What are the risks and complications associated with cosmetic lengthening?

Bone lengthening surgeries should be performed with intramedullary (Magnetic or Motorized) lengthening nails whenever possible. All the devices used for the lengthening are secured to the bones; other soft tissues (muscles, nerves, blood vessels, etc.) attached to the bones assist in the physiotherapy and rehabilitation process. The lengthening surgery can result in joint stiffness and severe scarring (unattractive cosmetic scarring) when external fixators are used that pass through the skin, muscles and tendons and are used to secure the bones in place from the outside with nails and wires. Also, external fixators situated on the outside can be uncomfortable when they are set up improperly. This happens, in part, from neglecting some orthopedic issues. Such problems, however, are unacceptable in cosmetic lengthening procedures. The biggest risk in these types of surgeries is for a person who had no issue or difficulty with walking in the past to start experiencing this problem, which is an unacceptable risk. It is also not possible to consider the possibility of leaving a permanent scar on the skin after a cosmetic surgery.

Complications From a Cosmetic Lengthening Performed at a Different Medical Center

A) A 24-year-old patient who had never experienced any orthopedic issues before underwent a lengthening operation with external fixators that were inserted from the outside, for cosmetic purposes, and the treatment was not successful; this was done at a different location.

B) When he was referred to us, after the external fixator had been used for cosmetic purposes to address the bone deformities in both tibiae, a discrepancy the two legs was observed, and the patient could not walk and could only be mobile with the help of a wheelchair. C) During the previous lengthening operation, an x-ray revealed that the external fixator nail was broken and that there appeared to be an acute deformity in both tibiae.

D,E) In this case, we decided that the best treatment option would be the Taylor Spatial Frame (computer-assisted external fixator) system. Both bones were treated in order and the "mechanical axes" (the line that defines the center of gravity of the body) were corrected again. The treatment lasted for 6 months.

F,G) At the end of the treatment, the patient was able to walk again and return to work.

The risks and complications that occur in other lengthening operations can also be seen in cosmetic lengthening surgeries. Cosmetic lengthening surgeries involving external fixators being attached to the outside of the leg run the risk of failure as well as the risk of producing an uneven walk for patients who have never experienced the problem before. 

Cosmetic lengthening surgeries involve detailed and intensive preparation during the decision-making period as well as during the preoperative planning phase. Throughout this process, in addition to detailed clinical examinations, advanced radiological examinations are done in addition to generating orthopedic templates which involves computer-assisted planning. The person's expectations should be reasonable, and both technically and medically feasible. After this detailed work is carried out and we understand that it can be executed flawlessly, and when both we and the patient understand the procedure involved, we proceed with the cosmetic lengthening surgery.