Friday, March 29

There are people having surgery to be taller: what is behind “leg lengthening” surgery


“If I can be … I’m going to be taller.” The man who speaks to the camera of a viral Inside Edition video He has no doubts about such a statement. Surgery is on his side, and he has more than 100 years of experience. Yes, lengthen a person’s limbs so that they can measure a few inches more than his wife. Behind this apparent frivolity there is the whole development of a series of medical techniques that have helped thousands of people throughout recent history. How does limb lengthening work and what dangers does it entail?

Getting taller with surgery: how it works

Ryan, which is the name of the protagonist of the video we mentioned, is not exactly short: 1.70 cm. However, he makes his wish clear in every frame of the interview. He has always wanted to be taller than his wife, who seems to agree very much. So there the two of them go to a fancy Las Vegas clinic for an expensive “limb lengthening” operation. This treatment is not unique to the United States.

A quick internet search will show us cosmetic limb lengthening ads in UK, Germany, India… although it seems especially popular in America. This technique costs several tens of thousands of dollars and is based on an intrinsic property of our body: osteogenesis.

Osteogenesis is the process through which the bone tissue formation, as the name suggests. For much of our lives, bone is naturally resorbed and restructured. It is the basis of our growth. A series of cells specially designed for this are responsible for dissolving part of the bone while others are placed in the gaps surrounding themselves with a cartilaginous matrix that will calcify (killing the cell inside). They also participate in bone regeneration when we break a bone.

This same foundation is used by all modern bone lengthening techniques. Basically, it is practiced a surgical tear in the limb to be lengthened. By means of a device, and there is a wide variety of them, the separation of the bone is forced, very little by little. The process of osteogenesis soon begins to “fill in” the small gap. Slowly, the length of the bones grows and, with it, the members.

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Ryan’s case is by no means the first. There is currently a whole clinical industry, with hundreds or thousands of patients per year, focused on this procedure. Not all of them are frivolous or purely aesthetic. The vast majority are aimed at improving the life of the patient or correcting deformities in the limbs. However, if there is enough money in your account, you can always earn a few inches. But is it really worth it? Before answering this question, let’s learn a little more about the state of the art.

A little history of limb lengthening

So and how they collect the pediatric hospital Scottish Rite from Dallas, Texas, the history of limb, leg and arm lengthening is a long one. The three techniques currently in use have been developed in the last 100 years. Each and every one of them is based on osteogenic distraction, an orthopedic technique used in other parts of the body, especially the skull, to correct bone problems.

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As we have explained, it consists of surgically cutting the bone and providing a force that deforms (or rather returns to the desired shape) the bone, little by little. In limb lengthening, the first to use it successfully clinically, considered the father of modern lengthening, is Alessandro Codivilla. Codivilla, in 1905, placed a nail at the end of the heel, cut the leg bone and, using a screwLittle by little, he was pulling the limb, forcing it to grow.

From this idea, his student, Vittorio Putti at first and Drs Leroy Abbott and John Saunders later, developed their own evolutions, all with screws to force elongation. Various doctors were “improving” the technology, which continued to look more like a horror movie, until they reached Gavriil A. Ilizarov. With a hat more like that of a chef and a device worthy of a terminator In the 1920s, Ilizarov saw the second revolution in limb lengthening. The Ilizarov method helped thousands of people correct all kinds of deformations. But we have not yet reached the most modern of the matter.

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All the above techniques are based on “external fixation”, that is to say, screwing the bone and causing the extension by means of a device, usually bulky, from the outside. However, Ryan, the protagonist of the video that heads this article, does not have a single iron on the outside. The latest and most innovative technique, attributed to a certain Bliskunov, from whom it takes its name, was developed in 1983 and consists of nothing less than introducing the happy screw into the bone marrow, with two nails holding the two parts of the bone.

After making the bone incision, it is only necessary to increase the turns of the inner screw, something that is done with a magnetic device. This technique greatly reduces the stress generated in the external tissues, invasion of nervous tissue and the probability of infection, which has crowned it as one of the most popular today. However, it is not a panacea. Wherever there are great benefits, even if they are counted in a few centimeters, there are also great risks.

Cut and screw the bone, what could go wrong?

Let us emphasize the fact that limb lengthening was developed to help people with different pathologies: uneven limbs, abnormal growths, developmental problems and other similar diseases. In 1905, the Ryans of the world did not consider that Dr. Codivilla would drive them through the heel with an endless screw. Currently, however, safety and technology have advanced so that many people consider it aesthetically, as we see.

But, in either case, lengthening a limb can have unpleasant consequences, when not dangerous. The osteogenesis process does not only affect the bone. The muscle, connective tissue, and nerves around it have to adapt to forced growth. If this does not happen properly, the partial or total mobility of the limb may be lost.

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In the worst case, the nerve may not develop properly, causing necrosis and loss of tissue or the nerve itself. If the muscle does not adapt properly, we will have a limb that does not work well and can cause other problems in the body. Thus, rehabilitation is crucial in the process. Monitoring of tissues, from bone to skin, is essential. You cannot go too fast or too slow in lengthening.

As if all were not enough, and although it is rare, the body could reject the prosthesis and cause a severe infection with all kinds of consequences. According one of the latest revisions carried out by the Benha University Hospital in Cairo, the scientific literature indicates that almost 100% of limb lengthening operations involve some type of complication. Is it worth it, in this case, to give yourself to this type of treatment? Well, as usual, it depends.

Time for telesurgery: How to operate on someone thousands of miles away?

If the goal is to solve a problem, as is often the case in medicine, the remedy is probably better than the disease. And in the aesthetic case? Well it also depends. You never know what the complication might be what a patient will face and if this will be worse than the reasons why he decides to start scratching a few more inches in his day to day life.



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