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[CuteIsNotWhatWeAimFor]

Hi everyone,


I'm super new here, and I'm so grateful for what I've seen on this forum. Yes, I've seen some toxicity, sure, but I've also gained knowledge that no therapist would have EVER told me (example: "You weren't actually annoying or unbearable during your formative years, you were just short!"). I could go on, but the summary is thank you. Thank you, thank you, thank you. Much love to you all. An incredible weight has been lifted off my shoulders.


Now, for background and advice:


Height: 169 cm / 5'6.5
Age:29
Race: White
Weight: 89kg/190lb (not fat, just pretty muscular build-- background in strength sports)
Goal: 177-179 cm / 5'9.7 - 5'10.5
Financial Situation: Very good career (years of toiling away compensating for height paid off! lol), so can afford absolute top tier procedures.
Timeline: Do surgery 1-1.5 years from now.
Proportions: 32 waist, 30 (maybe 31?) inseam. Wingspan seems average, fingertips hit exact mid thigh. Tibia vs femur unknown.
Procedure Considering: Dr. Pailey quad option (3 week break in between tibia and femur)

I am considering doing the quad option with Dr Pailey to go for an 8 cm minimum. I am completely fine with losing athleticism and explosiveness. However, I am nervous about going all in for Femur lengthening 8cm because I love lifting weights, and I am scared that someday an over lengthened femur might result in soft tissue blow out. To be clear, my passion for lifting weights is less about absolute power/strength and more about bodybuilding / physique. Not trying to go pro, just really enjoy looking good. It would just break my heart if I could not do something like a squat or a lunge ever again and was stuck with noodle legs.


As for my current condition, my flexibility is a bit tight. I never ever stretch, but I can still touch my toes. So I am assuming that with a year of legitimate stretch prep, I could be flexible enough for the procedure.


What are your thoughts?


Thank you so much!

[GrowGrow123]

If you’re only going for 8cm, then you should just do 8cm on femurs. Quadrilateral surgery is really for those who want to do 10-14 cm total.

Fwiw, there was one LL patient who did 11cm on femurs and got pretty huge after recovering. Looks like a pro bodybuilder. So I would assume you’ll be able to lift afterwards

[CuteIsNotWhatWeAimFor]

8 cm would be absolute bare minimum. Ideally I'd hit 10cm if I could, which is what Pailey's quad (not re-breaking) option strives for I think.

11 cm on femurs? That's nuts! I thought 8cm for femurs was the "safe" max-out?

[DanishViking]

Doing more than 8 cm is risking your long term health for minimum unnoticeable gain, which only idiotic surgeons allow and idiotic patients wants to do...

[CuteIsNotWhatWeAimFor]

DanishViking, do you mean going beyond 8cm on femur or do you mean going beyond 8 cm in total?

Because I heard that lots of people are unable to even go beyond 6cm on femur these days...

Edit: typo. "beyond cm" -> "beyond 8 cm"

[GrowGrow123]

Going beyond 8cm on just femurs is unsafe. I didn’t mention the patient who did 11cm on femurs to suggest you should do that. I bring it up just as an example of someone who did an extreme amount on femurs and is seemingly able to lift / do squats with no issue. So if you stick to the safe limit of 8, you’ll be fine.

[Omar]

for my part I hesitate between 4.5 and 7 cm. which will make me either 6'1 (an ideal height) or 6'2 a large and comfortable size for the next generation. However, the proportions and the anxiety of losing my athletic abilities push me to be 4.5 cm.

[CuteIsNotWhatWeAimFor]

I would literally sacrifice goats to the old gods to be 5'11, that is like the dream height to me lol.

[CuteIsNotWhatWeAimFor]

but yeah to me there is no difference between 6'1 and 6'2. Someone who is 6'1 is already in the tall club in my book. So i vote go 6'1.

[TheDream]

You should avoid squatting more than body weight after doing femur lengthening afaik

[Omar]

especially since it is easier and less risky. On the other hand, I wonder if stretching could make me grow over 1 year like 1cm or 2 cm (I'm not at all flexible). for example if you reach 1m71 and you are 8 cm or 9 cm that would allow you to reach 5'11. Which would avoid complications above 8cm and also in terms of proportions

[GrowGrow123]

You should avoid squatting more than body weight after doing femur lengthening afaik

This is cap. Where are you getting this misinformation from?

[GrowGrow123]

especially since it is easier and less risky. On the other hand, I wonder if stretching could make me grow over 1 year like 1cm or 2 cm (I'm not at all flexible). for example if you reach 1m71 and you are 8 cm or 9 cm that would allow you to reach 5'11. Which would avoid complications above 8cm and also in terms of proportions

No you aren’t going to grow from doing any stretching. Just not possible.

[Omar]

I think that yes, but it's not about growing but more about straightening your body as much as possible and exploiting its latent size to the maximum. Being very inflexible, I'm thinking of trying to see what happens and in 1 year I'll keep you informed.

