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[theuprising]

no i typed that wrong as i said, that wasn't the doctor i think that was a patient that said that, mitkovic never said 6cm was maximum at all, only 1 LL doctor on this forum has a 6cm maximum limit.

Dr Rainer Baumgart :
-In normal proportioned people lengthening of more than 5cm (2 inches) only at the femur or at the tibia creates disproportions, which is not advantageous.  If you want to get more than 5cm (2 inches), it is normally necessary to lengthen femur and tibia simultaneously. With this procedure you can reach 10-15cm (4-6 inches) or even more, but in most cases the relationship to the frame becomes disadvantageous if you lengthen more than about 10cm (4 inches).

Dr Alex Monegal:
-I recommend to use intramedullar devices. We can lengthen up to 8cm in fémur and 6 in tibia. It depends on your current height and the tibio-femoral proportion What i might advice you to lengthen.

Dr Mangal Parihar: 
- Max 6 cms. daily rate 0.75 to 1 mm, depending on pain and muscle tightness.

Dr Janet Conway : 
- The total recommended lengthening is 2 inches (5 cm) in the thigh bone (femur). Lengthening more than 2 inches in one bone is associated with higher complication rates. If desired, another entirely separate lengthening procedure can be performed one year later in the shin bones (tibiae) to gain an additional 2 inches (5 cm) of height.

Dr Franz Birkholtz:
-Functional recovery is multifactorial but we expect high levels of recovery in lengthenings between 5 and 10 cm.  Cosmetically 10cm still keeps people in proportion.  I would aim for 5-6 cm on femur and 4-5 cm on tibia.  Arthritis is probably due to malalignment, but also increased joint pressures.  This seems to be related to the extent of the lengthening as well.

Dr Donghoon Lee: 
- To minimize various complications resulting from limb lengthening, it is recommended that lengthening is performed under 20% of the original bone length, and by an experienced surgeon.  Since the femur is longer than the tibia, generally speaking it is possible to lengthen more when lengthening the femur. However, since the muscles surrounding the femur are very strong, too much lengthening could lead to joint contracture in the hip joint or knee joint, so caution must be taken. According to  Park's report (Park HW et al, JBJS,2008 ) , 25% of the people who lengthen the tibia(6cm in average) was found to have some difficulties in persuing vigorous activity  If both Tibia and Femur are lengthened sequentially, the maximum to be 10cm in total. But, one more important thing is to consider body ratio. So, I recommend to decide the target considering the safety, recovery of sports activity and body ratio.


There is a difference between a doctors recommended amount and the max they will allow. It is not their body and as long as you can perform daily activities it is not their concern your athletic ability has declined or you look weird for example. See Dr Betz for allowing patients to lengthen to the point where they can no longer run.

This surgery is all about trade offs. Guys with taller starting heights have the luxury of being concerned about bio mechanics and proportions which shorter guys don't.

[microman]

technically my statement holds true, only one doctor there has a true 6cm limit, at least for external tibia, those other doctors arn't saying anything about a 6cm limit at all, just suggesting if oyu want more than 5cm you do both legs. but 99% of people just do 1 LL of 6-8cm on one leg and call it a day, any doctor will tell you that is twice as safe as doing 2xLL 5cm per segment, as the trauma to your body is way worse your breaking bones twice.


Growing 5-7 cm is considered physiological and usually doesn't cause any complications. - barinov

Dr. Peng always recommends 6-8 cm lengthening.

Yes, our price included accommodation for 4 months with full boarding, this is sufficient for most of the patients who go for 7-8 cm lengthening. – dr. xia 

Cosmetic lengthening of the tibias is recommended a maximum of 7.5 cm with external fixation, LON, or LATP. - Dr Suhas Shah

8cm is pretty safe in our hand. - Dr Xia

The height that you may get will be about 5 - 8 centimeters depending on your anatomical structure. - Dr Porn-A-Nake

the recommended maximal lengthening is 5-7.5cm or 2-3 inches. – dr mitkovic

What maximum amount of lengthening do you recommend per segment, regarding patient safety?
8 cm, - dr. salemeh

[theuprising]

I understand where you are coming from microman as you were very short before and still ended up below average after LL so of course you would do the max.That is what I wrote in my last post about the difference between shorter and taller guys doing LL. I highly doubt athleticism and proportions were of concern to you and I wish you the best in recovery. 

This following post is from walk6 diary on old forum. I have not read many doctors discuss years later follow up with patients so it may be interesting to some.

"I personally asked Dr. Lee what he thought about this (lengthening past 6 cm) and he has told me that from his experience in talking to former lengthening patients (2-3 years post recovery) those that only lengthened 5 cm recovered fully and their previous athleticism returned close to 100% to pre-LL levels. On the other hand, those who chose to lengthen between 6 and 7 centimeters recovered 100% in performing daily functions (walking, light jogging, etc), BUT only recovered about 60-70% of their pre-LL athleticism when engaging in serious sports/strenuous activities (full sprinting, jumping, basketball, rugby,etc..). Additionally, those that lengthened beyond 7 cm saw an ever greater decline in their previous athletic abilities.

