Tacoma94 good on you for putting deep thought into this, you are thinking through CLL in a rational manner. Everyone should reflect deeply into why they are doing CLL and do the proper research and be informed of the risks and costs of this surgery before stepping forward. CLL should be the last resort to addressing height neurosis.
I successfully did 8 CM Stryde femurs with Paley. Having said that, I would only recommend CLL if height neurosis is consuming ones life and one cannot resolve height neurosis through other, less risky means.
CLL is by far the most risky, costly (both time and money), and difficult cosmetic surgery that exists today. It will test you both physically and mentally in ways you could never imagine.
Cases of fat embolism and pulmonary embolism are rare but have happened. Even with Paley. There has been one death that I'm aware of relating to pulmonary embo with Dr. Guichet. Having said that the risk of FE or PE is low with the proper preventative and detective measures, but still exists.
Lengthening your bones and soft tissues will forever change your biomechanics and functionality. At your desired length of 4 cm to a much lesser extent but still a factor to consider. I had a text book successful surgery, maxed out the rod at 8 CM, and am recovering well but many of my LL friends have not had the same fortune - some had to quit early before reaching their goal due to tightness, some had pre consolidation, some had prolonged nerve pain complications.
The sacrifices and opportunity costs are real. You will have to take a break from your career/school to dedicate yourself to this procedure. Some have worked through it but I guarantee they weren't 100%. I had to take a leave of absence from work. Moreso than the financial cost of not having an income while going through this, is the opportunity cost. The same applies to our personal lives. This process will put a strain on any relationship you have and if you are married or have a girlfriend....will be difficult for that person as well. I started to unexpectedly date a co worker before LL, and I had to end that to move forward with LL. This procedure requires you to dedicate yourself to it and put everything else aside.
Having said all that, for me it came down to performing a deep dive risk assessment and weighing the pros and cons.
My height neurosis was deep and had taken over my life. It put a real constraint on living out my purpose as a man, as a friend, as a family member, as a lover, and I needed to address it. I became addicted to shoe lifts and never went out without them. I was living a lie every day I put those on and felt depressed every time I took off my shoes. I declined one of my best friends weddings because it was on a beach w/ a barefoot dress code and I couldn't wear my shoe lifts. My life was no longer logical or rational. Height neurosis had taken a hold of my life and I was determined to change that.
In my case, the pros outweighed the cons and I'm very much happy with the outcome. The benefits of the freedom of height neurosis were in my opinion, greater than the risks and costs of doing this surgery.
I had a textbook successful surgery, maxed out the nail at 8 CM, and am recovering nicely in consolidation. I'm truly blessed and thankful....but still, I would not recommend this surgery until you have done a deep analysis of the risks and sacrifices you will have to make for this surgery. CLL should really be the last resort to addressing your height neurosis. Before moving forward with CLL, I literally drew out a venn diagram of the pros, cons, and risks of doing this. I had a few sessions with a therapist to see if I could address my height heurosis issue through therapy. I tried meditation. I tried different hobbies and lifestyle adjustments. Only until going through this process was I able to make a truly informed decision around doing CLL. This was all in all a 2 year process of me assessing whether this was the right decision before deciding to move forward.
Listen, it's a calculated risk, the risk is still there, pulmonary embo, fat embo, long term complications, you can do preventative and detective work to stack the odds in your favor, but a lot of it is out of your control and you have to leave some of it to fate. It was worth it in the end for me, but that is after some very deep deep reflection into myself and my height neurosis. Good luck my friend!