Limb lengthening in Turkey: procedure, recovery and cost

Who is leg lengthening for ?

In brief

• Main indication: leg length discrepancy, after-effects of trauma, achondroplasia4. A purely cosmetic request is assessed case by case3.
• Techniques: circular external fixator (Ilizarov) or motorized internal lengthening nail1, 2.
• Rate: about 1 mm per day15, or about 1 month of treatment per centimeter gained1.
• Risks: complications reported in 34% of segments with motorized nails2; infection, healing problems, nerve or vascular injury, thrombosis.
• Recovery: 3 to 6 months to resume daily life, often 6 to 9 months for full consolidation.

Leg lengthening is a surgical procedure mainly indicated to correct a length difference between the lower limbs. This difference can be due to:

• Congenital conditions, such as achondroplasia, a form of dwarfism.
• Trauma: poorly healed fractures, amputations, etc.
• Idiopathic discrepancies, meaning with no apparent cause.

In a discrepancy, the procedure usually involves only one leg, the one that is too short. A purely cosmetic request from a person whose limbs are already symmetrical is not a standard medical indication: it is assessed case by case. A systematic review of 795 patients operated on for cosmetic height gain reports high satisfaction, but based on low-level evidence and with frequent problems or obstacles during treatment3.

When should lengthening be considered?

According to published management strategies, a discrepancy under 2 cm is most often managed by observation or a simple lift (heel lift, insole). Between 2 and 5 cm, several options exist: compensation, growth arrest in children, shortening of the longer leg, or lengthening. Above 5 cm, bone lengthening is more often considered4, 5.

These thresholds are indicative: the surgeon decides after a clinical and radiological assessment, taking into account the impact on gait, back and joints.

At what age can leg lengthening be performed?

• In children and adolescents: lengthening may be offered for certain indications (major discrepancy, achondroplasia),case by case, by a pediatric orthopedic team. The stress on growth plates may be greater before the age of 1010.
• After growth has ended: growth plates generally close around 13 to 15 years in girls and 15 to 17 years in boys12. The procedure can then be considered in adults.

Eligibility depends on general health, the quality of the bone and soft tissues, and the ability to follow several months of rehabilitation.

Gaining height in Turkey: Limb lengthening surgery

Leg bone lengthening surgery consists of gradually lengthening the tibia, the femur, or both. It is first indicated for medical reasons (length discrepancy, after-effects of trauma, achondroplasia). A cosmetic request to gain height is assessed case by case.

Orthopedic surgeons mainly use two families of techniques:

• Circular external fixator (Ilizarov): an external device is fixed around the leg with pins and rods to create a gap between the two bone segments. The bone gradually regenerates in this gap, and the device is removed once the bone has healed1.
• Internal lengthening nail (Fitbone or Precice type): a rod inserted in the bone lengthens it gradually, with no device visible outside. The bone rebuilds around the implant. These motorized nails have been the subject of a systematic review covering 983 segments2.

The choice of technique depends on the indication, the bone involved, the gain sought and the surgeon's opinion. Each has advantages and constraints to discuss during the consultation.

Postoperative phase

The duration of recovery after bone lengthening surgery in Turkey varies with the technique used (Ilizarov, Fitbone, etc.) and the length sought. On average, the initial hospital stay lasts 5 to 6 days. Regular clinical and radiological checks are then scheduled about every 30 days to monitor bone consolidation.

External fixation systems such as the Ilizarov device must be removed once the lengthening is complete and the bone has healed. PRECICE internal nails are also generally removed after consolidation, most often one to two years after surgery, in a short procedure9.

The patient-surgeon relationship is essential throughout the process, which can last several months. In achondroplasia, reported length gains range from 6 to 21 cm depending on the series, sometimes over several operations, with risks of fracture and nerve injury; the timing of surgery is decided by the surgical team according to age and growth10.

Bone lengthening: Personalized recovery

Recovery after bone lengthening surgery is individual. Return to daily life usually takes 3 to 6 months, and full consolidation with return to sport can take 6 to 9 months depending on the length gained. The literature reports about one month of treatment per centimeter gained for a simple lengthening1. The first postoperative weeks are devoted to wound healing.

As the bone consolidates, a personalized rehabilitation program is set up. It includes specific exercises to:

• Improve the range of motion of the joint.
• Strengthen muscles weakened by immobilization.
• Regain stable balance.
• Retrain proprioception (the perception of body position in space).

The duration and intensity of rehabilitation are adapted to each patient and evolve with progress. It is essential to work closely with your physical therapist to reach the goals set.

The success of your recovery depends largely on attending physical therapy sessions and doing the home exercises regularly.

Risks of bone lengthening surgery

Bone lengthening is a major surgical procedure that should not be taken lightly. Contrary to a common belief, it is not a shortcut to gain height without medical evaluation. Specialists describe it as a potentially high-risk technique4.

