Frequently Asked Questions About Limb Lengthening Surgery

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This comprehensive limb lengthening FAQ answers the most common questions about cosmetic height surgery, femur and tibia lengthening, LON, PRECICE 2.2, FITBONE, quadrilateral lengthening, recovery, walking, physiotherapy, risks, costs and treatment in Turkey.

Lengthening Turkey Height Solutions provides cosmetic limb lengthening treatment in Istanbul for international patients. The information below is designed to help patients understand the complete process before deciding whether surgery may be appropriate for them.

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Limb Lengthening Basics

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What is limb lengthening surgery?

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Limb lengthening surgery is an orthopedic procedure that gradually increases the length of a bone by creating new bone between two surgically separated bone segments.

During surgery, the bone is carefully divided through an osteotomy. After an initial recovery period, the two bone segments are gradually moved apart using a specialized lengthening system.

The body responds by producing new bone in the gap. This biological process is called distraction osteogenesis.

For cosmetic height increase, the procedure is normally performed on both femurs, both tibias, or on both segments as part of quadrilateral limb lengthening.

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How does limb lengthening make a person taller?

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Limb lengthening increases height by physically increasing the length of the femur, tibia or both.

The bones are not stretched. Instead, they are surgically divided and gradually separated.

As the distance between the bone segments increases, the body forms new bone in the gap.

The surrounding muscles, nerves, blood vessels, tendons and other soft tissues must also gradually adapt to the increased length.

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What is distraction osteogenesis?

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Distraction osteogenesis is the biological process in which new bone forms between two bone segments that are gradually separated.

It has been used in orthopedic surgery for decades to treat limb-length discrepancies, deformities and bone defects.

Modern cosmetic limb lengthening uses the same biological principle to permanently increase height.

The process has three main stages:

• Surgery and initial recovery

• Distraction or active lengthening

• Consolidation and bone strengthening

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What is an osteotomy?

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An osteotomy is a controlled surgical cut made in the bone.

In limb lengthening surgery, the surgeon creates an osteotomy so that the two bone segments can gradually be separated during the distraction phase.

The objective is to create the conditions for controlled new bone formation while maintaining proper alignment.

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Is limb lengthening permanent?

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Yes. Once the newly formed bone has fully consolidated and healed, the increase in bone length is permanent.

The bone does not normally shorten again after successful healing.

The internal implants may later be removed, but removing the nail does not reverse the height gained through the procedure.

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Can adults become taller after their growth plates have closed?

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Natural bone growth generally stops after the growth plates close, but adults can permanently increase their height through surgical limb lengthening.

Exercise, stretching or supplements cannot reopen closed growth plates.

Limb lengthening works differently because it surgically creates a new area where bone can regenerate during controlled distraction.

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Can stretching, exercise or supplements increase adult height?

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Stretching, exercise and supplements cannot permanently lengthen the leg bones of an adult whose growth plates have closed.

Improved posture may make someone appear slightly taller, but it does not increase the actual length of the femur or tibia.

Permanent adult skeletal height increase requires bone lengthening.

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Which bones are lengthened for cosmetic height surgery?

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The two main bones used for cosmetic height lengthening are the femur and the tibia.

The femur is the thigh bone.

The tibia is the main weight-bearing bone of the lower leg.

In tibial lengthening, the fibula must also be managed appropriately because it runs alongside the tibia.

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Can both legs be lengthened at the same time?

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Yes. Cosmetic stature lengthening normally involves both legs so that the patient remains symmetrical.

For example, bilateral femur lengthening means both femurs are treated.

The same principle applies to bilateral tibial lengthening.

Regular X-rays are used to monitor the amount of lengthening and alignment on both sides.

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Is cosmetic limb lengthening the same as treating a leg-length discrepancy?

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The biological principle is similar, but cosmetic stature lengthening and medical correction of a leg-length discrepancy have different treatment goals.

Medical limb reconstruction may correct a difference between two legs, deformity or previous injury.

Cosmetic stature lengthening generally involves increasing the length of both legs symmetrically to increase overall height.

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Height Gain and Lengthening Limits

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How much taller can I become with limb lengthening surgery?

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At Lengthening Turkey, our usual planning limits are up to 8 cm from femur lengthening and up to 6 cm from tibia lengthening.

Patients who are suitable for quadrilateral femur + tibia lengthening may aim for approximately 12–14 cm in total.

These are planning limits rather than guaranteed outcomes.

The appropriate amount may be lower depending on:

• Muscle flexibility

• Joint mobility

• Bone formation

• Nerve tolerance

• Body proportions

• Pain and soft-tissue response

• Overall recovery

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Can I gain 5 cm with limb lengthening surgery?

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Yes. A 5 cm height increase is within the usual planning range for either femur or tibia lengthening in an appropriate patient.

The choice between femur and tibia should not be based only on the number of centimeters desired.

Body proportions, alignment, anatomy and lifestyle should also be considered.

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Can I gain 8 cm with limb lengthening surgery?

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Up to 8 cm may be planned for femur lengthening in suitable patients.

Eight centimeters is toward the upper end of our standard femur planning range.

The surgeon may recommend stopping earlier if flexibility, nerves, joints or bone formation indicate that continuing would create unnecessary risk.

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Can the tibia be lengthened by 8 cm?

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Our usual maximum planning limit for the tibia is 6 cm, not 8 cm.

The muscles, nerves and ankle structures of the lower leg must adapt during tibial lengthening.

For patients seeking a larger total height gain, combining femur and tibia lengthening is generally a more balanced strategy than aggressively lengthening the tibia alone.

