Height Reduction Surgery Methods

Newest Methods, Better Techniques

Intramedullary Nail

Height reduction surgery with intramedullary nail.

Cosmetic height reduction surgery,

although something that has been done rarely, it is possible. In fact, our doctor has successfully done this operation on January 17, 2023. There is more detailed information about this surgery in the rest of the article.

If the patient fulfills the conditions, they can have the surgery. It is more common that limb reduction surgery is done for counterbalancing the leg length differences, which some people suffer from, instead of for cosmetic purposes.

What are the Conditions for getting Limb Reduction Surgery?

The first and foremost condition is the patient should have stopped growing and their growth plates should be closed. Whether the patient’s growth plaques are open or closed can be understood by taking an X-Ray of their legs. Most people usually reach their maximum height at 18 or 20.

The second condition is that the patient should be healthy and ready for the surgery and the long process afterwards, both physically and mentally. For the limb reduction surgery, the upper leg of the patient should be thin because after the removal of the bone, the muscle density increases. In addition, the upper body of the patient should be strong because they are going to walk with a walker during their recovery process, which needs upper body strength. Especially the patients that are going to have surgery on the upper leg should do exercises that will lower the muscle density and strengthen the upper arms. If the patient requests, we can arrange a psychotherapy session before the surgery for the patient to be mentally prepared. You can contact our patient consultant to arrange your psychotherapy session, if you would like to have one. You can visit our other website as well, which is for limb-lengthening surgery.

You can view our patient's before and after the surgery photos, taken with our doctor side by side and see her height difference in between the photos.

Stages of Limb Reduction Surgery Process

Consultation and Getting the Necessary Medical Examination

After you decide to get your cosmetic limb reduction surgery, Radiological examinations, measurements, and other necessary examinations are performed before the operation. The clinical results are shared with the patient during the consultation and everything about the surgery is explained to the patient by the doctor. Both the physical and psychological state of the patient is evaluated by the doctor to decide whether the patient is ready for the surgery and the process or not. If there are no health problems that will prevent the surgery and the patient is psychologically ready, the date of the surgery is decided as soon as possible.

The Surgery

The operation is done under either general anesthesia or local anesthesia, depending on the patient’s request and the supervision of the doctor and the anesthesiologist. The chance of bleeding during the surgery is low because the surgery is performed with the help of a tourniquet. If it is needed, blood supplements can also be given to the patient.

In short, during the surgery, the doctor removes some of the femur by cutting the bone. Then the rest of the bone pieces are attached with an intramedullary nail until the bones heal.

Step-by-step height reduction surgery:

1- Cleansing the segment with an antiseptic solution

2- Determining the area where the bone-cutting will be done

3- Drilling inside the bone to create sufficient space to insert the intramedullary nail

4- Doing the osteotomy on the bone which is planned to be shortened

5- Removing the piece of the bone attentively

6- Placement of the intramedullary nail of the appropriate size in the patient's bone, taking into account the measurements of the medullary cavity

7- Fixing the nail by placing interlocking screws from both proximally and distally.

Limb reduction surgery can also be done on the arms, yet surgery on the legs is more common. With one limb shortening surgery, a maximum 5 cm height decrease can be achieved.

From Femur: 5-5.5 cm

From Tibia: 2 to 3 cm height reduction can be achieved.

The first surgery is most commonly done on the femur and if the patient requests and their health condition is appropriate, the second surgery is usually done on the tibia.

Hospital Stay

The hospitalization process takes approximately 5 days. During this time, the patient stays in a single room with a bathroom and a single sofa, for the caretaker to stay. During the hospital stay, physical therapy sessions are taken 2 times, necessary exercises to be done are taught to the patient, dressing changes are made and what things should be paid attention to are explained.

The Recovery Process

After discharge, patients are highly advised to spend their recovery process here for at least 2 months, in Turkey in order to receive regular and intense physical therapy and health care service in the accommodation place offered by the company, which is needed for a healthy recovery. During this time, patients need a walker and a wheelchair’s assistance in the first 4-6 weeks. Gradually, they can then use crutches under the supervision of a doctor. On the 6th week after the surgery, X-rays of the patient’s legs are taken, and based on the results and physical condition, they are required to use only one crutch until the doctor recommends stopping.

The physiotherapist helps patients with exercises and teaches them the stretching, muscle, and joint movements that should be done during this recovery process. It should be noted that patients should not neglect physical therapy sessions and the exercises recommended to be done during this period. Otherwise, it can lead to health problems such as a limited range of motion, joint/muscle contractures or muscle imbalance. The patients are expected to walk unaided for 2-3 months after they have limb reduction surgery. Once they complete walking with assistance, they can return to their normal lives, except for doing sports or extreme activities until the bone is fully healed. Driving a car can be allowed 2-4 months after the surgery depending on the recovery progress.

After the surgery, new bone tissues are formed in the shortened bone area. The estimated full bone healing is between 6-9 months. (It may take a bit longer than expected depending on the patient’s bone recovery speed.)

Nail Removal Surgery

If full consolidation is sustained in the area where the osteotomy was done, the intramedullary nail is removed by the doctor under local anesthesia or general anesthesia, again depending on the patient’s requests and the anesthesiologist’s supervision.

What are the Risks and Complications that might occur with Limb-Reduction Surgery?

Like all surgeries, limb-reduction surgery also has its own risks and side effects. Some of the side effects that the patient may face are listed below.