This operation carries significant risks, including:

• Nerve and vascular damage, which may cause sensory or motor disorders.
• Infection, especially at the pin entry points of an external fixator, which can delay healing and require additional treatment11.
• Bone healing disorders: delayed or failed healing may occur and require additional surgery1, 2.
• Thrombosis: the formation of blood clots is a risk to consider, especially in the lower limbs.
• Joint stiffness or deformity, particularly of the ankle (equinus foot),and deviation of the axis of the lengthened bone3, 4.

To give an order of magnitude: in a systematic review of 795 patients who had cosmetic lengthening, there were on average 0.78 problems, 0.94 obstacles (requiring an intervention) and 0.15 complications per patient3. For motorized nails, another review reports complications in 34% of lengthened segments2. The authors stress that the level of evidence of these series is low.

Contraindications and precautions

The preoperative assessment looks for situations that may contraindicate the operation or increase the risk: active infection, circulation or clotting disorders, unstable bone disease, unfinished bone growth, persistent smoking6, or inability to follow rehabilitation and follow-up. Only the surgeon can conclude after examination and imaging.

Choosing an experienced orthopedic surgeon and strictly following postoperative instructions are essential. Regular medical follow-up is needed to detect and treat any complications.

Every patient is unique, and risks vary from case to case. It is important to discuss these issues in detail with your surgeon in Turkey before making a decision.

Can you increase your height without surgery?

Adult height depends mostly on genetics and on growth during childhood and adolescence. Growth plates generally close around 13 to 15 years in girls and 15 to 17 years in boys; once closed, the bones no longer grow12.

During growth, some habits help avoid slowing it down:

• Sufficient and varied nutrition: insufficient intake of protein, calories and other nutrients can slow growth. However, extra vitamins or special diets do not make a child grow taller when short stature is familial or due to constitutional growth delay14.
• Enough sleep: growth hormone is secreted in a peak at the onset of deep sleep13.
• Regular physical activity, adapted to age, which is good for general health.

Growth is controlled by hormones: in case of growth delay, a pediatric or endocrinology opinion is recommended14. For a simple length difference between the legs, shoes or insoles that compensate correct the gait without changing the length of the bone4.

Sources and references

1. Paley D. Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clin Orthop Relat Res. 1990;(250):81-104. PubMed 2403498
2. Frost MW, Rahbek O, Traerup J, Ceccotti AA, Kold S. Systematic review of complications with externally controlled motorized intramedullary bone lengthening nails (FITBONE and PRECICE) in 983 segments. Acta Orthop. 2021;92(1):120-127. PMC7919879
3. Marwan Y, Cohen D, Alotaibi M, Addar A, Bernstein M, Hamdy R. Cosmetic stature lengthening: systematic review of outcomes and complications. Bone Joint Res. 2020;9(7):341-350. Bone & Joint Research
4. Vogt B, Gosheger G, Wirth T, Horn J, Rödl R. Leg length discrepancy: treatment indications and strategies. Dtsch Arztebl Int. 2020;117:405-411. PMC7477698
5. POSNA (Pediatric Orthopaedic Society of North America). Leg length discrepancy (LLD),Orthopaedic Knowledge Online study guide. posna.org
6. Hernigou J, Schuind F. Tobacco and bone fractures: a review of the facts and issues that every orthopaedic surgeon should know. Bone Joint Res. 2019;8(6):255-265. Bone & Joint Research
7. Douketis JD, Spyropoulos AC, Murad MH, et al. Perioperative management of antithrombotic therapy: an American College of Chest Physicians clinical practice guideline. Chest. 2022;162(5):e207-e243. Summary: du Breuil AL, Am Fam Physician. 2023;108(2):208-211. AAFP
8. American Society of Anesthesiologists Task Force. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures. Anesthesiology. 2017;126(3):376-393. asahq.org
9. Paley Institute. Nail removal (PRECICE). paleyinstitute.org (institutional page, accessed October 2026).
10. Boero S, Vodopiutz J, et al. International expert opinion on the considerations for combining vosoritide and limb surgery: a modified Delphi study. Orphanet J Rare Dis. 2024;19:347. DOI
11. Kazmers NH, Fragomen AT, Rozbruch SR. Prevention of pin site infection in external fixation: a review of the literature. Strategies Trauma Limb Reconstr. 2016;11:75-85. DOI
12. KidsHealth (Nemours). Growth plates. Medical review: Amy W. Anzilotti, MD, January 2019. kidshealth.org
13. Takahashi Y, Kipnis DM, Daughaday WH. Growth hormone secretion during sleep. J Clin Invest. 1968;47(9):2079-2090. PMC297368
14. KidsHealth (Nemours). Growth problems (growth hormone). Medical review: Mary L. Gavin, MD, January 2021. kidshealth.org
15. Popkov D, Shevtsov V, Popkov A. High-frequency progressive lengthening for congenital lower limb length discrepancy in children (conference abstract; standard rate: 1 mm per day). Orthop Proc. 2008;90-B(SUPP II):248. Bone & Joint

References consulted in October 2026, mostly in English. These sources document the general information on this page; they do not replace your surgeon's advice.