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The Ilizarov method for leg lengthening was used for cosmetic reasons in 54 patients with constitutional short stature. A mean lengthening of 7 cm with a low rate of complications produced an excellent or good outcome in all the patients, including improvement in psychological disturbances related to short stature. Those who undergo the procedure must be highly motivated, fully informed and understand the technique and possible complications. We suggest that the Ilizarov method for cosmetic limb lengthening is a technique without major complications. However, it requires careful follow-up, and the involvement of orthopaedic surgeons who are familiar with use of the circular frame and are experienced in limb lengthening and correction of deformity for pathological conditions.

Society places considerable value on physical beauty and presentation. These prejudices extend to short stature 1 which may cause psychological disturbance, mostly in early adolescence, 2 but also in childhood. 3 Leg lengthening by the Ilizarov method is well established for the treatment of patients with dwarfism 4 and deformities resulting from congenital anomalies, trauma, tumour or infection. 4,5

Recently, the technique has been applied to individuals with constitutional short stature 6 who wish to be taller. This new application is called cosmetic leg lengthening or symmetrical extended limb lengthening and has been compared with the more simple options of plastic surgery. 7 It is becoming more popular and is generating interest and controversy. 7 However, there are few, if any, reports on the use of the Ilizarov method to gain height for aesthetic purposes and little is known of the inherent risks and benefits.

Patients and Methods

Between 1985 and 2001, of a total of 136 individuals seeking cosmetic leg lengthening, 54 (32 men and 22 women) with constitutional short stature were selected for bilateral leg lengthening using a hybrid advanced fixator. 4,8,9

Their mean age was 25.8 years (17 to 47); 28.1 in men and 23.6 in women. Their mean pre-operative height was 153 cm (141 to 174); 159 cm in men (145 to 174) and 147 cm in women (141 to 155). Two patients had a varus deformity of the knee which also required correction during the treatment. All patients were practising non-competitive sports.

Pre-operative assessment and selection of cases.

Assessment included psychological evaluation of the patients and their families, anthropometry with particular attention to the proportions of the limbs and trunk and radiological examination for deformity and/or leg-length discrepancy.

During the first consultation the authors examined the impact of short stature on the patient’s everyday life and how they might cope with difficulties encountered during treatment. Actual and perceived problems related to short stature were also discussed. We considered a good motivation for gaining height the functional limitations of short stature, including the difficulty to drive motorcycles of larger sizes. All the patients wishing to undergo this surgery were invited to discuss treatment with at least two other patients, one undergoing treatment and one after recovery.

Those selected for lengthening were below the 5th percentile for age and gender, and had no illness, hormonal deficiency or dysmorphic syndrome. 2 In order to exclude dysmorphophobia, 10 a detailed history of all previous aesthetic interventions was included.

Patients with deformity and discrepancy were treated by simultaneous correction and lengthening.