The blood vessels, nerves, muscles and skin also lengthen with the bone.

 During the limb lengthening procedure common complications are:
A. Pin track infection, which is prevented by proper pin track care. If this is neglected, pin loosening is inevitable.
B. Joint stiffness occurring because of the muscles contra pulling effect during lengthening, which is prevented by regular physiotherapy.
C. Deformity of the bone regenerate occurs due to selective muscle pull. This complication needs correction during lengthening.
D. Vessel and nerve injury during wire insertion. The chances of injury reduce as the experience of the surgeon increases.

Physiotherapy plays a pivotal role in getting good outcome. The patient should start with early weight bearing exercises and physiotherapy as this stimulates muscle action and blood supply of the bone. To follow doctor’s instructions is another very important factor.

It is not necessary to be in the bed. The regeneration of new bone relies heavily on blood flow occurring during functional use of the limb "see dictionary- Ilizarov effects". So we allowed the patients to walk independently with crutches or even without them, some of them can drive the car in first days after the operation, but some patients prefer to use crutches for support and balance.

The patients stay at the hospital for only a few days after the surgery, but he has to stay in constant touch with the doctor during the lengthening phase. The patient is given instructions on what to do at home and most adjustments can be done in the clinic.

Yes, definitely.

Presently the minimum cost is at HillsClinic as compared to similar facilities around the word. Our cost is US$4000 including the surgery, Ilizarov frames on both sides and 1-2 days hospital stay. Afterward charges comparatively also very low and we have got different packages to offer.

At HillsClinic patients are managed by trained and qualified team members under the supervision of the senior surgeon. Our team members include: surgeons, physiotherapists, psychologists, orthotists, exercise physiologists, case managers, ward and operating theatre staff.

It depends upon the type of patient and the stage of height increase process. We only selected patients for swimming in chlorinated water and clean swing pool. Do NOT swim in sea, hot water, lakes. This can lead to wire tract infections.

Most of or patients are from Pakistan and Afghanistan but we also have been receiving patients from citizens of the United States of America, Germany, Canada, Turkey, Malaysia, Australia, India.

 Concerning increasing one's height due to the cosmetic conditions, the optimum increment value (taking into account the average proportions of human body) is 5-7 cm (2-3 in). In dwarfism or short stature, height can be increased up to 6 inches.

Complications occur in less than 0.4% of all cases. Those include soft tissue inflammation and slow bone union. Possessing great experience in curing miscellaneous consequences of bone and joint traumas, we have succeeded in cutting out the complications completely. That allows us to have 100% success in the cosmetic surgical procedures.

Our approach to the height increase issue is well balanced. The increase, taking into account the average body proportions do not lead to the remote negative consequences. The growing reclaimed bone is the human's own tissue; therefore, no tissue incompatibility immune conflict occurs. During leg shape correction, the change in the lower extremities axis location leads to better-balanced loading of the knee joint's load-bearing faces. Thus, in this case, the cosmetic leg shape correction also appears to be preventive, since improving of the knee joint's operation environment prevents the early development of deforming arthritis.

Following conditions are the contraindications: alcoholism, narcotic addiction, mental diseases, psychological problems, patients with impatient attitude to expect quick results, metabolic disorders
personality problems, uncooperative patients, poor bone quality, peripheral vascular diseases, till the natural height is attained, venereal diseases, some infection, hematological and skin diseases, active forms of tuberculosis, acute conditions of individual chronic purulent diseases, AIDS, chronic hepatitis, syphilis, mental disease, chemical addiction, individual systemic diseases and any systemic disease like diabetes.

 Using hormone-based drugs for increasing an adult person's height is strongly discouraged. Hormone-based drugs cannot affect just the person's height alone; they also affect the person's other organs and systems (e.g., facial bones, hand bones, etc.) Elevated concentration of hormones in one's body may lead to a number of health conditions, such as acromegaly, gigantism, etc. Such medications are normally prescribed only for treating children due to medical conditions.

Ilizarov Method is a low invasive technique. It means that all manipulations are done through small incisions (1-1.5 cm) and all soft and bone tissues are damaged as little as possible. After operation the limb is fixed with an external device (Ilizarov apparatus), which is removed after the end of treatment. No metal remains inside the body and that is the great difference versus internal fixation. Complications are very rare, and if they happen they are temporary and do not influence the final result of treatment because the doctor can control the postoperative care and make corrections during the whole treatment without additional operation, which is impossible with conservative or internal techniques. Our patients start walking on the next day after the operation. They do not keep to bed; they are active during the whole treatment. Experienced instructors of the physical therapy department supervise them during exercising.
 

