Height reduction surgery, commonly referred to as limb shortening surgery or limb reduction surgery as well, is a highly specialized orthopedic procedure that focuses on decreasing an individual's height. The concept may initially appear counterintuitive, given society's often height-obsessed views, but for some, it's a necessary medical intervention or a decision born out of a desire for a physical change. The intention of this procedure isn't merely to cater to aesthetic considerations but predominantly to address specific medical conditions leading to disproportionate limb lengths.
Delving into the Details of Height Reduction Surgery
An In-depth Look at Height Reduction Surgery
Height reduction surgery involves meticulously modifying the skeletal structure, particularly the length of the long bones in the legs, to bring about the desired height decrease. This surgery falls under the umbrella of orthopedic procedures that require a high degree of surgical proficiency, coupled with extensive post-operative care.
During the procedure, the surgeon performs an osteotomy where the bone is surgically cut. A specific section is then removed, and the remaining parts are carefully realigned and fixed using orthopedic devices like plates, rods, or screws. The objective is to strike a balance between achieving the required height decrease while maintaining the functionality of the limbs.
The Reasons Behind Height Reduction Surgery
Height reduction surgery isn't performed on a whim but has valid medical and psychological motivations. Some individuals are born with genetic conditions like dwarfism or Marfan syndrome that cause limbs to be disproportionately long. These conditions can lead to discomfort, mobility issues, and difficulties performing everyday tasks, which can significantly impact quality of life. In these instances, height reduction surgery serves as a potential solution to alleviate such problems.
On the psychological side, the societal focus on height can be distressing for those at the extremes. Some taller individuals may feel their height draws unwanted attention or impedes their ability to fit societal norms. This can result in self-esteem issues and mental health problems. In such cases, height reduction surgery can be a path to alleviate these psychological stressors.
The Stages of Height Reduction Surgery
01
Initial Consultation and Essential Medical Examination
Once you make the decision to undergo your desired cosmetic limb reduction surgery, preliminary medical procedures such as radiological examinations, measurements, and other necessary tests are conducted prior to the operation. The doctor will discuss the clinical findings with you during a consultation and provide a comprehensive explanation of the surgical process. A thorough evaluation of both your physical and psychological condition will be carried out to determine your readiness for the surgery. Assuming there are no health issues that would impede the procedure and you are psychologically prepared, the surgery date will be scheduled promptly.
02 The Surgical Procedure
The surgery can be performed under either general anesthesia or local anesthesia, depending on your preference and in consultation with the doctor and anesthesiologist. The likelihood of bleeding during the surgery is minimal due to the use of a tourniquet. If necessary, blood supplements can also be administered to the patient. In summary, the surgeon will remove a portion of the femur by cutting the bone. The remaining bone fragments are then joined together using an intramedullary nail until they heal.
Step-by-step process of height reduction surgery
1- Cleansing the segment with an antiseptic solution. 2- Identifying the precise location for bone cutting. 3- Drilling into the bone to create enough space for inserting the intramedullary nail. 4- Performing the planned osteotomy on the targeted bone for shortening. 5- Carefully removing the bone piece. 6- Placing an appropriately sized intramedullary nail into the patient's bone, considering the measurements of the medullary cavity. 7- Securing the nail by inserting interlocking screws both proximally and distally. Limb reduction surgery can also be performed on the arms, but it is more commonly done on the legs. With a single limb shortening surgery, a maximum decrease of 5 cm in height can be achieved.
From Femur: A reduction of 5-5.5 cm in height can be achieved. From Tibia: A reduction of 2 to 3 cm in height can be achieved.
The first surgery is typically performed on the femur, and if the patient desires and their health condition allows, the second surgery is usually done on the tibia. However, Assoc. Prof. Dr. Yunus Öç doesn’t usually recommend height reduction surgery from the tibia because there are too many nerves on the tibia that can cause difficulty to perform the surgery healthily.