In short, those who lengthen beyond 5 cm will not be able to recover all of their pre-LL athletic abilities because their muscles, nerves, tendons will be stretched well beyond their natural limits and will be permanently damaged. He used the rubber band analogy and Dr. Lee believes strongly in this. Once a rubber band (muscle) is stretched beyond its natural limit, even if its by only half a centimeter, then it will begin to tear and will forever lose its previous elasticity. The muscle's natural limit seems to be at 5 cm for many patients, though it can be higher or lower depending on the patient's initial tibia/femur length."


It should also be noted that at least one of those doctors you listed allowed a patient to lengthen 16cm on tibia. Once again it's not their body.

[ShortandStubborn]

  about 60-70% of their pre-LL athleticism when engaging in serious sports/strenuous activities (full sprinting, jumping, basketball, rugby,etc..).

When you say 60-70% pree-LL athleticism, you are referring to strength or endurance?
Say I run at 10 Miles for an hour. Now after lengthening between 6 and 7 CM, would I be still able to run at 10 Miles for 36 to 42 MINS or I'd be running at 6 to 7 Miles for an hour?

[Penguinn]

Dr Mangal Parihar: 
- Max 6 cms. daily rate 0.75 to 1 mm, depending on pain and muscle tightness.

For Precice 2, Dr. Parihar has told me 6cm will definitely be lengthened, and after that we'll see depending on the recovery. We can go to 8. But he greatly favours function over length.

[theuprising]

For Precice 2, Dr. Parihar has told me 6cm will definitely be lengthened, and after that we'll see depending on the recovery. We can go to 8. But he greatly favours function over length.

I believe you are lengthening femur, 6cm was his tibia max. Hope your prep for surgery is going well.

[microman]

lol 16cm , you mean salemeh? yeah i think maybe he rebroke the bone, so its like 8cmx2, i read yellowspikes diary and i think he mentioned guichet did something similar, that is a different thing to doing one segment, as you are doing it twice.

anyway athletic ability is a non issue unless you are a profesional athlete, medium drink of water did 7.5cm and he says ability is 85% and only notices it when running, i think it affects his endurance rather than speed, im pretty sure if he had a choice of 95% athletic ability and 5cm LL or 7.5cm with 85% he would take the latter each time.

so athletic ability is of no concern for the majority of patients, you simply just don't lose enough to care, doctors say different things about cosmetic LL, many will say things just so they don't have to work on minor complications that might arise so they may say some blanket statemet like that to ensure you don't go above 6cm, but fact is for normal everyday tasks you wont be worse off 7cm vs 5cm.

proportions are not an issue as well even with 7cm, only 10cm+ may your arms appear too short depending on wingspan.

[Penguinn]

I believe you are lengthening femur, 6cm was his tibia max. Hope your prep for surgery is going well.

Yup, I meant femur.
Thank you, I haven't done anything special besides regular work outs.

[Medium Drink Of Water]

When you say 60-70% pree-LL athleticism, you are referring to strength or endurance?
Say I run at 10 Miles for an hour. Now after lengthening between 6 and 7 CM, would I be still able to run at 10 Miles for 36 to 42 MINS or I'd be running at 6 to 7 Miles for an hour?

I didn't notice much of a change in my speed.  There's a need to take breaks sooner and more frequently because the muscles get tired more easily.

[Uppland]

"I personally asked Dr. Lee what he thought about this (lengthening past 6 cm) and he has told me that from his experience in talking to former lengthening patients (2-3 years post recovery) those that only lengthened 5 cm recovered fully and their previous athleticism returned close to 100% to pre-LL levels. On the other hand, those who chose to lengthen between 6 and 7 centimeters recovered 100% in performing daily functions (walking, light jogging, etc), BUT only recovered about 60-70% of their pre-LL athleticism when engaging in serious sports/strenuous activities (full sprinting, jumping, basketball, rugby,etc..). Additionally, those that lengthened beyond 7 cm saw an ever greater decline in their previous athletic abilities.

What more is there to say? Yes, some patients experience a very successful recovery even though they exceeded 5 cm but 2 inches is still the most common and conservative rule of thumb. Obviously safety is the major concern when engaging an invasive surgery such as this, I say aim for 4-5 cm and if things are going well you can proceed with caution.

[Taller]

What Dr. Lee said is regarding tibia lengthening. For femurs, the limit for recovering nearly all athletic ability with hard work seems to be 6.5-8CM depending on the patient. OBG had a very severe skiing accident that damaged his knee badly before he underwent femoral LL so that impacted his recovery and he even said so.