After treatment with low invasive Ilizarov method, there are small skin scars (1-1.5cm), which can be easily removed by a plastic surgeon if a patient wishes to do it.
 

All surgeries have a certain risk. The possible complications with Ilizarov method are: wire-track infection, limited range of motions in the knees. The complications are temporary and do not influence the final result of treatment.
 

After the end of rehabilitation period all function of muscles and joints returns back to normal completely. The new bone is able to stand all static and dynamic stresses. Your physical condition is preserved after height increase and will be able to go in for sports without any restrictions.
 

Certainly the shape of the legs can be corrected at the same time when lengthening is under the process.
 

As we do pre arrival complete on line assessment of our patients, so you will only complete a few other formalities after your arrival and can be operated on the next day of your arrival.
 

At HillsClinic simultaneous tibial and femoral lengthening is not performed, mainly because of the psychological difficulties patients may experience as a result of the long total limb lengthening period.
 

Patients may require additional surgery in less than 3% of cases mainly because they have not followed the doctor's and physiotherapist’s advices.
 

Ilizarov frame is removed when your bone has a good regeneration.
 

There can be certain specific aspects of a patient’s lifestyle that may have an adverse impact on his or her health. This includes such habbits as smoking, alcohol consumption, drug abuse, diet, and exercise. We will try to identify any such issues and then counsel a patient on steps to reduce the health risk. Evidences show that lifestyle modification can lessen risks and prevent complications after surgery.
 

The Ilizarov device is usually removed under light sedation without having much pain or discomfort.
 

You can have shower as early as 24 hours after surgery, but you will not be allowed to wet the legs with the devices on.
 

Yes we do recommend diets and meals to provide you with vitamins and a balance of micro-elements for a better recovery process. You need to have a balanced diet while undergoing treatment, but if you want something special - it will be arranged.
 

For those who are vegetarian/vegan etc. or having special dietary requirements, the clinic gladly helps for your needs. It is important to inform us beforehand.

 

Accommodation is provided at the HillsClinic and the facilities depend upon the package you select.If there are 2 people undergoing surgery and they are willing to share a room, they may do so and the accommodation cost for each will be much lower.
 

The surgery cost does not include accommodation. Surgery costs cover the limb lengthening surgery itself, Ilizarov devices for both legs, all necessary medical equipment and medication for pre-surgery and post-surgery care, x-rays, etc. It also includes removal of the Ilizarov device after the treatment is over.
 

You will need to stay in the country and cannot return home while distracting is going on. Distraction starts on the 10th day after the surgery. After it ends, you may go home, although we'd advise staying at the clinic for the whole period of treatment to get the desirable results.
 

Ilizarov device is worn for 3-4 months during distraction and then the device remains on the leg until the bones fully consolidate. This generally takes 6-7.5 months after surgery, depending on how much you increased your height.
 

The age of patients may be from 16 to 60 years.
 

There is not any necessity for wheelchairs. Patients can walk independently with crutches or even without them in the first days after the operation.
 

Yes at the present time there are foreign patients from Canada and Afghanistan. These patients are undergoing the height increase procedures at our setup.
 

Upper arms lengthening procedures are also performed at HillsClinic only in cases with very big visible disproportions of the body, legs and arms.
 

No. Categorically not. Once you have stopped growing, the growth plates in your bones fuse and this prevents any further growth of your bones. Bones are the major contributing factor to your height. Any company claiming to offer pills, chemicals, machinery or other magical solutions to permanent height increase are trying to scam people. No such solution has ever been proven to work.
 

Yes only by limb lengthening surgery and not by any other method.
 

It involves one or more of the bones in a limb being broken, and then the two separate parts of that bone being slowly pulled apart (distracted). Normally this involves small adjustments done several times a day. Bone regenerates in this situation, and new bone cells will be produced and will fill the space in the break. The new bone will not be fully hardened (consolidate) for over a year, but should be strong enough to support walking within a few months of surgery. There are a number of different techniques, some involving only internal procedures, others using external and sometimes a combination of the two. The principle was discovered by Professor Ilizarov of Russia, and the standard external device for lengthening or leg correction is called the Ilizarov frame. There are many alternatives, but nearly all are based on the principles discovered by Professor Ilizarov.
 

