SIMULTANEOUS BILATERAL LEG LENGTHENING FOR AESTHETIC PURPOSES

Abstract

Purpose: Surgery offers a remarkable means for modifying the physical appearance of people desiring more acceptable conformity with aesthetic standards. Height is a qualifying element for each individual. Society sometimes views persons with a short stature as different. Leg lengthening surgery to improve one’s appearance has thus become a common request. We report our experience to demonstrate that the objective is both possible to achieve and useful.

Material and methods: From 1985 to 2000, we operated 54 patients (32 men and 22 women). Mean follow-up was five years three months (16 years – 1 year). For these patients, we found a valid justification for the request for increased height, while surgery was declined for 82 other patients. Mean age at surgery was 5.8 years (range 18–47) (28.1 years for men and 23.6 years for women). Mean height was 153 cm (159 for men and 147 for women). Patients were given psychological support. We performed simultaneous bilateral leg lengthening because of the better tolerance compared with the femur. The standard device had three rings and a proximal semi-ring. A two-level lengthening system was used, requiring double osteotomy, a proximal tibial metaphyseal osteotomy and a distal metaphyseal osteotomy. Seven days after trepan osteotomy and twelve days after Gigli saw osteotomy, we initiated the lengthening procedure with 1/4 turn (1/4 mm) three times a day. Achilles tendon lengthening was associated for 19 patients. For three patients (4 limbs) the regenerated bone collapsed requiring insertion of a new device.

Results: Mean lengthening was 7 cm (11- 5 cm). Mean duration of treatment was eight months ten days. Aesthetic outcome was considered excellent by 92% of patients and good by 8%.

Discussion: The patient’s desire for greater height must be well motivated and associated with good knowledge of possible risks (detailed informed consent). Using the circular device for leg lengthening allows correction of associated moderate alignment anomalies.

Conclusion: If the patient has a valid psychological justification and an objective height below the mean of the local population, leg lengthening procedures can be performed for aesthetic purposes with reasonable risk and satisfactory results.