KEY QUESTIONS TO BE ANSWERED

Is it possible to increase height? Up to how many centimeters?

Are there any medications, hormones, procedures, or girdles that increase height without surgery?

If I am short, without any medical condition, can I undergo bone lengthening?

What is the surgical procedure, what does the surgery consist of, and how long does the complete treatment take?

What are the risks and complications I might face? Is this a dangerous surgery?

Are these treatments performed well in Colombia? Is there good technology, or, like in the past, do you have to leave the country?

Is the treatment very expensive? Is it covered by insurance or EPS?

QUESTIONS WITH ANSWERS:

1. Is it possible to increase height? Up to how many centimeters?

Of course it is possible to increase height, but the only way after the period of bone growth has ended is with bone lengthening surgery. Humans grow through the growth plates in their bones (physes), and these close completely during adolescence. In women, they close up to ages 12-16, and in men, they grow until ages 14-18. Once the growth plate is closed, there is no way to increase height except through surgery.

In theory, you can lengthen a bone as much as you want, but you have to consider that it’s not just the bone that is lengthened; the blood vessels, nerves, muscles, and tendons are also stretched. Stretching these structures can cause changes and limitations in mobility, which is why the lengthening method must be completely supervised and managed by experts in the field. In addition, it is required that the elongation is controlled. You can safely lengthen at a rate of 1 millimeter per day to avoid damage to the vital structures. The patient must undergo this lengthening with an external device (an external fixator) or with new technologies, using an internal device, an intramedullary nail with magnetism. What is currently recommended to avoid complications is to lengthen an average of 20-30% of the bone’s length. This means it’s recommended not to lengthen a femur by more than 8 centimeters and a tibia and fibula by 6 to 8 cm. So, for lengthening for short stature, up to about 15 centimeters can be achieved in the first stage of treatment. In some cases of diseases like achondroplasia or hypophosphatemic rickets, several stages of lengthening are performed every 2 to 3 years to achieve greater lengthenings, up to 40-60 centimeters.

2. Are there any medications, hormones, exercises, or girdles that increase height without surgery?

Growth hormone is naturally produced by the human body and stimulates the growth of all organs, including bones, but the bone grows until the growth plate naturally closes. In very rare cases, the body does not produce the hormone adequately in childhood, and in this case, it would be the treatment of choice before the growth plate closes. In adults, it would have no effect or indication because there would be no way to stimulate the growth plate. Therefore, it is not indicated, nor are there any natural products or vitamins that can replace it.

Growth through exercise or special postures during the night or day do not actually increase height. This is a form of deception. The only thing that is true is that you should have good body posture so that the appearance of height is real. For example, people who walk a little hunched over can look taller and more erect if they improve their posture, but they are not actually growing; they are just improving their body posture. Therefore, books or brochures that promote gaining 10 to 15 centimeters are really a deception. There is no medication of any kind or vitamin that actually produces an increase in height. Publications on social networks or the internet that base their advertising on being able to grow up to 10 to 20 cm with just exercise in 2 to 3 months are misleading publications, based on false cases of growth.

3. If I am short, without any medical condition, can I undergo bone lengthening?

Cosmetic lengthening or height increase with surgery should be a personal decision for the patient. The patient is the one who, in their view of their personal image, feels and lives with the discomfort of feeling short compared to others. For this reason, it must be clear what they want and they must be willing to undergo the surgical treatment. There is no measurement or height limit to define as a parameter for short stature from a cosmetic standpoint. A man who is 165 cm tall in Peru may be of normal height, but in the USA or Europe, he would be considered short. The important thing is the individual analysis of the case, to define the goals of the lengthening and what is expected at the end of the treatment, as well as the decision to undergo a surgical treatment that requires care and physical therapy, that will incapacitate you for a few months, and that will require all your attention to ensure everything goes well.

4. What is the surgical procedure, what does the surgery consist of, and how long does the complete treatment take?

A complete process of preparation and comprehensive visualization of the treatment is carried out. The first thing is a specialized medical consultation with the orthopedist who is an expert in bone lengthening of the limbs. With them, the treatment and goals are discussed. A comprehensive clinical evaluation of the patient is performed to detect possible alignment disorders of the limbs, contractures, muscle stiffness, or deformities that may require special care during the treatment. The period of the surgery, the physical therapy and rehabilitation plan, the surgical budget, and the type of device to be used for bone lengthening (an external fixator or an intramedullary lengthening nail, Precice nail) are all planned.

A pre-surgical evaluation is performed by the anesthesiologist before the surgical treatment. Then, in the operating room, a low-energy osteotomy is performed on the bone to be lengthened, whether it is the femur, tibia and fibula, or humeri. It is always planned to be performed bilaterally. This cut in the bone is performed in a very delicate, low-energy way, without damaging the periosteum and taking care of the vital structures and the muscle. The external fixator or the lengthening nail is then applied. A period of 9 to 15 days is then awaited to begin the progressive lengthening of 1 mm per day. This latency or waiting period allows for the formation of a soft fracture callus, like “gum,” which will be stretched slowly so that new bone for lengthening is formed. A lengthening of 10 centimeters takes 100 days, which is about three and a half months. At the end of this period, the fixator is removed and an internal plate is placed, or a period of several months is awaited until the bone matures completely and allows for the removal of the external fixator. In the case of lengthening with a nail, these additional procedures are not performed; it is only a matter of waiting for the bone to mature completely to allow for a return to sports activities and the patient’s daily life. In total, this treatment takes about 4 to 6 months for the bone to be fully mature.

5. What are the risks and complications I might face? Is this a dangerous surgery?

The treatment must be carried out by experts. It is not free of risks, problems, and complications, and therefore requires close monitoring by the specialist, with the support of the orthopedist and the physical therapy and rehabilitation team. The support of the family is also important to provide support and facilitate the patient’s care. The performance of lengthenings, especially in children and patients with some limitations, must have an analgesic regimen and in some cases, require antibiotics for inflammation control. The most frequent problems are some muscle stiffness due to the lengthening, contractures that require a diligent at-home and directed physical therapy program. Local infection may occur at the pin insertion site, which requires taking antibiotics and an adequate cleaning of the external fixator. Pain may occur due to the lengthening as all the tissues are tensed. This is controlled with analgesia with Acetaminophen and on some occasions requires opioid derivatives for a few days.

6. Are these treatments performed well in Colombia? Is there good technology, or, like in the past, do you have to leave the country?

In Colombia, there are several centers where comprehensive bone lengthening and deformity correction treatments are performed. There is an experience of more than 20 years in this type of procedure. In our group, more than 16,000 surgeries for Limb Lengthening and Reconstruction have been performed, with high-quality results and patient recovery. We currently have the best technology used for these procedures, with bone lengthening rails, the Ilizarov system for complex deformities, and we also have the newest and most modern technology, which are progressive lengthening nails, the Precice nail, which is a device that goes inside the bone and allows for more comfortable bone lengthening with fewer scars.

7. Is the treatment very expensive? Is it covered by insurance or EPS?

Bone lengthening treatments secondary to congenital problems or trauma with growth plate closure or deformities are covered by insurance and the EPS. When it is cosmetic, that is, for constitutional short stature without any disease, it is considered an aesthetic treatment and is therefore not covered by the POS or the EPS. The cost of the treatment can vary between 15,000 to 60,000 US dollars depending on the treatment method.