The human body has astonishing growth abilities, and significant height increases have been realized by people with growth deficiencies. Technically, in excess of 12 inches is possible where medical reasons dictate. For cosmetic reasons, most surgeons recommend a maximum of 5cm per limb, but up to 12cm is possible with some techniques. However, excessive lengthening may cause problems with the patient's bodily proportions which may make them unattractive. It may also lead to future health problems such as premature arthritis, bone weakness or muscle atrophy.
 

Both parts of the legs - the thighs containing the femur bone and the shins containing the tibia and fibula bones - can be lengthened. However, most techniques focus on the shins due to the lower risk of complications.
 

In regard to the lengthening surgery, we usually lengthen the tibiae for cosmetic purposes, as most of people with short stature have relatively shorter tibiae, 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 the femurs and special cares are needed to keep the patients comfortable during the lengthening). However, the femoral lengthening can be performed for patients with shorter femurs and for larger extent (>12cm) lengthening, in which cases, both tibiae and femurs have to be lengthened under two separate procedures.  

Yes! There is certainly some pain involved in leg lengthening (LL), but in most cases the pain is manageable using painkillers and therapies. Some people may find the pain unbearable and be able to continue with the treatment, others will experience very little pain and discomfort. In general, internal methods are less painful than external methods but there are no 'pain-free' treatments available.
 

For an increase of 5cm (50mm) a normal, healthy adult should expect the whole process to take about 6 months from operation, to being able to walk again. Some people will take longer. For those who are particularly fit, healthy and have a high pain tolerance, it may be possible to do it more quickly. Whilst the bone can regenerate at a rate of 1mm per day, muscles, blood vessels, nerves and tendons grow more slowly, and so a lengthening rate of 0.666mm per day is recommended as the maximum for a normal, healthy adult. A strong person with an above-average level of fitness may be able to achieve a rate of 0.833mm per day. Some doctors allow 1.00mm per day lengthening, but at this pace of lengthening, muscle and tendon problems are common, especially with the knees and ankles.  

Technically this is possible, but it is strongly discouraged. Very few doctors condone this approach, and some of those that do have had terrible results, sometimes requiring that their patients take years to recover Where a patient feels that they really do require lengthening to both parts of their legs, this should be done sequentially with a gap of at least one year between operations.
 

All unnecessary cosmetic surgery carries an element of danger and doctors should ensure that their patients fully understand all of the risks and potential complications before they accept them for surgery. Whilst there are very few reports of serious injury or limb loss, it is a possibility with this type of surgery.
 

There are several possible reasons for this. Firstly, developing countries usually have a lower level of nutrition than industrialized nations which may lead to higher incidences of bone and growth deformities. This means that they often have more doctors focused on this field, and there is a close link between the techniques used to treat deformities and those employed in Leg Lengthening. Secondly, tighter regulation and legal frameworks in industrialized nations make cosmetic leg lengthening very expensive and problematic for surgeons due to the possibilities of litigation and problems with medical regulators. Finally, the average height in industrialized nations is greater than that in developing countries, meaning that demand for such services is greater in the developing world. For example, the average height in the UK is 177cm, whilst the average height in China is 165cm.
 

The full costs for an LL treatment of 5cm are likely to be between 4000 and 125,000 US Dollars depending on a number of factors.
 

As well as nutrition, a person's height will be affected by genetics (the height they inherit from their parents or other ancestors), illness and their lifestyle. Some research indicates that young people who engage regularly in sports and have a healthy, balanced diet are more likely to achieve their maximum possible height than a young person who doesn't exercise and has poor nutrition. There are a number of childhood illnesses that can stunt a person's growth, some of them related directly to growth, others that simply affect nutrition (e.g. digestion problems).
 

Use resources like Make Me Taller (http:// www.makemetaller.info) to do your research, learn about different techniques and decide which method is best for you.
 

There is no answer to this question. The best method for a particular person will depend on their individual circumstances and requirements.
 

