Limb Lengthening Surgery Is Becoming More Popular

Dr. Shahab Mahboubian, the orthopedic surgeon who performed Scott’s surgery, is a bit of a social media star. On Instagram, the 46-year-old Californian boasts more than 45,000 followers. On TikTok, another 50,000. His handle is pretty straightforward: @heightlengthening. On his social media pages, you can see him doing dances and answering questions about the procedure.

Height-increase surgery is not Mahboubian’s entire practice. He said he performs about 30–40 of these surgeries a year. “I would say most of my work is still general orthopedics. I still do a lot of sports. Patients with shoulder issues, knee issues, back issues. I still see a wide range of orthopedic problems,” he told me in his office in Burbank, California. Still, judging by the large sign that reads “Height Lengthening Institute” at the door, it’s fair to say it has become his brand. “It’s become a big part of my practice. It’s the thing most people are interested in. That’s where I get most of my consultations,” Mahboubian said. He added that he’s seen a marked increase in surgeries during the pandemic. “Since a lot of people had more time on their hands, they opted to undergo their procedure,” he told me.

Though he’s been performing the surgery for more than a decade now, stature lengthening was not Mahboubian’s original plan. He was originally interested in sports medicine, a core part of the orthopedic profession. But he soon realized that that’s what the majority of his fellow doctors-in-training wanted to do. “I didn’t want to do the same things that all the other orthopedic surgeons do, which is mostly joint replacements, fracture care, or sports injuries. Those are the top three,” he told me. That’s when he found a fellowship focused on limb lengthening and deformity correction.

Surgically lengthening limbs is not new. It has existed in some form for nearly 100 years. People wounded in military service or car crashes would get the procedure, often as a way to correct mismatched length in legs. What is relatively new is the deployment of the surgery for elective and cosmetic ends — that’s only about 15 years old. In other words, people are now choosing to undergo the procedure just because they want to.

Mahboubian nonchalantly described the “minimally invasive” procedure like a man recounting his breakfast. “Through small little incisions, I cut the bone surgically,” he began. “Then I insert a rod — we call it a nail or a rod — that goes inside the bone. The rod is magnetic and it has gears. Then there’s an external device that communicates with the nail. And over time, little by little, it lengthens out the nail.” The lengthening happens gradually. “We usually say about a millimeter a day, until they get to their desired height.”

There is a ceiling on how much height a patient can gain. “The maximum is 8 centimeters, because that’s the limit of the nail. Anything beyond 8 centimeters is when we see most of the complications.”

Hang on, I protested. “Minimally invasive” and “cut the bone” are not concepts that naturally go together. “You want details on how you break the bone?” the doctor asked with a laugh. “I make a small incision — a 1-centimeter incision — and basically what I do is first weaken the bone by drilling through it. Using a small drill, I make a few drill holes. Then we use an osteotome, which is kind of like a chisel.” The chisel is what cuts the bone. “It’s done surgically and very accurately,” he added.

Is the broken bone the most painful part of the recovery process? “When you cut the bone, you get swelling around that area, but that goes away after a few days. Then there’s the lengthening pain, which is a stretching type of pain,” the doctor said. “But it’s tolerable because it’s done very slowly.” Mahboubian is quick to acknowledge the potential complications and how he seeks to address them. Anxious about infection? He starts his patients on antibiotics right away. He puts patients on blood thinners because there’s a risk of blood clots. There’s a risk the nails could break, hence why patients have walkers. “As some patients lengthen, they could make too much bone. Others may not make enough bone.” To address that, he takes regular X-rays to monitor how the healing is going. “The majority of my patients,” he said proudly, “have zero complications. The ones that do, it’s either because they didn’t listen to me, or didn’t do the proper therapy.”

In social media posts, Mahboubian often appears in before and after pictures with his patients. He is the reference point for the height they’ve gained. He is 5’9”, the average height for men in the US. “I was a late bloomer, so I was always the shortest one of my friends,” he said. “So I got a lot of the jokes and the being talked down to during those stages of my life.” He said he had a growth spurt later in his teens, but because of his years being shorter, he knows what his patients have gone through.

Was it those years that made him interested in this surgery? “Maybe subconsciously,” he said. “My motivation to get into this field was to change people’s lives for the better.” But it helps to have a reference point for the frustrations patients are expressing. “When they tell me their stories, I can relate to them.”