.
What are the Lengthening Drugs?
Lengthening drugs are drugs that must be used under the supervision of a doctor. Almost all of the lengthening drugs offered on the market are prepared with growth hormone stimulating substances.
In unconscious use, major side effects can be seen, leading to a faster progression of an unknown disease of the person, especially early puberty. Never use lengthening drugs without prescribing by your doctor.
What are the Height Increasing Exercises?
There are a number of height increase exercises that are thought to be particularly effective in adolescence. Jumping exercises are one of the most effective of these.
Jumping and jumping exercises or sports with intense jumping movements such as basketball and volleyball are effective sports in increasing height. Jumping, pulling up on the trampoline, hanging at the bar, jumping rope expands the growth plates and makes your bones elongate.
Another sport that helps increase height is swimming. Swimming activates many muscles of the body, separating and joining the spinal discs. If you can find the opportunity, swim and do the exercises known as dry swimming at home.
The flexibility of the body, stretching movements, some pilates and yoga practices also allow the expansion of the growth plates between the bones and thus the length of the neck.
Who Are The Right Candidates For Lengthening Surgery?
It would be more correct to examine the lengthening surgeries in three main groups:
- The first group includes patients due to shortness of one leg, arm or finger.
These patients may be congenital shortnesses, or they may present with reasons such as accidents, bone infections, tumors, pause of unilateral elongation, relative shortness due to bone curvature (DEFORMITY).
- The second group includes congenital dwarfism.
The most common cause is achondrodystroplasia, and it can also occur in growth hormone deficiencies.
Generally, male height is 135 cm and female height cannot exceed 130 cm.
First intervention in these patients should be done at the ages of 5-6.
Second session operations are performed on average 10-12 years old.
Some patients may require a 3rd session of surgery. An average lengthening of 20-25 cm is possible. It is also possible to perform curvature correction (deformity) and lengthening operations in the same session in adult patients.
- The third group includes patients for cosmetic purposes.
Cosmetic lengthening surgeries can be performed in patients whose growth lines are closed, and who do not expect further growth by natural means.
How Is Lengthening Surgery Performed?
Lengthening surgery is performed by “Orthopedics and Traumatology” doctors under general anesthesia. The surgery is performed by cutting the bone to provide leg lengthening and attaching the “External Fixator Device” around the opened bones.
With the help of the External Fixator Device, the bone is removed 1 mm every day. by opening, a gap is created in the bone. The opened bone cavity is slowly filled with bone tissue and new bone formation occurs. After the bone hardening, the External Fixator Device is removed with a minor operation.
Lengthening is a surgical treatment with processes, lengthening surgeries according to the needs of the person are performed with 3 main techniques.
1. External Fixator Assisted Lengthening Surgery
It can be done with two basic extension devices. The first of these is the Ilizarov External Fixator. It is also known as the “Ring Method”. This method, which is used especially in curvature treatments, is not preferred today due to skin problems, the risk of infection and the rough appearance of the device.
The second method, which works on the same principle, is called the Monolateral External Fixator, in other words a unilateral extension device. This device has a gentle form and ergonomic structure compared to the other method. The risk of skin problems and infections is much less. Therefore it is common method. It carries full load.
2. Length Extension Method with Closed System (Precice, Fitbone)
In this system known as the closed (laparoscopic) method, a nail is placed in the marrow space of the bone. This method does not harm blood production, since the bone marrow only works actively in the spine and pelvis except in childhood. Two generations of nails are available.
- 1st generation nails are used with motorized system and
- 2nd generation nails are used with magnetic rod system.
No matter what type of treatment will be applied, nails are specially produced. The basis of the application is to increase the height with the principle of stimulating the nail from the outside with the help of special tools.
Since the method is applied closed (laparoscopic), skin problems are less and the aesthetic results are close to perfect. The risk of infection is almost nonexistent. However, the method does not guarantee full load bearing like the External Fixator method. It is a high cost method.
3. Lengthening with Combined System
In lengthening surgery with the combined method, both a closed nail and a fixator system that provides extension from the outside are applied together. The purpose of this system is both to ensure that the person gets rid of the external apparatus much earlier and to extend more anatomically without shifts in the bone through a more stable system.
This method also provides a significant advantage because it provides a more affordable cost than the closed (laparoscopic) method.
How Long Can I Walk After Lengthening Surgery? How Long Can Devices Be Removed?