There is no set answer to this. It depends on your existing proportions, your height and only a Leg Lengthening specialist is qualified to give advice on this. Once you have chosen which doctor to work with, they will advise you on what increase is possible and also what increase is advisable. There is no other way to answer this question. Everyone is different. It is possible to be 160cm tall with long legs and to be the same height with short legs. There is no formula that will allow you to work out what is possible.
 

Our golden standard for perfect body length balance is 10 (Leg length, distance from feet to belly button):6 (trunk length, distance from belly button to top of the head) and the perfect ratio is around 1.63. This is a standard we use to guide lengthening, and the ratio should be around 1.6- 1.9 in practice. But for individual we do not recommend to use this as only standard, as it depends on the individual’s body shape and functional requirements.
 

Leg lengthening procedure is a kind of controlled fracture healing and once the bone is healed, there is no long term effects on the lengthened bone, as bone is under constant remodeling, hence the newly formed bone is as strong as the intact original bone. The real concern is on the long term mechanical effects on the joints. As change of height and bone length, will lead to change of body balance and loading pattern on the joint will be changed. However, our body can adjust the gait pattern to adopt the changes, and it will take a few years for the body to fully adapt to the new changes .During this period, we will recommend modest exercise.
 

The bones will fully regenerate several months after the operation completed and they will be as strong as before the treatment.
 

No. As most of short people have relatively shorter tibiae, so that tibial lengthening is usually recommended. In addition, there are more muscles around the femurs, so that this makes the wear of the frame a little more cumbersome when comparing to the tibiae. You should not worry about the complications as in fact femur is much easier to heal as compared to tibiae due to its abundance of muscle and vascular supplies.
 

All the tissues you mentioned will grow together as a result of the lengthening treatment; this is called "tension stress effects on tissue regeneration". Leg-lengthening mimics normal leg development as we did in our childhood, so that there is no long lasting side effect once the procedure is completed.
 

Yes, at HillsClinic we always start physiotherapy prior to surgery. To stay fit definitely will help you to have a speedy recovery, and most of such patients are able to go back to their normal life 3-4 months after the surgery.
 

Yes, you can have a sitting job at your office desk and walk around with the help of crutches. We encourage our patients to be active as soon as possible up to their limits.
 

Some longitudinal scars do develop along the pin pathway during the lengthening. Most of the scars get softened after 1-2 years following the surgery. Some people have more scars. We can offer cosmetic surgery to remove the scars at very reasonable cost after the lengthening is completed.
 

According to the literature on the subject and my experience during of 33 years of clinical practice, the irreparable or non-treatable damages are very rare.
Most of the damages to nerves are reversible as they are partial; if the damage has caused a functional deficit then we have got other valid and effective ways to regain the lost function if it is affecting the day to day activities. But it is very rare. Nerve damage at the most can cause a toe drop or partial foot drop which if given time mostly recovers.
 

The height neurosis is a phenomenon and can become a syndrome and cause lifelong psychological disability; which is only treatable if the patient goes through the process of virtual height increase. As the limb lengthening by surgery is a well controlled scientific method and function assessment and retaining of preoperative abilities are managed dynamically, so the risks are well calculated and are brought to the negligible point. The functional ability of the limbs is well titrated as the process of limb lengthening is going on and we always give priority to the function over the limb lengthening. We can slow down the process or stop it all together till we regain the function.
 

If the patient follows the physiotherapy protocol and other important and essential inputs, he remain fully functional for physically demanding sports and can become even more fit to participate in most of the sports after limb lengthening.
The patient usually needs another 4-6 months after removal of the frames, for regaining full preoperative physical status.
 

Another 6-8 months in addition to the 6 months of three inches height increase.
 

During the limb lengthening process they do get into psychological problems but not after completion of the process. Moreover over patients are psychologically evaluated preoperatively and we only accept them if they are psychologically fit to undergo the process. The psychotherapy coverage is a mandatory part of the process at our set up.
 

Pain management is not only by drug treatment but it is a multi-phasic approach at over set up. We employ multiple ways to manage the pain and drug dependency or long term side effects are reduced to the minimum.
 

Every patient and their close relatives have such valid concerns. As the process is well controlled and monitored by a team of health care providers at our set up, such chances are reduced to the negligible amount. The main purpose of team approach is to fragment the treatment process into smaller chunks to be managed by trained individuals in that particular field and get the quality results and to reduce the chances of complications to the minimum and provide quality care.
 

