I'm a leg-lengthening surgeon. Most of my clients are men with confidence issues — here's what the procedure's like
Courtesy of Shahab Mahboubian
- Shahab Mahboubian performs 30 to 40 cosmetic limb-lengthening surgeries a year.
- He said the majority of his patients are men who feel passed over in relationships and careers.
- He can add up to 6 inches to a patient's height and said patients usually leave more confident.
This as-told-to essay is based on a conversation with Shahab Mahboubian, an orthopedic surgeon in his 40s who specializes in limb-lengthening surgeries at his private practice, Height Lengthening, in Burbank, California. It has been edited for length and clarity.
I love what I do. I see my height-lengthening patients as my kids, and I get to watch them grow. After surgery, some of them are actually taller than me — I'm 5-foot-9 — putting them above the national average.
I grew up in LA and got my medical degree from Western University of Health Sciences in Pomona, California. Then I spent six years in New York doing my residency at Long Island's Peninsula Hospital and completing my limb-lengthening fellowship at the Hospital for Special Surgery. I've been practicing for 13 years, including two years at my current office in Burbank, California.
As a child, I loved working with my hands and was always taking things apart and putting them back together
I especially enjoyed working with tools like screwdrivers, hammers, and drills, but the human body especially fascinated me. The only field in medicine that uses all of these tools is orthopedic surgery, so it seemed like the right fit.
I specialized in limb-lengthening surgery specifically because I wanted to do something that was different from everybody else. I also wanted to help a portion of the population that didn't have access to services that correct deformities and limb-length discrepancies. It's a difficult field to get into because orthopedic-surgery programs are very competitive, and there aren't many fellowships or training facilities for limb lengthening, but I found the challenge very gratifying.
In the beginning of my career, I mostly focused on surgeries that correct deformities from prior traumas or birth
Kids sometimes get hurt and end up with leg-length discrepancies. Others are born with leg-length discrepancies or bow-legged and knock-kneed deformities. I had a young lady who came to me with a knock-kneed deformity when she was 16 years old. Seven or eight years later, she came back with her own child who was having orthopedic problems after a car accident. It was very memorable to treat her as a child then have her come back to make sure her own child was OK — fortunately, she was.
Surgery helps patients with these deformities or injuries walk better and participate more fully in activities like sports, but my practice has since evolved. Now the people who reach out to me seem more interested in cosmetic limb-lengthening — or leg surgery to increase height — so that's the direction that my practice has taken, though I still see a small percentage of patients to correct deformities.
The idea of being taller fascinates people
I get about 20 emails a day asking about limb-lengthening procedures and up to 40 when one of our posts goes viral on TikTok or Instagram. The general population believes that whatever height you grow to is your final height, but that's not the case — a lengthening procedure provides an opportunity to become taller.
People mostly ask the price of the surgery, how soon they can return to work or get back to playing sports, and how long they'll be in a wheelchair or using a walker. They want to know how the procedure will affect their lives. We also get some international patients who ask us how to get a visa if they come from elsewhere. We can't do that for them, but we try to guide them on where to go.
The surgery is quite expensive — it can cost anywhere from $75,000 to $90,000, depending on exactly what the patient wants to do — and insurance does not cover it if it's cosmetic. People that undergo limb-lengthening surgery are from all walks of life, and many used COVID lockdowns to recover post-surgery.
Courtesy of Shahab Mahboubian
For the most part, it's men who want the procedure
Most men who come to me complain that they're not taken seriously or that they're made fun of. Plenty of patients say that they don't get attention from women, while others say they've been passed over for career opportunities because of their height.
When I talk to these same patients after height-lengthening surgery, they feel like they're on the same playing field with everyone else. They're happier, they have a lot more confidence, and they feel like they're able to conquer a lot more than before.
I would say 80% to 85% of my cosmetic limb-lengthening patients are men, and 15% to 20% are women. A lot of our patients are entrepreneurs, in the military, or work in tech. I've performed height-lengthening surgery on individuals ranging from 16 to 65 years old. I've had twins, siblings, and even a father and son who've undergone the procedure.
All of them are unique in their own ways. Some have gained as little as four centimeters, while others have gained up to 16 centimeters, or about six inches.
I've had a few transgender men as patients
As they transition, some patients want to have more masculine features, including being taller.
One of my patients was very hesitant to tell me about their transition — I guess because of bad experiences they'd had with other physicians for things they wanted to do, including gender-affirmation surgery. I figured it out, based on anatomy and X-rays, and told them the best thing to do is be honest. Once I gained their trust and let them know that their experience is nothing abnormal, they felt a lot more comfortable with me.
Like most other cosmetic surgeries, I don't think an additional psychiatric evaluation is necessary before getting the procedure, unless the patient is seeing a psychiatrist or feels they need one.