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Can I lengthen my tibias by 10 cm?

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We do not recommend or plan 10 cm of cosmetic tibial lengthening.

Our standard upper planning limit is approximately 6 cm for the tibia.

Trying to obtain extreme length from a single segment can increase stress on muscles, nerves and joints.

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Can I lengthen my femurs by 10 cm?

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Our standard femur planning limit is up to approximately 8 cm rather than 10 cm.

Patients seeking 10 cm or more of total height increase should generally be evaluated for a combined femur + tibia strategy rather than pushing a single bone beyond the recommended range.

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How can I gain 10 cm in height?

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Patients seeking approximately 10 cm of height increase usually require a combination of femur and tibia lengthening.

For example, the total increase can be distributed between the two segments rather than attempting extreme lengthening of one bone.

The exact distribution should be based on proportions, flexibility and orthopedic evaluation.

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Can I gain 12 cm with limb lengthening?

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Approximately 12 cm may be achievable through quadrilateral femur + tibia lengthening in an appropriately selected patient.

This is a significantly more demanding treatment than single-segment lengthening.

It requires more extensive rehabilitation and careful monitoring.

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Can I gain 14 cm with limb lengthening?

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Approximately 14 cm represents the upper end of our usual quadrilateral planning range.

This would involve lengthening both the femurs and tibias.

Not every patient is suitable for 14 cm, and the final amount should depend on safety rather than reaching a predetermined number.

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Can I gain 16 or 18 cm?

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We do not recommend cosmetic lengthening beyond approximately 12–14 cm as part of our standard treatment philosophy.

More centimeters do not automatically mean a better result.

Alignment, joint function, nerve tolerance, muscle flexibility and long-term mobility must take priority.

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Is the maximum number of centimeters guaranteed?

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No. No responsible limb lengthening center should guarantee that every patient will safely reach the maximum planned amount.

Your surgeon may slow, pause or stop lengthening if your body indicates that continuing would be inappropriate.

The treatment should adapt to the patient rather than forcing the patient to reach a number.

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Can I decide exactly how many centimeters I want before surgery?

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You can discuss a target before surgery, but the final achievable amount depends on how your body responds during treatment.

Your initial goal helps determine the surgical plan.

However, X-rays, flexibility, joint movement, nerve symptoms and bone formation remain more important than the original target.

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Femur vs Tibia Lengthening

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Is femur or tibia lengthening better?

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Neither femur nor tibia lengthening is automatically better for every patient.

Femur lengthening generally allows a larger planned increase at our clinic, with up to approximately 8 cm.

Tibial lengthening is generally planned up to approximately 6 cm.

The better option depends on:

• Body proportions

• Current femur-to-tibia ratio

• Height goal

• Joint flexibility

• Previous surgery

• Bone alignment

• Lifestyle

• Surgeon assessment

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Which gives more height: femur or tibia lengthening?

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Femur lengthening generally allows a greater single-segment height increase in our treatment protocol.

Our usual planning limits are:

Femur: up to 8 cm

Tibia: up to 6 cm

These limits are intended to balance height gain with soft-tissue and orthopedic considerations.

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Will femur lengthening make my legs look disproportionate?

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Not necessarily. Body proportion depends on your anatomy before surgery and the amount lengthened.

Some patients naturally have relatively short femurs, while others have relatively short tibias.

We therefore evaluate full-leg proportions rather than assuming one method will look better for everyone.

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Will tibia lengthening make my legs look disproportionate?

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Tibial lengthening can change the femur-to-tibia ratio, so proportions should be evaluated before surgery.

Full-length standing X-rays and physical measurements help determine whether femur, tibia or combined lengthening is more appropriate.

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What happens to the fibula during tibia lengthening?

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Because the fibula runs alongside the tibia, it must be surgically managed during tibial lengthening so that the lower leg can lengthen correctly.

Your surgeon will explain the specific surgical technique and fixation plan before surgery.

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Limb Lengthening Methods

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Which limb lengthening methods do you offer?

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Lengthening Turkey currently offers LON, PRECICE 2.2, FITBONE and quadrilateral combinations of these methods.

The main options are:

• LON

• PRECICE 2.2

• FITBONE

• PRECICE + PRECICE

• PRECICE + LON

• FITBONE + FITBONE

• FITBONE + LON

The most appropriate method depends on your medical assessment, anatomy, preferences and budget.

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What is the LON method?

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LON, or Lengthening Over Nail, combines an internal intramedullary nail with a temporary external fixator.

The external system is used to gradually lengthen the bone.

The internal nail helps provide stability and remains after the external fixator is removed.

LON is generally the most economical method we offer, but it involves external hardware and pin-site care.

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How does LON work?

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During LON surgery, an intramedullary nail is placed inside the bone and an external fixator is attached to the leg.

After the latency period, the external fixator is adjusted according to the prescribed schedule.

As the bone segments gradually separate, new bone develops between them.

After the planned distraction is completed and the medical team confirms appropriate progress, the external fixator can be removed.

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What is PRECICE 2.2?

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PRECICE 2.2 is a fully internal magnetic limb-lengthening nail.

The nail is implanted inside the femur or tibia.

An external magnetic remote controller activates the mechanism inside the nail and gradually extends it.

Because the system is internal, there is no external fixation frame during distraction.

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How does PRECICE lengthening work?

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PRECICE uses magnetic interaction between an external controller and the internal nail to gradually extend the implant.

The patient uses the controller according to the schedule prescribed by the medical team.

The amount and frequency of lengthening should never be changed independently by the patient.