I will be very happy to go through those and answer all your questions. We always encourage patients and their relatives to fully educate themselves regarding the process of limb lengthening; which is ultimately help full for the smooth completion of the height increase process.
 

 It takes 5.5 6.5 months for limb lengthening of 6-8 cm. It is done through the tibias (lower legs). Lengthening (distraction) stage starts in 5-7 days after the operation and lasts for 2.5-3 months. The rate of lengthening is 1 mm per day. After the lengthening stage is the fixation stage for approximately 2.5 months. This time period is for maturation of the newly formed bone. Patients are kept fully active during the whole period of treatment and they walk and do physical exercises.

 Usually it does not hurt but some people experience discomfort immediately or a few minutes later after they start turning the nuts. Others will feel nothing after turning the nut. If you are feeling extreme discomfort, please let your doctor know and he should be able to resolve pain problem.

 This much lengthening is done in two stages at two different bones. In the first stage tibias are lengthened for 6-8 cm and in the second stage femurs are lengthened for the remaining increase in height.

 We encourage our patients to walk with the help of crutches on the next day after the operation.

 A cut in the bone by using the Ilizarov ring external fixator, give us a possibility to pull the bone fragments apart (distraction maximum of 1mm to 1.5 mm/day), causing the bone in between to regenerate. Very slow distraction as in Ilizarov technique allows new bone to form between two cut ends. This way the device lengthens the bone and stimulates cells to regenerate, thus creating a new bone that is as strong as the original bone.

 The ring fixator is better for the following Safety reasons:-

- Simultaneous correction and lengthening of deformities can be achieved in more than one plan,
- Patient can be mobilized at an early stage after surgery.
- Unlike other procedures it is single surgical procedure;
- It is proven for its High- stability.
For the leg lengthening procedure the it is the best option!

At HillsClinic, we use Ilizarov technique for height increase by limb lengthening. It is a universally recognized most appropriate method for height increase because it is low invasive, it allows control of the lengthening process and prevention of complications.

This is a very valid question…..
At HillsClinic only external fixation for limb lengthening is used, because our philosophy is based on Professor's Ilizarov understanding of his concept "minimal invasive surgery, with maximum stability"
So the main reasons not to use combination approach are:
Combination of intramedullary nail insertion and external fixation is an easy and desirable approach for the doctor, but not safe for the patient. The main reason is that the Ilizarov philosophy is based on "maximum stability with minimum vessels and other tissue damage"; SO the bone have three components for healing and restoring of bone blood supply :
Peri-osteol Factor – it is an important factor – and located around the bone "peri-osteom and muscles",
Osteoal Factor – this is the bone it's self healing factor,
End-osteoal Factor - the internal or inside the bon healing factor.
SO it is when decided to do a combination of external and internal fixation, it leads to destruction of all the healing factors! So it is against the Ilizarov philosophy of treatment. It is because the intra-medullary nail well destroy the internal small vessels of the bone. For insertion of the nail the surgeon has to do complete osteotomy by saw unlike closed corticotomy as in Ilizarov technique, which leads to bone burn, and destroying the osteal (nonny) and extra osteal healing mechanism.
In the combination technique there are very high chances of infection because the external wires and pins are connected to the internal bonny canal. In Ilizarov technique if pin site infection occurs, it is managed easily while if the bonny canal gets infected the whole apparatus both the internal and external has to be taken off to get rid of the infection.
Here it is important to mention about the technique for bone cut: in Ilizarov technique semi closed corticotomy for bone cut is used. This technique is a tricky and difficult for surgeon, as he has to be trained for it. From the patient point of view a small or 0.5 cm. incision is used to access the bone for a very gentle bone cut by a low kinetic technique.

A special breaks in the bone is also done. Hinges are placed and by regular turning of "nuts and bolts", the deformity is gradually corrected. It is possible to perform limb lengthening and correction during the single procedure. This procedure is like the simple limb lengthening operation and takes almost the same time but it  uses more complicated technology.

The method of lengthening over a nail was introduced by Russian doctor, Professor Alexander Bliskonov. In my view this method of lengthening has still got some technical and medical issues; the most important of them is the infection! Although the infection rate is low, but it can becomes a real tragedy to have infected nail inside the bone! Another problem faced by surgeon is that such distractores sometimes don't have enough power to distract the limb for the wanted distance.