Edema
Hematoma
Muscle Pain
Muscle Stiffness
Muscle Weakness
Nerve Pain
Difficulty falling asleep or sleeping
Contracture (Hip, knee, and ankle); it is the loss of range of motion in the joint or the restriction of the joint movement in certain directions due to loss of elasticity for various reasons in the muscles, tendons, joint capsules, and ligaments surrounding the joint. Fortunately, physical therapy is the best way to reduce contractures. If your rehabilitation continues steadily during the recovery phase, the severity of the mobility limitation is significantly under-maintained. If there is negligence in rehabilitation, the severity of movement limitation increases significantly and another surgical intervention may be required.
Having difficulty walking due to muscle imbalance but with intense and customized physical therapy, patients will regain their normal walking.

Each limb-reduction patient is expected to experience the above symptoms at least to a certain degree. These are natural side effects that will go away with physical therapy and over time.

Although it is not very common, these are all the potential risks and complications that might occur after limb-reduction surgery:

● Having difficulty walking due to muscle imbalance (With intense and customized physical therapy, patients will regain their normal walking. However, if it is not received properly, returning back to daily life might take longer than anticipated)

● Joint and Muscle Contractures

● Infection

● Vascular trauma

● Having thicker thighs/calves/upper arm due to muscle building on top of the muscle (temporarily) - the muscle, after finding its balance, will return to its former state.

● Cartilage Damage

● Nerve Damage

● Slow Bone Union

● Non-bone union

● Axial Deviation

● Bone Deformity

● Fat Embolism

● Thrombosis

● The nail breakage or crooked nail

● Technical problems linked to the nail or interlocking screws

Slow or non-bone unions are caused by the biological reaction of the person and for their diagnosis, X-rays are performed at regular intervals. In cases where the bone is not consolidated, bone grafting can be made or stem cell therapy for the slow bone union can be applied.

The doctor's examination is of great importance in the process of recovery. Patients should express their complaints or requests. If the process is to be spent away from the hospital or abroad, remote patient monitoring can be done via online consultation. For the slightest problem of the distance, the doctor should be informed and should be referred to the nearest hospital where necessary.

After the reduction surgery, the wounds heal in 2-3 weeks, thus the possibility of infection or bone infection is less likely to occur. During the recovery process, the tension in the muscles and rotation can cause pressure on the bones. Therefore, deviations or curvature are observed in the broken bone. They can be corrected during the device removal surgery or by an additional surgical intervention performed upon the patient’s request. During the treatment process, some patients may experience psychological problems and therefore request psychological support. Psychotherapy service is provided if needed.

All these complications result in additional charges for hospital and treatment expenses being paid by the patient.

In the past, if there is the consumption of addictive drugs (Tramadol, Opioid, Adderall, Methamphetamine, etc.) or substances (cigarettes, alcohol, cocaine, etc.) by the patient, it may cause some health problems to be triggered after the surgery due to certain damage to the chemical and physiological order of the body. For instance, insufficient effectiveness of the painkiller, blood clotting, late healing of the wound, slow bone union or none bone union, headache, insomnia, skin sensitivity, loss of appetite, and emotional disorder.

Muscle Imbalance

We would like to talk in more detail about muscle imbalance because this is the most difficult complication that the patient may face after the surgery. The reason why it happens is that after the bone is removed, the muscles get on top of each other and become thicker, which affects the patient’s ability to walk for the first few weeks tremendously. In order to make this a temporary difficulty, the patient should get an intense physical therapy program. Otherwise, the patient will continue to experience difficulty in walking and won’t be able to walk normally again. If this happens, the doctor will recommend lengthening the shortened leg for the patient to return back to their health and normal walking.

Incisions in Limb Reduction Surgery

For limb-reduction surgery, some incisions are opened on the legs of the patient.

This is how the incisions look on the leg after the surgery. The scarring is minimal with limb reduction surgery, however you can still get fractional laser treatment if you don't like the way it looks after the process. To get more information, you can check out our Services page.

Height Reduction Surgery Price

The height reduction surgery cost is 19,850 USD.

If you plan to get your cosmetic limb reduction surgery, please contact our patient consultant to start your process. After your consultation with both the patient consultant and the doctor, they are going to show you the way to prepare for the surgery.

Our First Limb Reduction Surgery

Our American patient has chosen the Height Reduction team and our Doctor Yunus Öç to get her limb reduction surgery after her detailed research around the world. Before the surgery, our patient was anxious but once she understood that she was in good hands with the meeting she had with our doctor, she decided to get her limb reduction surgery.

This is the picture of our patient pre-surgery, taken with our doctor at her side.

Our patient is in her early 20s. Her pre-surgery height was 173 cm. Her post-surgery height is now 168 cm, and her height decreased by 5 cm by the femur. Before the surgery, our patient stated that because of personal reasons, she was feeling that she was too tall and wanted to get this surgery.

The picture on the right shows our patient's X-ray images of her legs before and after the surgery. You can view from the picture that the nails are fixated in the bones after the surgery and they aren't removed until the bone union is completed.

This X-Ray image of the bone being cut during the surgery

The surgery went very healthily and everything was as it was planned. Our patient’s recovery process is going well and comfortably right now. We wish her a happy and healthy life with her new height.

You can also reach more information about limb reduction surgery from our FAQs page and by asking our patient consultant.