I turn away some people, either because they don't have enough muscle flexibility or because they have unrealistic goals
As we lengthen the bone, the surrounding soft tissue, such as the muscles, tendons, veins, arteries, and nerves, will also lengthen. Hence, the more flexibility a person has, the easier it will be to lengthen the bone against the surrounding soft tissues. As long as a person is healthy and active, and doesn't have any bone disease, they should be fit for the surgery.
There are some people who want to be a foot taller and I'm like, "That's not going to happen." The maximum amount I can add to someone's height for cosmetic reasons is about 6 inches in two separate surgeries at least three or four weeks apart. For most patients undergoing one surgery, the max we can add is just over three inches.
We do the surgery through a minimally invasive process
We make small incisions, and then we put in guidewires and use X-rays to make sure everything is being placed accurately on the bone. Then we surgically cut the bone and put a rod — also known as a Precice nail — that's about 10 to 13 inches long and one-third to half-an-inch wide into the middle of the bone, where the marrow is. Then we put in screws to stabilize the nail.
After surgery, we start the lengthening process using a magnetic machine that communicates with the nail, or rod, that's now inside the bone. The machine turns tiny gears that are inside the nail to lengthen the space between the segments of the bone, 1 millimeter at a time. When we lengthen really slowly over time, the patient's body creates new bone and it fills in the gaps. It's amazing, right?
Courtesy of Shahab Mahboubian
All my patients leave one millimeter taller because we test the nail during surgery to make sure it's functioning properly. A patient will typically spend two to three days in the hospital to recover, then lengthen their legs at home by about 1 millimeter a day. It's actually fairly painless because it's such a small amount at a time.
If a patient's job requires them to sit for long periods of time, they can get back to work as soon as two weeks. It takes anywhere from six to eight months to a year to do activities that require being on your feet, such as labor-intensive work and competitive sports.
My caseload was on the higher end during 2020. Now, it's about the same as it was in 2019.
In a year, I do anywhere from 30 to 40 cases. When everyone was dealing with COVID-19 at home and not doing things, it was a good time to have the surgery and recover.
An orthopedic surgeon can make $250,000 to $2 million a year. Some make more than that, but it really depends on how business-minded you are and what other things — like investing or getting involved with orthopedic products — you're doing outside of seeing patients.
Doctors in all specialties are not making what they did 20 years ago. Insurance reimbursements keep getting lower every year as expenses get higher. It's a challenge for everybody. You've got to be smart and have some business sense to make a good living.
Every day that I wake up and go to work, I feel like it's a new opportunity for me to do good and help people.
When a patient comes in for a limb-lengthening consultation, I talk to them about why they want to get it done
We discuss whether their goals are achievable and which surgery would be best for them — either working on the femur bones in the high parts of the legs or the tibias and fibulas in the lower part of the legs. Then I make the proper measurements for the implants and make sure the patient's fully ready for their surgery.
Before surgery, I meet the patient at the hospital, say hello, then get them pumped up and ready to go for the procedures. Before surgery, one of my favorite traditions is to play the song "Ten Feet Tall" by Afrojack on my phone as we're walking to the OR suite. It always gets them pumped up for their surgery.
Though I've done limb-lengthening surgeries hundreds of times, I still get a little nervous. But when I actually start the surgery, all of that goes away.
Every job has its stresses, and mine is no different
There are times when we run into some difficulty, such as blood clots or compartment syndrome, which is when a patient bleeds a lot into the muscle. This problem can damage muscles and nearby nerves. I've also had a couple of patients who didn't grow good bone during their lengthening, but after making several adjustments to the lengthening rate — and even using stem cells — we were able to help the bone grow nice and strong.
As an orthopedic surgeon, I'm constantly dealing with patients who come into the office upset and in pain, and my job is to make them feel better. I'm like their coach or cheerleader when they're down on themselves. People talk about this surgery so much — it's all over social media and forums. After I do these surgeries, I want my patients to be happy and encourage others to trust me and get good results.
Courtesy of Shahab Mahboubian
When cosmetic surgeries started to gain popularity, people criticized it. The same is true for height-lengthening procedures.
There will always be people who have their opinions about changing what God has given us. But as more people realize that this surgery exists and as it becomes more popular, the level of criticism will decrease. There are colleagues who may bad-mouth you, but as long as they do good work, doctors, for the most part, have respect for one another.
In general, people see you for how you treat them, but you can't make everybody happy. There will always be people who have complications or continue to have pain despite a perfect surgery. So you have to be able to relate to patients as well as peers.
It's definitely not easy to do what I do. I have my own practice with my own staff, and sometimes it's very difficult to balance patient care and business aspects. But as I get older and become more experienced, I think I'm able to handle those stresses better. In the end, you have to treat people with respect and always maintain open lines of communication.
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