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What is FITBONE?

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FITBONE is a fully implantable motorized intramedullary limb-lengthening system.

The system includes an internal lengthening nail and a receiver positioned under the skin.

An external control set supplies energy to activate the implant and gradually lengthen the bone.

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How does FITBONE work?

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FITBONE uses an internally implanted motorized nail that is operated through an external control system and a subcutaneous receiver.

Like PRECICE, FITBONE does not require an external fixation frame during the distraction phase.

The patient is taught how to use the system according to the prescribed schedule.

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What is the main difference between PRECICE and FITBONE?

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Both PRECICE and FITBONE are fully internal limb-lengthening systems, but they use different mechanisms to activate the nail.

PRECICE uses magnetic technology and an External Remote Controller.

FITBONE uses a motorized nail with a receiver beneath the skin and an external control set.

Both require careful monitoring, physiotherapy and weight-bearing restrictions.

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What is the main difference between LON and internal nails?

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The major difference is that LON uses an external fixator during distraction, while PRECICE and FITBONE remain fully internal.

LON:

• Lower cost

• External fixator

• Pin-site care

• More visible scars

• Generally more discomfort

PRECICE/FITBONE:

• Fully internal

• No external pin sites

• Higher cost

• Smaller surgical scars

• Specific implant weight-bearing restrictions

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Which method causes the least scarring?

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PRECICE and FITBONE generally produce less visible scarring than LON because they do not require multiple external fixation pins.

They still require surgical incisions for nail insertion and locking screws.

FITBONE also requires placement of its receiver.

No limb lengthening technique is completely scar-free.

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Which method is the least painful?

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Fully internal systems such as PRECICE and FITBONE are generally more comfortable than LON because there is no external fixation frame or pin sites.

However, all limb lengthening procedures involve major surgery, bone distraction, muscle stretching and intensive rehabilitation.

No method should be considered pain-free.

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Which method is the cheapest?

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LON is currently our most affordable single-segment limb lengthening method.

The lower cost comes with the trade-off of external fixation, pin-site care and generally more discomfort during the distraction phase.

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Which limb lengthening method is best?

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There is no single best limb lengthening method for every patient.

LON may be preferred when budget is a major consideration.

PRECICE or FITBONE may be preferred when avoiding an external fixator and reducing scars are priorities.

The decision should be based on medical suitability rather than marketing claims.

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Are the implants new or reused?

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The implants used for surgery are new implants supplied for the individual patient; implanted orthopedic nails are not reused between patients.

Specific implant details can be discussed with the team before surgery.

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Quadrilateral Limb Lengthening

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What is quadrilateral limb lengthening?

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Quadrilateral limb lengthening means lengthening both femurs and both tibias as part of one overall treatment plan.

It is intended for suitable patients who want a larger height increase than a single segment can provide.

Our typical overall planning range is approximately 12–14 cm.

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Can femur and tibia surgery be performed together?

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Yes. In selected patients, femur and tibia lengthening can be performed as part of the same surgical treatment period.

A staged approach is also available.

The appropriate approach depends on health, anatomy, rehabilitation capacity and the surgeon's assessment.

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Can quadrilateral surgery be staged?

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Yes. The two surgical stages can be separated, including an option of approximately three weeks between procedures (additional USD 5,000 for the hospital stay).

A staged approach may make certain aspects of recovery more manageable for some patients.

It involves additional planning and cost.

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Is quadrilateral lengthening harder than femur-only surgery?

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Yes. Quadrilateral lengthening is substantially more demanding because both the femur and tibia are being treated.

It places greater demands on:

• Rehabilitation

• Mobility

• Muscle flexibility

• Joint movement

• Daily support

• Patient motivation

Careful patient selection is especially important.

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Which quadrilateral combinations are available?

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We currently offer four main quadrilateral combinations.

They are:

• PRECICE + PRECICE

• PRECICE + LON

• FITBONE + FITBONE

• FITBONE + LON

This allows patients to balance internal-system comfort and overall treatment cost.

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Surgery and Hospital Stay

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Which hospital performs the surgery?

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Our limb lengthening surgeries are performed at BHT Clinic Istanbul Tema Hospital in Istanbul, Turkey.

Preoperative evaluation, surgery and the immediate postoperative hospital period take place there.

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Who performs the limb lengthening surgery?

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Our limb lengthening surgeries are performed by orthopedic surgeon Dr. Fatih Arslanoglu and the surgical team.

You meet the surgeon before surgery for physical examination, imaging review and final surgical planning.

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Will I meet the surgeon before surgery?

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Yes. An in-person consultation and physical evaluation take place before the operation.

The surgeon reviews:

• Medical history

• X-rays

• Mechanical alignment

• Flexibility

• Previous surgery

• Height target

• Selected method

• Risks and limitations

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Is limb lengthening performed under general anesthesia?

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Limb lengthening surgery is performed under anesthesia with an anesthesiology team monitoring the patient.

Your individual anesthesia plan is determined after preoperative assessment.

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How many nights will I stay in hospital?

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Our standard package includes four nights in hospital.

The actual discharge date is based on medical condition and readiness for safe postoperative care.

Longer hospital stays are not automatically better, because unnecessary hospitalization can also increase exposure to hospital-acquired infections.

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What tests are performed before surgery?

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Patients undergo medical and orthopedic evaluation before surgery.

Testing can include:

• Blood tests

• Anesthesia assessment

• X-rays

• Mechanical Axis Evaluation

• Physical examination

• Joint mobility assessment

• Review of medications

• Review of previous medical conditions or surgery

Additional testing may be requested when medically necessary.

