Breaking both legs to get taller: The rise of cosmetic height surgery

The complicated and costly operation to lengthen a femur is nothing new, but it’s traditionally been relegated to people with bone disease or accident victims. Today, with YouTube channels dedicated to its effects and public figures like Rich Rotella working on a documentary about his own experience, it shows signs of becoming a more popular practice

Breaking both legs to get taller: the rise of cosmetic height surgery
It can cost up to $215,000, require up to two years of recovery and have serious side effects. Still, there are men whose height anxiety leads them to cosmetic surgery geared towards becoming taller.Getty Images / Blanca López (Collage)
Lucía Franco

“I’m just so sick of people telling me, ‘You’re too short to play the lead.’” Those words came from the mouth of actor and comedian Rich Rotella, and were published in an interview with People magazine. In the United States, he became well-known for being, at 38 years old, the first public figure to undergo one of the most controversial, under-the-radar and questionable operations in modern medicine: so-called cosmetic height surgery via bone elongation. Rotella is now working on a documentary that will be released in coming months on his experience with a leg-lengthening operation that promised he would grow by 3.25 inches.

In interviews with various media sources, Rotella explains that this was born out of a simple, long-held desire. “I think anyone who is 5′8″ or taller might have a hard time understanding why someone would voluntarily break their legs to become taller,” he says. In 2020, Rotella began looking for a permanent solution after using lifts in his shoes for decades. He came across the YouTube channel Cyborg4life, on which a man named Victor Egonu explains his experience with the procedure. Some of his videos have been seen 150,000 times. Rotella decided to send Egonu a message in hopes of collaborating with him on a documentary about the experience. That project is currently underway.

Rotella put his trust for the operation in Dr. Dror Paley, of the Orthopaedic & Spine Institute in West Palm Beach, Florida, whose track record of carrying out more than 25,000 such operations inspired trust in the comedian. Rotella’s operation cost $107,000 and may increase his height from 5′5″ to 5′8″ by the end of the process. Along the way, he spent more than a year in recovery and had to break both his legs.

Dozens of patients, largely men between 20 and 45 years old who stand between 4′9″ and 5′7″, write to Doctor Javier Downey every day out of desperation. They want to be taller. Downey is a specialist in orthopedic surgery and traumatology at his Downey Institute in Sevilla, Spain. His most popular procedure is that of height increases. “Discover how to become 6.3 inches taller,” reads an English language translation of his website.

On the site, one can also read comments from men who don’t care that they have to break their leg bones to achieve their dream of increasing their height by a few inches. “I would like to undergo this surgery because I am not satisfied being 4′9″, it affects my emotions. Everyone laughs at me.” The doctor explains to EL PAÍS that their motivation is clear: “Short men suffer from low self-esteem. A man always wants to be taller than his partner,” he says, although this attitude may be changing. Downey decided to open his clinic in Spain in 2019 after studying in the United States and seeing the success that the procedure was having there. “I decided to bet on health tourism, which is on the rise. Many people come from abroad to be treated here, and cosmetic height surgery wasn’t going to be an exception,” he says.

How tall do you want to be?

The surgery’s not new: operations to increase height have been carried out for decades, but always in the case of people who suffered from illnesses like achondroplasia, poliomyelitis, or who had been injured in accidents. What is relatively new is the desire to undergo one of the most difficult surgeries with the longest-lasting recovery period without suffering from one of these indicating health conditions, but simply a desire to look differently, an urge akin to wanting a hair, breast or penis implant.

Treatment begins with a question: how tall do you want to be? Once that’s settled, the patient has to submit to a psychological evaluation. “There are moments in which the surgery can be very stressful, and before undergoing it, they have to know what they are going to run into and have good psychological support,” says Downey.

Every centimeter lengthens the recovery process by a month. “During the recovery process, the patient can’t walk or put weight on their feet. Complete rest,” says the doctor. The price of the surgery goes from $53,700 to $215,000, depending on the increase in height. For example, if a person wants to grow six inches, they’ll have to undergo two procedures during an average time period of two years and pay $215,000 at the Downey Institute. “It’s a surgery that is in reach of very few people,” recognizes the specialist. “Many people ask about the operation, but hardly anyone has the resources to pay for it.” Over the last year, the doctor has carried out four of these operations.

The main part of the surgery consists of breaking the bones in the legs. “An electromagnetic lengthening pin is inserted into the femur. The bones are hollow tubes, so you have to go through the bone. The bone is then cut, the nail is inserted, and it is fixed near the knee and hip with two screws. Once the nail is fixed, after a week, the lengthening process begins with a machine that emits electromagnetic waves that cause the screw to unscrew and increase its length,” says the doctor. Once the desired length is reached, the bone begins to heal.

Orthopedic surgery and traumatology specialist and member of the European Board of Orthopedic Surgery Juan Arnal explains: “It’s quite uncommon to carry this out in both legs. Usually it is performed to correct lower limb dysmetry, which means that the patient has one leg longer than the other when their hips are at the same level.”

Still, in the United States, the procedure has become part of the turbulent world of cosmetic surgery, and the fever to gain a few extra inches is starting to spread internationally. Arnal has seen more and more patients at his hospital in Madrid ask about the surgery. “It’s on the rise, there are more and more people without any kind of pathology who are interested in undergoing this operation simply to increase their height,” he says.

The procedure is still in its early days of international acceptance, however. “If a person is short, first it’s important to find out if they have some kind of hormone deficit or if they can be treated in a less aggressive manner,” Arnal says. “It’s a very aggressive process, the patient loses a lot of blood. You run a lot of risks in terms of the bones, and the fractures can heal incorrectly, which can cause serious problems,” he continues.

For anesthesiologist physician David Callejo, the surgery, if not today’s motivations to attempt it, is old news. “The lengthening of bones has been performed for a long time, but now people are attempting it for cosmetic reasons. The procedure has become simpler with the magnetic pins, and beauty standards are putting more pressure on men and their height.”

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