Page 1 - Abstract

Objectives
In the last decades, limb lengthening has not been limited to the treatment of patients with dwarfism and deformities resulting from congenital anomalies, trauma, tumor and infections, but, has also been used for aesthetic reasons. Cosmetic lengthening by the Ilizarov method with circular external fixation has been applied to individuals with constitutional short stature who wish to be taller.

Materials and methods
From January 1985 to December 2010, the medical records of 63 patients with constitutional short stature (36 M, 27F; 126 legs) who underwent cosmetic bilateral leg lengthening using a hybrid advanced fixator according to the Ilizarov method, were reviewed, retrospectively. The mean age was 24.8 years, while the mean preoperative height was 152.6 cm. Paley’s criteria were used to evaluate problems, obstacles, and complications from the time of surgery until 1 year after frame’s removal. Result The mean lengthening achieved in all patients was 7.2 cm (range: 5–11 cm), with a mean duration of treatment of 9 months and 15 days (range: 7–18 months). The mean follow-up time was 6.14 years (range 1–10).

Conclusion
The cosmetic leg lengthening was helpful to all patients, improving their social capabilities and selfconfidence. All patients considered their stature as normal and they reported satisfaction and gratification with important changes in their professional and personal life. Cosmetic leg lengthening may raise some ethical objections and for that reason patients should be well informed about all the risks and complications related to this type of surgery.

Keywords
Short stature, Limb lengthening, Ilizarov hybrid circular external fixator, Cosmetic leg lengthening.

Introduction
Over the past several decades, bone lengthening has been performed not only for the treatment of dwarfism and/or skeletal deformities caused by congenital abnormalities, trauma, tumor or infections but also for aesthetic reasons [1, 2].

Cosmetic lengthening using the Ilizarov method with circular external fixation has been applied to individuals with constitutional short stature who wish to be taller. This new application is called cosmetic leg lengthening or symmetrical extended limb lengthening, and has been compared with the simplest options of plastic surgery [3, 4].

However, in the literature little is known about the use of the Ilizarov method to gain height for aesthetic/cosmetic reasons, and the correlated inherent risks and benefits of this type of surgery.

The aim of this work was to present our experience at the Ilizarov Unit of the A. Manzoni Hospital of Lecco (Italy) for cosmetic bilateral leg lengthening using an hybrid external circular frame according to the Ilizarov technique, and to present the limits of this procedure.