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What is a Mechanical Axis Evaluation?

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Mechanical Axis Evaluation assesses the alignment of the legs using full-length standing X-rays.

It helps identify:

• Bow legs

• Knock knees

• Existing deformity

• Differences between the legs

• Femur-to-tibia proportions

• Overall lower-limb alignment

Height increase should be planned together with proper orthopedic alignment.

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Can bow legs or knock knees be corrected during treatment?

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In some patients, existing alignment problems may be evaluated for correction as part of surgical planning.

Whether correction can or should be combined with lengthening depends on the individual deformity and X-ray measurements.

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Lengthening Phase

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When does lengthening begin after surgery?

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Lengthening usually begins approximately seven days after surgery in our standard programme.

The initial period allows the body to begin recovering from surgery before active distraction starts.

The exact start date can be changed by the surgeon if needed.

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How many millimeters are lengthened per day?

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Our typical planned rate is approximately 1 mm per day for the femur and 0.75 mm per day for the tibia.

The total daily amount is usually divided into smaller sessions.

The rate may be reduced, paused or adjusted depending on X-rays and the patient's response.

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How long does it take to gain 8 cm?

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At approximately 1 mm per day, 8 cm of active femur distraction requires roughly 80 days.

However, the rate is not guaranteed to remain exactly 1 mm every day.

The surgeon may change it based on:

• Bone formation

• Muscle tightness

• Nerve symptoms

• Joint movement

• Pain

• X-ray findings

The total recovery period is much longer than the active lengthening phase.

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How long does it take to gain 6 cm in the tibia?

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At approximately 0.75 mm per day, 6 cm of tibial distraction takes around 80 days of active lengthening.

Again, this is an approximate calculation.

Individual medical factors may require adjustments.

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Can the lengthening rate be changed?

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Yes. The surgeon can slow, pause or modify the distraction rate when clinically necessary.

A fixed rate should never be followed blindly if the patient's body is showing signs that adjustment is needed.

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What happens if the bone forms too slowly?

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Slow bone formation may require changes to the lengthening schedule and further medical evaluation.

The surgeon may review:

• Lengthening rate

• Nutrition

• Vitamin and metabolic factors

• Smoking status

• Stability of fixation

• Blood supply

• X-ray appearance

In selected cases, additional treatment may be necessary.

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What happens if the bone heals too quickly?

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If the bone begins consolidating faster than desired during the distraction period, the treatment schedule may need to be adjusted.

Regular X-rays are important because premature consolidation can make continued lengthening difficult.

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Can I stop lengthening before reaching my original target?

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Yes. Lengthening can be stopped earlier if you are satisfied with the result or if the medical team believes further distraction is not appropriate.

Safety should always take priority over reaching a predetermined centimeter goal.

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Pain and Comfort

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Is limb lengthening surgery painful?

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Limb lengthening involves pain and discomfort, particularly after surgery and during certain stages of distraction and rehabilitation.

Postoperative pain is managed with medication and hospital care.

During distraction, patients may experience:

• Muscle tightness

• Stretching sensations

• Joint discomfort

• Pain during physiotherapy

• Temporary nerve irritation

The intensity varies considerably between patients.

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Which part of limb lengthening is usually the most difficult?

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The most challenging period varies between patients, but the early postoperative period and later stages of distraction can be demanding.

As more length is gained, muscles and other soft tissues become progressively tighter.

Consistent physiotherapy becomes increasingly important.

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Does pain increase as I become taller?

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Muscle tightness and soft-tissue tension can increase as distraction progresses, but pain does not follow exactly the same pattern in every patient.

Increasing or unusual pain should be reported rather than accepted as normal.

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Is LON more painful than PRECICE or FITBONE?

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LON is generally associated with more discomfort because of the external fixation frame and pin sites.

Fully internal systems eliminate external pins but do not eliminate surgical pain or soft-tissue tension during lengthening.

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Walking and Mobility

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Can I walk after limb lengthening surgery?

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Patients begin assisted mobility during rehabilitation, but unrestricted walking is not recommended during the early stages of treatment.

The amount of weight that can safely be placed on the legs depends on:

• Implant

• Bone segment

• Patient weight

• Healing stage

• X-rays

• Surgeon instructions

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Will I use a walker?

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Yes. A rollator walker is commonly used during the rehabilitation and adaptation period.

It provides support while allowing the patient to practise controlled movement.

Walking without support should not be attempted simply because the patient feels capable.

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Will I need a wheelchair?

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A wheelchair is commonly used for outdoor movement and longer distances during the early and intermediate stages of recovery.

Using a wheelchair does not mean the patient should remain inactive.

Physiotherapy and medically approved assisted walking remain important.

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Can I walk without support during lengthening?

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Unsupported walking is generally not recommended unless the medical team has specifically cleared you to do so.

Excess loading can damage an implant, affect alignment or place unnecessary stress on newly forming bone.

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Can I put my full body weight on PRECICE?

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Weight-bearing with PRECICE must follow the specific restrictions for the implanted nail and the surgeon's instructions.

The fact that the implant is internal does not mean it can automatically support unrestricted body weight.

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Can I put my full body weight on FITBONE?

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FITBONE patients must also follow individualized weight-bearing instructions.

The permitted load depends on the implant, surgical configuration, patient and stage of healing.

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Can I walk normally once I finish the lengthening phase?

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Finishing active distraction does not mean the bone is fully healed or that normal unsupported walking is immediately safe.

The new bone must continue to consolidate.

Walking progression is based on X-rays and clinical examination.

