Second Limb Lengthening: Tibia After Femur
Short answer
Yes, you can have a second lengthening in the other bone after the first one has healed. We recommend a gap of 1 year between femur and tibia lengthening; together they usually give 12–14 cm. If you are suitable, femur and tibia can also be lengthened at the same time, or in a staged quadrilateral with 2 surgeries about 3 weeks apart.
Why a second lengthening?
One bone can only be lengthened safely by a certain amount: up to 8 cm in the femur and up to 6 cm in the tibia. Patients who want more height can add a second stage in the other bone. See Femur vs tibia lengthening.
Options for femur and tibia
• Staged with a gap: femur first, then tibia (or the other way round), with a recommended gap of 1 year so the first bones heal.
• Simultaneous quadrilateral: femur and tibia at the same time, if you are suitable.
• Staged quadrilateral: 2 surgeries about 3 weeks apart, with an additional USD 5,000 for the extra hospital stay.
With LON, upper and lower legs are never lengthened at the same time, and LON stages are planned at least 3 months apart.
When is the second stage possible?
The surgeon checks on X-rays that the first lengthening has consolidated. We recommend about 1 year between stages, and you should be walking normally and have regained good joint movement.
Total height gain
Femur and tibia together usually give 12–14 cm (4.7–5.5 in) in total. See How much taller can limb lengthening make you? and the height calculator.
Cost of a second stage
Each stage is priced as a package by method, and the price is the same whether you gain 1 cm or 8 cm. See Quadrilateral package and the cost calculator.
Which bone first?
Many patients start with the femur, because it can gain more (up to 8 cm) and its recovery is often easier. Others start with the tibia for proportion reasons. The surgeon recommends the order after looking at your body proportions and X-rays. See Femur vs tibia lengthening.
Recovery from the first stage
Before the second stage, you should have recovered well from the first: the new bone consolidated on X-rays, normal walking, and good movement in the hip, knee and ankle. Continuing the physiotherapy programme at home helps you get there. See the recovery timeline.
Nail removal and the second stage
The nail from the first stage is removed when at least 3 cortices have healed, usually 8 to 18 months after surgery. The surgeon plans the timing of nail removal and the second lengthening together.
Proportions after both stages
Lengthening both the femur and the tibia keeps the ratio between thighs and shins closer to natural proportions when a large total gain is planned. The surgeon sets the amount for each bone with this in mind.
Is a second stage right for you?
A second stage means another stay of about 3 months, another recovery and another package price. Read Is limb lengthening worth it? and talk it through with the surgeon.
What changes the second time
Patients who return for a second stage already know the routine: the latency phase, the daily lengthening, the physiotherapy and the X-ray checks. Many find the second stage easier to plan because they know what to expect, what to pack and how to organize work and family. The stay and the recovery follow the same steps as the first stage.
If your first lengthening was elsewhere
Send us your X-rays, the type of implant and your operation notes. The surgeon checks the healing, the alignment of the leg and your joint movement before recommending a second stage.
Plan your second stage
Send us your current X-rays and how you are recovering on WhatsApp (+90 533 016 45 62) for a free assessment with our surgeon.
FAQ
How long should I wait between femur and tibia?
We recommend about 1 year, so the first bones heal before the second stage.
Can femur and tibia be done at the same time?
Yes, if you are suitable. A staged quadrilateral with 2 surgeries about 3 weeks apart is another option.
How much height can I gain in total?
Usually 12–14 cm with femur and tibia together.
Can I do my second lengthening at your clinic if the first was elsewhere?
Send us your X-rays and history; the surgeon will assess whether a second stage is suitable.
Can LON be used for both stages?
Yes, but upper and lower legs are never lengthened at the same time with LON, and LON stages are at least 3 months apart.
Will the second stage take as long as the first?
The steps are the same: latency, lengthening at about 1 mm a day and consolidation, with an average stay of about 3 months.
Related pages
How Much Taller Can Limb Lengthening Make You?