03 Hospital Stay
The duration of hospitalization is approximately 3-5 days. During this period, the patient will be accommodated in a private room with a bathroom and a sofa for the caregiver. Throughout the hospital stay, the patient will receive 1 to 2 sessions of physical therapy, where they will be taught the necessary exercises, undergo dressing changes, and receive instructions on what precautions to take.
04 The Recovery Process
The recovery process following height reduction surgery is comprehensive and lengthy, requiring several weeks to months depending on the individual case. Post-operative care is a crucial aspect that significantly contributes to the success of the surgery.
Following discharge, it is strongly recommended that patients spend their recovery period, which typically lasts 1-2 months, in Turkey. This allows them to receive consistent and intensive physical therapy and healthcare services provided by the company in the provided accommodation, ensuring a healthy recovery. During the initial 3-4 weeks, patients will require assistance from a walker and a wheelchair.
Gradually, under the supervision of a doctor, they can transition to using crutches. On the sixth week after the surgery, X-rays of the patient's legs will be taken. Depending on the results and their physical condition, they may be required to use only one crutch until the doctor advises otherwise.
A physiotherapist will guide patients through exercises and teach them stretching techniques, as well as muscle and joint movements recommended during the recovery process. It is crucial that patients do not neglect their physical therapy sessions and the prescribed exercises during this period. Failure to do so may result in health issues such as limited range of motion, joint/muscle contractures, or muscle imbalances. Patients are expected to walk unaided within 2-3 months after undergoing limb reduction surgery. Once they are able to walk with minimal assistance, they can resume their normal activities, with the exception of sports or strenuous activities, until the bone is fully healed. Driving a car is permitted 1-1.5 months after the surgery.
Following the surgery, new bone tissue will form in the area where the bone was shortened. The estimated time for complete bone healing is between 6-8 months.
05 Nail Removal Procedure
If the bone has fully consolidated in the area where the osteotomy was performed, the doctor will remove the intramedullary nail. This can be done under local anesthesia or general anesthesia, depending on the patient's preferences and in consultation with the anesthesiologist.
Understanding the Risks of Height Reduction Surgery
Like any surgery, height reduction surgery also comes with a set of potential risks and complications. These include, but are not limited to, infection, the formation of blood clots, bone non-union (where the bone segments fail to heal), nerve damage, and a reduction in mobility. It's also crucial to note that the desired height decrease might not be achieved in all cases.
Given these factors, it's vital for anyone considering height reduction or limb shortening surgery to have a comprehensive discussion with their healthcare provider. This allows for a clear understanding of the procedure, its potential risks, and the expected outcomes.
In conclusion, while height reduction surgery is a complex and potentially risky procedure, it offers a potential pathway for individuals grappling with medical conditions causing disproportionate limb length or psychological distress due to their height. The decision to undergo such a procedure should always be a well-considered one, undertaken in consultation with a trusted healthcare provider and with a full understanding of the potential risks and benefits.
Frequently Asked Questions
1- How long is the hospital stay after limb reduction surgery?
- The hospitalization period typically lasts around 3-5 days. During this time, you will receive necessary care, physical therapy sessions, and instructions on post-operative care.
2- How long does the recovery process take?
- The recovery process usually takes about 1-2 months. It is recommended to stay in Turkey during this time to receive regular physical therapy and healthcare services for optimal recovery.
3- When can I start walking without assistance after limb reduction surgery?
- Patients are generally expected to walk unaided within 2-3 months after the surgery. However, the timeline may vary depending on individual factors and the guidance of your doctor.
4- Can I drive a car after limb reduction surgery?
- You may be able to drive a car approximately 1-1.5 months after the surgery, once you have regained sufficient mobility and your doctor approves it.
5- What are the potential risks and complications of limb reduction surgery?
- Like any surgical procedure, limb reduction surgery carries certain risks, including infection, bleeding, blood clots, nerve damage, and scarring. Your doctor will discuss these risks with you and take necessary precautions to minimize them.
I wonder the reasons behind the request for height reduction surgery.