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Physiotherapy and Flexibility

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Is physiotherapy necessary after limb lengthening?

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Yes. Physiotherapy is one of the most important parts of successful limb lengthening rehabilitation.

The bones are becoming longer, but the muscles, tendons and other soft tissues must also adapt.

Without appropriate rehabilitation, joint stiffness and muscle contractures can develop.

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How often do patients receive physiotherapy?

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Patients in our main aftercare programme receive private physiotherapy six days per week.

Current packages generally include one-hour private physiotherapy sessions during the three-month treatment programme.

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What does limb lengthening physiotherapy focus on?

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Physiotherapy focuses on preserving movement, flexibility, muscle function and safe mobility.

Exercises may target:

• Knee extension

• Hip mobility

• Ankle movement

• Hamstring flexibility

• Quadriceps flexibility

• Calf flexibility

• Muscle strength

• Gait and walker use

• Prevention of contractures

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Do I need to exercise outside physiotherapy sessions?

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Yes. Patients are normally given exercises and stretching to perform outside supervised sessions.

One hour of physiotherapy cannot replace appropriate movement and stretching throughout the rest of the day.

Only exercises approved by the rehabilitation team should be performed.

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What is a muscle contracture?

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A contracture occurs when muscles or other soft tissues become too tight and restrict normal joint movement.

Because bones are being gradually lengthened, the surrounding tissues are placed under increasing tension.

Regular stretching, physiotherapy and appropriate distraction rates help manage this risk.

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What happens to the muscles when the legs are lengthened?

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The muscles do not suddenly become longer; they gradually adapt as the bones are distracted.

This adaptation is one reason limb lengthening must happen slowly.

Excessive or overly rapid distraction can place unnecessary stress on muscles and joints.

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What happens to the nerves during limb lengthening?

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Nerves must gradually adapt to the increasing limb length, which is why neurological symptoms are monitored carefully.

New numbness, tingling, weakness or unusual pain should be reported immediately.

The lengthening rate may need to be modified if nerve irritation occurs.

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X-Rays and Medical Follow-Up

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How often will I have X-rays?

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During the main lengthening period, X-rays are generally obtained approximately every 15 days.

The surgeon uses them to evaluate:

• New bone formation

• Alignment

• Implant position

• Progress on each side

• Whether the distraction schedule should change

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Why are X-rays so important during limb lengthening?

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X-rays show whether new bone is forming correctly and whether the legs remain properly aligned.

A patient may feel well even when an X-ray indicates that the treatment rate should be modified.

For that reason, symptoms alone are not enough to manage limb lengthening safely.

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What if I return to my home country before treatment is finished?

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Patients who continue treatment abroad must follow the agreed X-ray and rehabilitation schedule and maintain communication with the medical team.

Returning home does not eliminate the need for:

• Imaging

• Physiotherapy

• Weight-bearing restrictions

• Wound monitoring

• Medical follow-up

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How often will I see the surgeon while staying in Istanbul?

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Patients are monitored regularly by the medical team throughout their stay, with orthopedic review arranged according to the treatment stage and clinical needs.

Additional examinations are performed if symptoms or X-rays require closer assessment.

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Recovery Timeline

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How long does limb lengthening recovery take?

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Full recovery takes many months and is significantly longer than the active lengthening period.

There are several different milestones:

• Surgery recovery

• Active distraction

• Bone consolidation

• Increasing weight bearing

• Independent walking

• Muscle and flexibility recovery

• Return to sports

Patients should not treat one of these milestones as equivalent to complete recovery.

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What is the consolidation phase?

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The consolidation phase begins after active lengthening stops and the newly formed bone continues to harden and mature.

The implant continues to support the bone during this period.

X-rays determine when the regenerate bone is strong enough for increased activity.

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Does reaching my target height mean I am healed?

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No. Reaching your height target means active distraction is finished, not that recovery is complete.

The new bone still requires time to become strong enough for normal loading.

Muscles and joints also continue recovering.

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When can I walk independently?

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Independent walking begins only after the surgeon determines that the bone and implants can safely tolerate it.

The timing differs between patients and methods.

X-rays are more important than a predetermined calendar date.

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When can I return to office or computer work?

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Desk work can usually be resumed before full physical recovery, but timing depends on pain, medications, mobility and the ability to sit comfortably.

Working remotely is easier than commuting to an office during early rehabilitation.

Patients should plan realistically for fatigue, physiotherapy and frequent medical appointments.

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When can I go back to the gym?

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Upper-body and modified exercises may be possible earlier, but lower-body loading must follow medical clearance.

Heavy leg training should not be resumed simply because active lengthening has finished.

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When can I jog after limb lengthening?

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Jogging is a later-stage milestone and should begin only after sufficient bone consolidation and medical clearance.

In uncomplicated recovery, some patients may begin progressing toward jogging around the later months of recovery, but individual timing varies substantially.

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When can I run or return to heavy sports?

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Running, jumping and high-impact sports require advanced bone healing, strength and joint mobility.

For many patients this can take around a year or longer.

Depending on the amount lengthened and individual recovery, return to demanding sports may extend into approximately the 12–16 month range.

These are general recovery ranges, not guarantees.

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Will I be able to run normally after full recovery?

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Many patients can return to running and sports after complete healing, but no clinic can guarantee that every patient will return to exactly the same athletic performance level.

The result depends on:

• Bone healing

• Joint mobility

• Muscle recovery

• Rehabilitation

• Complications

• Preoperative fitness

• Amount lengthened

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Safety and Complications

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Is limb lengthening surgery safe?