[GrowGrow123]

Nothing wrong with stretching. It’s a good thing to do. But don’t expect to get taller from it. Your skeleton is your skeleton. The only things that would be holding you back from standing straight are things like scoliosis or lordosis.

[TheDream]

You should avoid squatting more than body weight after doing femur lengthening afaik

This is cap. Where are you getting this misinformation from?

From SirStretchAlots post a few months back:

Hi all, I just saw a sports physiotherapist and my knee pain is almost entirely fixed now.
1) Turns out that my quads were too tight, which made it pull on my knee cap. This impacted knee traction, which ultimately caused the pain when bending. Discomfort while sitting was a dead giveaway. Joints rarely causes pain when they're not being used or inflammed. Muscle tightness was obvious in hindsight. Do stretch your quads until your heel touches your glutes in a lunge.
2) I was informed that given my elongated femur, my center of gravity has shifted forward significantly during squats. This means that my knee will be stressed much more than a regular person when squatting. He recommended that I should never squat beyond my body weight (68kg~). Normal people can usually squat until 1.5x their body weight (100kg in my case) if they had normal t/f ratio.

[GrowGrow123]

Yeah that's cap. Normal people can squat far more than 1.5X their body weight with a normal Tibia to Femur ratio. That's a pretty weak squat. Any decently fit person can do 2-3X their body weight without long-term issues.

There's no doubt that squatting after elongating your femur will be more difficult. You'll need more muscle to squat as much as you did before due to having less leverage. But it's certainly not a medical limit as that PT made it seem.

Like I said earlier, there are examples of people who have lengthened their femurs by 8+ cm, who have recovered well, and are able to lift monstrous amounts still.

[CuteIsNotWhatWeAimFor]

I feel like having super artificially long femurs and repping 2-3 plate squats would just annihilate your knees. I already have to use knee sleeves for high bar / medium stance squats because of knee tension. Low bar not the case but screw low bar.

[guy_incognito]

I have a hard time believing you are not just fat at that height. I am (or rather I was) your height, and felt fat at <80kg with some decent lifts. This weight is a bad sign, during LL surgery especially. I have a problem keeping my appetite in check during recovery, thats for sure. Also weight makes everything harder when recovering. Other than that, you are good to go. As for the quad surgery, Id probably go with either femur/tibias first, and then see how I stand with my new height, so to speak. Get yourself some nice set of dumbbells at the place where you are staying. Upperbody workout does wonders for recovery.

[guy_incognito]

Also I dont know where you are from, but consider that you have few nice options available across the globe.

[reaching_goals]

I would do 4 femurs and 4 tibias if i were you that should get you at 5'9 and a half to 5'10 and with footwear you'll be an inch taller. One thing you need to consider is if you want to do more you will for sure need to stop working out your legs and lose muscle on you legs. before surgery. The more muscle you have the more tighter your muscles will be and will make the lengthening process more harder with discomfort. Especially quad lengthening. Benefit of quad lengthening though is your proportions will look great and your biomechanics wont be affected for squats and lunges as much as doing one segment.

[CuteIsNotWhatWeAimFor]

@guy_incognito: no I am definitely not fat. BF% I'm probably 18% right now. So visible abs and such, mostly just not vascular. Been lifting weights for probably 15 years, am floating between intermediate and expert in all my lifts (using strength standards). I hear you on the appetite thing though-- i have an insane appetite, and I'm either muscular or chubby, depending on whether or not I'm diligently training. Oh and I am located in NYC rn. PS how tall did you end up getting to and what procedure? And how is life now on the other side for you? I'm trying to really analyze how worth it this all is since it's an insane commitment.


@reaching_goals: Okay I see. This is good to know. Thank you. I didn't know that having more muscle was such a bad thing.

[Jayyy23]

I'm around ur height but only 60kg , I also plan on doing LL in 2 years from now

[GrowGrow123]

@guy_incognito: no I am definitely not fat. BF% I'm probably 18% right now. So visible abs and such, mostly just not vascular. Been lifting weights for probably 15 years, am floating between intermediate and expert in all my lifts (using strength standards). I hear you on the appetite thing though-- i have an insane appetite, and I'm either muscular or chubby, depending on whether or not I'm diligently training. Oh and I am located in NYC rn. PS how tall did you end up getting to and what procedure? And how is life now on the other side for you? I'm trying to really analyze how worth it this all is since it's an insane commitment.


@reaching_goals: Okay I see. This is good to know. Thank you. I didn't know that having more muscle was such a bad thing.

Doing 4 cm on femurs and and 4 cm on tibias is silly. Don't do that. Just do 8cm on femurs. Femurs heal quickly and recover well. Tibias are much more likely to result in complications, heal slowly, and will impact your athleticism more. Not to mention doubling the amount of surgeries (4 instead of 2). Quad is really for patients who want to do like 10cm+.