The main difference in extension methods is the duration of removal of the extension device seen from the outside.
In all external methods (extension with external fixator), this time is approximately 4-5 times the amount of extension.
In the combined method, this period is between 4-5 months due to the load bearing of the nail inside. In completely closed (laparoscopic) methods, there is no external devic
|Duration (days)||External Fixator||Combined Method||Laparoscopic Method|
|Removal Of Device||300-360||120-150||60*|
Table: Average treatment times for 5 cm lengthening.
Due to the inability of the device to carry a load in the closed method, the time is doubled in cosmetic extensions as the sides are done one by one.
Since the system is under the skin, removal is not possible. The specified time is the time required for the second party to be made, and the extension is completed in 120 days in total.
You can start walking with or without support 1 or 2 days after the Lengthening Surgery (Combined Method), and after 15 days without support.
The duration of stay in the hospital is between 5-7 days, and the duration of the devices in the legs is around 4-5 months.
You can return to normal life 6 months after the operation, and start doing heavy sports after 1 year.
Is Lengthening Surgery a Painful Surgery?
Lengthening Surgery may involve a painful operation and treatment process. The person may have intense pain after surgery. Post-operative pain can be alleviated with painkillers recommended by your doctor.
During the treatment process, pain can be reduced only by regular physical therapy and exercises recommended by the doctor. Bone and muscle tissue strengthened with exercises helps reduce pain.
What are the Risks of Lengthening Surgery?
Lengthening surgery has a number of risks as well as any surgery. Basically, the risks of these surgeries are handled in 2 main groups.
- The first is the risks related to the anesthesia method chosen.
- The second is postoperative pain, bleeding, infection, joint stiffness, vascular coagulation (thromboembolism), material insufficiency and late union.
These operations can be performed with spinal-epidural anesthesia or general anesthesia depending on the patient’s preference and general health status. The complications associated with the anesthesia taken are the same as the risks associated with anesthesia for any surgery of this size.
One of the risks of lengthening surgery is the remaining scars that will cause aesthetic problems after the surgery. The external fixator assisted system is less scarring than the closed system method.
Acute severe pains in muscles, vessels and nerves can be seen during the lengthening process after the lengthening surgery.
Muscle weakness may occur due to immobility in the operated leg, which cannot be actively used during the lengthening process.
Post-operative rehabilitation process is important. People who cannot have a good rehabilitation process may have stiffness and restrictions in joint movements. Therefore, physical therapy exercises should not be neglected.
In lower leg extensions; If more lengthening is made than the muscles and nerves can handle, the Achilles tendon may be short and short Achilles syndrome may be seen.
Infection and material risks are in the most common group in lengthening surgery. Bone infection risk may occur due to both orthopedic implants placed in the bone and internal nails placed in the closed system.
“Nail root infection” is another infection risk. It may develop depending on externally applied devices in soft tissue. Your doctor will apply postoperative antibiotic therapy to minimize the risk of any infection.
Another risk in lengthening surgery develops due to insufficient materials used. Problems caused by the risks such as loosening or breaking of the materials as a result of loading or failure may cause the healing process to be prolonged or difficult. It is one of the rare risks.
Are Height Increasing Drugs Harmful?
All of the drugs sold under the name of height increase drugs have harmful effects and are dangerous unless they are under doctor’s control and doctor’s recommendation.
What is the Age Limit for Increasing Height?
The lower age limit for Lengthening Surgery is determined as 3 years. For children whose height ratio is below the percent value of peer groups and who cannot catch up with their peers in terms of height, a lengthening surgery can be planned from the age of 3.
Although there is no upper age limit for Lengthening Surgery, height extension surgery is not recommended for the group aged 40 and over as long as the bone development quality is weakened.
Do Height Increase Exercises Work?
It is known that some exercises and preferred sports have an effect on increasing height. Individual team games such as swimming before the age of 8, basketball and volleyball after the age of 8; activities such as walking, spending time outdoors, jogging, which are known to increase metabolism; Exercises to stretch the joints such as jumping, jumping, pull-up, hanging at a bar, jumping rope are ideal sports to increase height.
Spine movements that help to open between the vertebrae in height extension exercises are especially effective in the developmental age. Exercise steps such as building a bridge, basic leg stretching, cat stretching, cobra movement and stretching every other day have a positive effect on height growth.