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Limb lengthening is an established orthopedic procedure, but it is major surgery and cannot be considered risk-free.

Safety depends on:

• Patient selection

• Surgical technique

• Alignment planning

• Implant choice

• Physiotherapy

• Regular imaging

• Patient compliance

• Early management of complications

No responsible clinic should promise a zero-risk procedure.

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What are the main risks of limb lengthening?

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Possible complications include infection, delayed bone healing, nonunion, joint stiffness, muscle contracture, nerve problems, alignment problems, blood clots and implant-related complications.

Other surgical and anesthesia-related risks are also possible.

Additional treatment or surgery may occasionally be required.

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What is nonunion?

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Nonunion means the new bone does not heal sufficiently to form a solid bridge between the bone segments within the expected period.

Treatment depends on the cause and severity.

It may involve changes in weight bearing, stimulation of healing, bone grafting or additional surgery.

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What is delayed union?

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Delayed union means the bone is healing, but more slowly than expected.

It is different from established nonunion.

The treatment team monitors bone regeneration on serial X-rays and decides whether additional intervention is necessary.

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Can an internal nail break?

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Yes. Implant breakage is a recognized possible complication, particularly if the device is overloaded before the bone is sufficiently consolidated.

This is why patients must respect weight-bearing restrictions even if they feel physically capable of walking more.

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Can limb lengthening cause nerve damage?

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Nerves are placed under tension as the limb becomes longer, so nerve irritation or injury is a recognized risk.

Symptoms may include:

• Numbness

• Tingling

• Burning pain

• Weakness

• Changes in movement

New neurological symptoms should be reported immediately.

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Can limb lengthening cause blood clots?

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Yes. Deep vein thrombosis and other blood-clotting complications are recognized risks of major lower-limb surgery and reduced mobility.

The medical team evaluates clotting risk and determines appropriate preventive measures, which may include medication and mobilization.

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Will I need blood-thinning medication?

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The need for anticoagulant medication is determined individually according to surgery, mobility and clotting risk.

Patients should use prescribed medication exactly as directed and should not discontinue it independently.

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Can infection occur with PRECICE or FITBONE?

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Yes. Fully internal implants remove external pin sites, but they do not eliminate the possibility of surgical or deep infection.

Any increasing redness, drainage, fever or worsening pain should be assessed promptly.

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Is infection more of a concern with LON?

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LON has additional pin sites passing through the skin, so careful pin-site hygiene is particularly important.

Pin-site irritation or infection can occur with external fixation.

Patients receive instructions regarding daily care.

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What warning signs should I contact the medical team about?

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New or worsening symptoms should be reported rather than waiting for the next routine appointment.

Important symptoms can include:

• Fever

• Increasing redness

• Wound drainage

• Significant swelling

• New numbness

• New weakness

• Severe or rapidly increasing pain

• Sudden loss of joint movement

• Chest pain

• Shortness of breath

• Problems with the implant or controller

Urgent symptoms may require emergency medical assessment.

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Candidacy and Age

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Who is a good candidate for cosmetic limb lengthening?

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A suitable candidate is generally an adult with closed growth plates, appropriate bone quality, good overall health and realistic expectations.

The patient must also be able to commit to months of rehabilitation and follow-up.

Final candidacy is determined medically rather than from height alone.

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What is the minimum age for cosmetic limb lengthening?

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Cosmetic stature lengthening is intended for adults whose growth plates have closed.

Being 18 years old does not automatically make someone a good candidate.

Medical and orthopedic assessment is still required.

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Am I too old for limb lengthening?

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There is no single age number that determines suitability by itself.

Bone quality, joint health, general medical condition, flexibility and healing potential become increasingly important with age.

Older candidates may require additional investigations before a decision can be made.

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Can someone over 40 have limb lengthening surgery?

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Possibly. Patients over 40 are not automatically excluded, but they require careful assessment of bone quality, joints, general health and recovery capacity.

A DEXA scan or additional medical testing may be appropriate in some candidates.

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Does body weight matter?

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Yes. Body weight affects mobility, implant loading and rehabilitation.

A higher body weight can make recovery and assisted walking more difficult and may affect which internal nail or treatment strategy is appropriate.

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Can smokers have limb lengthening surgery?

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Smoking is strongly discouraged because nicotine can negatively affect bone healing and circulation.

Patients should discuss smoking, nicotine products and cessation timing with the medical team before surgery.

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Can someone with diabetes have limb lengthening?

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Diabetes does not automatically exclude every patient, but it must be well controlled and individually evaluated.

Poorly controlled diabetes may increase risks related to wound healing and infection.

Medical clearance may be necessary.

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Scars and Appearance

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Does limb lengthening leave scars?

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Yes. Every limb lengthening method leaves surgical scars.

Internal systems usually require fewer skin openings than methods using external fixation.

Scar appearance varies according to:

• Skin type

• Healing

• Surgical technique

• Scar care

• Individual tendency to form prominent scars

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How many scars does limb lengthening create?

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The number and position of scars depend on the bone and method used.

As a general clinic planning guide, internal systems usually involve fewer scars, while LON includes additional pin-site scars from the external fixator.

The exact incision locations are explained before surgery.

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Can limb lengthening scars disappear completely?

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Scars generally fade over time but cannot be guaranteed to disappear completely.

Their final appearance can take many months to mature.

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Will my legs look natural after limb lengthening?

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The goal is to preserve balanced proportions and mechanical alignment while increasing height.

This is why treatment planning considers both the number of centimeters and the patient's existing anatomy.

Extreme single-segment lengthening is discouraged partly because proportion and function matter.