Having more muscle makes the process more painful, but it's by no means a "bad" thing. You're going to lose a bunch of leg muscle anyways as part of the process. I was literally doing 350+ lb squats the week leading up to my surgery lol. My first two weeks post-surgery were hell pain-wise, but fine afterwards.

And yeah if you can get your weight down that's ideal. Although depending on when you do the surgery, the new Precice Max nails that support up to 250 pounds will be released and your weight won't matter quite as much.

[guy_incognito]

I dont know how far are you into medical help, but I make it easier for myself with ozempic. Also, Ive heard that in the US have astronomical prices for LL. I dont know if you are willing to travel, but any good doctor with a precice device will do. Plenty of those in europe for 30K-100K USD. Its the crazy people that go to turkey to get butchered with externals. But than again, whatever suits you.

As for the commitment, I wouldnt say its that bad. Im 2.5 months post surgery, Im almost done with the distraction phase. I've gained 4.3cm on my tibias. Its easier then it sounds, my doc says I might be able to walk in less than 2 months. Right now Im able to walk with crutches, doing short walks (up to a kilometre). I am able to work remotely and lift. Its not that bad.

[CuteIsNotWhatWeAimFor]

@guy_incognito: I've heard that doing internals on tibia is tricky and that external on tibia is safer. What are your thoughts on the matter?

[Body Builder]

@guy_incognito: I've heard that doing internals on tibia is tricky and that external on tibia is safer. What are your thoughts on the matter?

As a former veteral LLer I can assure you that this is true. External tibias, if you are ok with some bulky fixators for about 9-10 monthhs (for 6cm) is the best way for tibias, the safest, the less painful and the cheapest.

And for 8cm either do femurs only or if you get both segments go for at least 12cm (6.5 femurs, 5.5 tibias) which is the absolute minimum gain that makes it worth for me. 2 segments for 8cm only is a joke.

[CuteIsNotWhatWeAimFor]

what do you think about for 10cm? Really I just want to hit 5'10, where under zero circumstances in the US would I be considered short.

I would only accept 8cm if there were complications, and I've heard that some people who do femur only cannot hit 8cm due to complications.

If after all of this stuff I couldn't even reach 177cm, I would be absolutely devastated. This is why I was thinking quad, so that in worst case scenario (soft tissue / body acceptance wise), I still hit 8cm min. 8cm is like best case scenario for femur only, no?

[GrowGrow123]

Not saying it doesn’t happen ever, but it is uncommon for someone to not be able to hit 8cm on femurs due to doctor stoppage with Precice.

[markr09]

what do you think about for 10cm? Really I just want to hit 5'10, where under zero circumstances in the US would I be considered short.

I would only accept 8cm if there were complications, and I've heard that some people who do femur only cannot hit 8cm due to complications.

If after all of this stuff I couldn't even reach 177cm, I would be absolutely devastated. This is why I was thinking quad, so that in worst case scenario (soft tissue / body acceptance wise), I still hit 8cm min. 8cm is like best case scenario for femur only, no?

8cm is the safest max limit for most doctos(other doctors go above 8cm to even 10cm+ but just go with less). There are various reasons why people stop though at around 5cm to 6cm most of the time, usually it's only down to pain, proportions, and plausible long-term adverse effects. While 8cm is still "relatively safe", it's no secret that the less lengthening, the less possible complications in the future or ill-effects that can happen like early onset arthritis. Which is why 5 to 6 is usually the stopping point, because less than that will feel like the cost to the operation and stress isn't worth it below 5cm, basically it's the "sweet spot". That's not to say there aren't people who do less than 5cm, but usually those people are the ones who couldn't tolerate going past 4cm, fwiw though you still gained height so that's a win even if you didn't meet that goal.

Quad can be a mixed-bag there and usually isn't worth less than 4cm for femurs. I'd say You either go 5cm on femurs and tibia or 6cm on femurs and 4cm on tibia for a total minimum of 10cm. Ignoring costs, 4+4cm isn't worth the effort and pain you'll go through quad lengthening and it's a lot more dangerous even if you are able to lengthen as slow as you can(without early union) for soft tissue to catch up, as well as consolidation will take longer than just bilateral lengthening because you're effectively disabled from the waist down, so it'll be a lot harder to do physical therapy. If you really are set on the 4+4 or even 10cm, just go with two separate bilateral lengthening. Even if you went under two surgeries, it'll still be separate and will be safer. You can do femurs first and after 1 year or more to post-consolidation, tibias next. It's also good to just start with bilateral lengthening to see if you are able to tolerate the pain and do physical therapy without much of a problem, and if you are still not satisfied with your post-op height, atleast after that you'll be able to decide if you still want to do tibial lengthening or not. This is one of my personal plans as well, to do two bilateral lengthenings if I'm not satisfied with femur lengthening alone.

[sxxa]

 I would advice you just go with precice and 7cm max on femurs. Why? It's quite the best amount of cm minimazing almost entirely the risks.