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Will my arms look shorter after increasing my height?

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Increasing leg length changes the relationship between arm span, torso and leg length, so proportions can appear different after significant height gain.

The effect is more noticeable with larger increases.

Patients considering substantial lengthening should discuss overall body proportions during planning.

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Preparation Before Surgery

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How should I prepare for limb lengthening surgery?

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Preparation includes medical evaluation, lifestyle changes, treatment planning and preparing for a period of limited mobility.

Patients should:

• Provide complete medical history

• Provide a medication list

• Stop smoking as advised

• Maintain appropriate nutrition

• Follow preoperative instructions

• Prepare accommodation

• Plan practical daily assistance

• Prepare mentally for months of rehabilitation

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Should I exercise before surgery?

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Good general fitness and flexibility can be beneficial, but excessive training immediately before surgery is unnecessary.

Stretching programmes may be recommended according to your flexibility.

Do not begin an extreme exercise programme just before surgery without guidance.

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Should I stop medications before surgery?

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Some medications and supplements may need to be stopped or modified before surgery, but only under medical instruction.

Always provide a complete list of:

• Prescription medication

• Over-the-counter medication

• Vitamins

• Supplements

• Hormones

• Blood thinners

Never stop an important prescription medication without medical advice.

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Is nutrition important for bone healing?

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Yes. Adequate calories, protein, vitamins and minerals support the body's recovery and bone formation.

Extreme dieting during active bone regeneration is generally not appropriate.

Specific supplements should be discussed with the medical team.

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Staying in Turkey and Aftercare

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How long should I stay in Istanbul?

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Many patients stay for approximately three months during the main lengthening and rehabilitation period.

The ideal stay depends on:

• Method

• Lengthening amount

• Recovery

• Accommodation

• Ability to access physiotherapy abroad

• Ability to obtain and send X-rays

Quadrilateral treatment may require a longer stay.

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Why is staying near the aftercare center recommended?

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Staying near the aftercare team makes regular physiotherapy, X-rays and medical assessment easier.

Limb lengthening requires much more than the operation itself.

The weeks and months after surgery are a major part of treatment.

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Can I rent an Airbnb instead of using the hotel package?

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Yes. Patients selecting a hotel-excluded package can arrange appropriate accommodation near our aftercare location in the Kağıthane area.

The accommodation should be practical for reduced mobility and regular transportation to treatment.

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Can a family member stay with me?

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Yes. Many patients travel with a family member, friend or companion for practical support.

Assistance can be particularly valuable during the early postoperative period.

Accommodation arrangements should be confirmed before travel.

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Do I need a caretaker?

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Patients often benefit from assistance with daily activities during the early postoperative period.

The amount of help required differs between patients and procedures.

Quadrilateral patients generally require more practical support than single-segment patients.

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Can I go home after one month?

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Some patients may continue treatment abroad after the early postoperative period, but whether this is appropriate depends heavily on the method and individual recovery.

A patient returning home must have reliable access to:

• Physiotherapy

• X-rays

• Medical care

• Mobility support

• Communication with our team

LON patients must also consider external fixator management and the timing of fixator removal.

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Can I fly after limb lengthening surgery?

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Flying after major lower-limb surgery requires medical clearance and individual assessment of blood-clot risk, mobility and wound condition.

Do not schedule a long-distance flight simply according to a fixed number of days after surgery.

The medical team should evaluate you first.

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Cost and Packages

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How much does LON limb lengthening cost?

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Our current single-segment LON packages are $26,000 USD without hotel and $38,000 USD with 90 nights of hotel accommodation.

The hotel-inclusive option covers the main treatment period in Istanbul.

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How much does FITBONE limb lengthening cost?

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Our current FITBONE package is $50,000 USD without hotel or $62,000 USD with 90 nights of hotel accommodation.

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How much does PRECICE 2.2 limb lengthening cost?

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Our current PRECICE 2.2 package is $56,000 USD without hotel or $68,000 USD with 90 nights of hotel accommodation.

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How much does quadrilateral limb lengthening cost?

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Quadrilateral package prices currently range from $76,000 to $124,000 USD depending on the implant combination and accommodation option.

Current options are:

PRECICE + PRECICE
Hotel Excluded: $112,000
Hotel Included: $124,000

PRECICE + LON
Hotel Excluded: $82,000
Hotel Included: $94,000

FITBONE + FITBONE
Hotel Excluded: $100,000
Hotel Included: $112,000

FITBONE + LON
Hotel Excluded: $76,000
Hotel Included: $88,000

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What is included in the limb lengthening package?

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Package inclusions depend on the selected treatment, but our main programmes include the surgery and structured postoperative care.

Typical inclusions may include:

• Surgery

• Implant or fixation system

• 4 nights in hospital

• Preoperative testing

• Mechanical Axis Evaluation

• Medication

• Regular X-rays

• Physiotherapy

• Walking aids

• Wheelchair

• Transfers

• Medical follow-up

• LON fixator removal when applicable

• Hotel accommodation when the hotel package is selected

• Free Mandatory Complication Insurance

Always confirm the exact inclusions before booking.

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Does the price depend on how many cm I gain?

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No. The package price is the same whether you gain 1 cm or the maximum: up to 8 cm in the femur or up to 6 cm in the tibia. You don't pay per centimetre.

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Are there hidden costs?

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Patients should receive the package scope before treatment and understand which services are included and which future procedures are separate.

For example, later internal nail removal is generally a separate procedure and is not part of the original lengthening package.

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Do you accept credit cards?

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Our current treatment payment arrangements do not include credit or debit card installment plans.

Patients should confirm the accepted payment method and timing directly with the team before travelling.

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Do you offer financing or monthly installments?

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We do not currently provide clinic financing or monthly installment plans.

Patients should financially prepare for the full treatment and potential unexpected medical expenses before undergoing elective limb lengthening.

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Is there a surgery booking deposit?

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Our surgery booking policy should be confirmed directly with the patient coordinator when selecting a date.

Equipment or controller return arrangements, when applicable, are separate from the surgery package and are explained before treatment.

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Implant Removal

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Do internal nails need to be removed?

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Internal limb-lengthening nails are generally removed after the bone has completely healed and the surgeon considers removal appropriate.

Implants should not be removed before adequate consolidation.

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When are PRECICE or FITBONE nails removed?

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Internal nail removal is commonly considered approximately 12–18 months after surgery, depending on healing.

The exact timing is decided from X-rays and orthopedic assessment.

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How much does nail removal cost?

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Our current price for nail removal from one treated region is $6,000 USD.

For patients who have internal implants in two separate regions after quadrilateral treatment, removal costs should be confirmed according to the required procedures.

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How long do I need to stay in Istanbul for nail removal?

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Patients usually need only a short stay for uncomplicated nail removal, but travel dates should be confirmed with the team.

A typical plan may include one hospital night and several days in Istanbul for evaluation and early postoperative follow-up.

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Will removing the nail reduce my height?

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No. Removing a healed internal lengthening nail does not reverse the bone length that was gained.

Once the regenerate bone is fully consolidated, the increased skeletal length remains.

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Long-Term Results

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Will my new height remain for life?

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The skeletal height gained through successful limb lengthening is permanent once the new bone fully heals.

Normal age-related height changes later in life can still occur, just as they do in people who have never undergone limb lengthening.

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Will the new bone be real bone?

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Yes. Distraction osteogenesis stimulates the body to produce new living bone between the original bone segments.

During consolidation, this regenerate bone gradually mineralizes and strengthens.

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Is the new bone weaker forever?

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The newly formed bone is initially immature and weaker, but it becomes stronger as consolidation progresses.

Activity and weight bearing must be increased gradually according to radiographic healing.

After appropriate maturation, the regenerate becomes part of the patient's skeletal structure.

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Can I have problems years after limb lengthening?

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Long-term problems are possible after any major orthopedic procedure, although many patients recover without major long-term limitations.

Potential concerns include:

• Joint stiffness

• Residual muscle tightness

• Alignment problems

• Implant-related issues if hardware remains

• Persistent nerve symptoms

• Additional surgery

Long-term outcomes depend heavily on surgery, rehabilitation, amount lengthened and complications.

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Will cold weather cause pain after I heal?

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Some people with orthopedic implants report temporary sensitivity or awareness around previous surgical areas, but persistent severe pain is not considered an expected goal of recovery.

New or significant long-term pain should be medically evaluated rather than automatically attributed to weather.

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Choosing a Clinic and Surgeon

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What should I ask a limb lengthening clinic before surgery?

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Patients should ask about much more than price before choosing a limb lengthening clinic.

Important questions include:

• Who performs the surgery?

• Where is the surgery performed?

• Which implants are used?

• How often are X-rays taken?

• How much physiotherapy is included?

• Who monitors the patient after discharge?

• What happens if complications occur?

• What is the recommended maximum lengthening?

• What are the walking restrictions?

• What is included in the quoted price?

• What expenses are separate?

• What happens if bone healing is slow?

• How is alignment evaluated?

• How long does the aftercare programme continue?

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Should I choose a clinic based only on price?

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No. Limb lengthening is a months-long orthopedic treatment, not simply a one-day operation.

A lower headline price may not include:

• Physiotherapy

• X-rays

• Accommodation

• Aftercare

• Equipment

• Transfers

• Additional procedures

The entire treatment pathway should be compared.

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Why is aftercare so important?

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The outcome of limb lengthening depends not only on surgery but also on what happens during the following months.

Bone formation, muscle flexibility, joint mobility, alignment and implant condition can change throughout distraction.

Regular monitoring allows problems to be identified before they become more difficult to treat.

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Booking and Contact

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How do I start the limb lengthening consultation process?

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The first step is to contact Lengthening Turkey Height Solutions and provide basic information about your height goal and medical history.

Useful information includes:

• Age

• Sex

• Current height

• Weight

• Desired height

• Previous orthopedic surgery

• Medical conditions

• Current medications

• Preferred method

• Preferred travel period

Existing full-length X-rays can also be reviewed when available.

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How do I book a surgery date?

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After initial consultation and treatment planning, our coordinator can discuss available surgery dates and travel arrangements with you.

Your final suitability is confirmed through the required medical and orthopedic assessments.

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How can I contact Lengthening Turkey Height Solutions?

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You can contact our international patient team directly for an individual assessment and current availability.

Email: info@lengtheningturkey.com

Phone / WhatsApp: +90 533 016 45 62

Istanbul, Turkey

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Important Medical Information

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The information on this FAQ page is intended for general education about limb lengthening surgery and does not replace an individual examination by an orthopedic surgeon.

Every patient's anatomy, bone quality, medical history, flexibility, treatment goals and recovery are different.

The safest number of centimeters, appropriate implant, weight-bearing level and rehabilitation timeline must therefore be determined individually.

The goal of limb lengthening should never be to achieve the highest possible number of centimeters at any cost. The goal should be to achieve an appropriate height increase while protecting alignment, joint function, mobility, bone health and long-term quality of life.