Imagine, if you will, a surgeon breaking your leg bones in four places, then attaching a steel scaffold frame to the outside of your limbs with metal pins jutting into your bones.
Every day for months you rotate screws attached to the pins in your legs. There are many moments of excruciating pain and the constant worry of infection. After that there is a grueling regimen of physical therapy. Now imagine, this was all completely voluntary — in fact, it was your idea.
It's called limb lengthening and for years the procedure was done almost exclusively to correct developmental deformities or repair damage to limbs after an accident. But more and more often the surgery is being done for cosmetic reasons to help people — primarily men — grow a little taller.
At 18 years old, Akash Shukla stood just 4 foot 11. "I would get carded all the time at PG-13 movies. It was really tough to find a date. I didn't know a single other guy who was my height and I was really insecure about it. I just felt like my height was really holding me back in many ways."
Shukla's story is a familiar one to Robert Rozbruch, the director of the Institute for Limb Lengthening and Reconstruction in New York. He estimates that between 5 percent to 10 percent of his patients come to him for cosmetic reasons, although he bristles at the suggestion that limb lengthening could be a new cosmetic frontier.
"Orthopedic surgeons don't do cosmetic surgery. It's not in our normal routine. We do this for a guy who is maybe [5 foot 2] or [5 foot 3] and well adjusted but being short is something that is very disturbing to them. When they walk into a room and they're [5 foot 2] they can't stand it. … When you talk to them you can feel the pain they go through," said Rozbruch.
And beauty buffs beware, this kind of cosmetic surgery isn't like a nose job or liposuction.
Patients in Rozbruch's practice must undergo hours of psychological testing to determine whether they are appropriate candidates for the procedure.
"We weed out the nuts, the ones who just think it would be kind of cool to be taller," said Rozbruch.
Psychologist Ellen Westrich works with Rozbruch in evaluating patients for surgery. Westrich describes a condition called short stature dysphoria where patients are deeply dissatisfied with their height.
"This is an interesting group of patients. … They tend to be extremely successful at work or very focused on their studies. You've heard of the Napoleon complex. In a way, compensating for their height gives them a heightened sense of themselves. They may be very happy with their life but being short makes them very unhappy."
So unhappy, in fact, that they are willing to undergo a very lengthy and punishing procedure.
Shukla started talking to his family and friends about having surgery three years ago.
"A lot of friends said, don't worry about your height be happy with what God gave you. But my dad always used to respond to people by saying if we're supposed to be happy with what God gave us then why dye your hair when you go gray."
Orthopedic surgeons use several different methods to lengthen legs but the most common involves breaking the bones and attaching a steel frame to the outside of the limbs. The patient is taught to turn the screws on the frame, essentially pulling their own leg bones apart about one millimeter a day.
The bone is a unique tissue in that it can regenerate itself. So when bones are separated, new tissue grows to fill in the gap. The existing muscle, nerves and arteries stretch as well. Doctors are able to add as much as three inches to a patient's height per treatment session. And the surgery is followed by intensive physical therapy.
The price tag is steep — about $120,000 — and it's not covered by insurance.
If all of this sounds a little "out there" or even a bit barbaric, consider this: Forty years ago the thought of sucking the fat out of a woman's thighs wasn't exactly mainstream either.
"As we become familiar with something, it becomes more acceptable and more routine. … This is safe and effective and it can make a big difference in someone's life," said Rozbruch.
Although he continues to have reservations about offering the surgery for cosmetic reasons, Rozbruch said he does so because like it or not "if you don't do it, they will go somewhere else." And that somewhere else can be China, Egypt, Greece, Russia or Iran where the surgery can be had for as little as $20,000 but the clinical standards can be less than ideal.
For a window into why someone would undergo such a punishing procedure, you don't have to look any further than the Web site Make Me Taller.
It's a forum for men and women who call themselves "stature seekers." Many of them have had the surgery and others are seeking help. There are online diaries and pictures that give other seekers a peek at what they're in for. The site has 1,800 members and gets about a 100,000 hits a month, according to the site administrator who described himself as a 37-year-old, graphic designer from Brighton, England. He calls himself MMT and wished to remain anonymous for this story.
In a typical post, a new member describes what it's like to consider leg lengthening.
"I'm also worried about family and friends finding out about my surgery and what they'll say … will they think I'm pathetic or desperate for going through months of pain, enduring seemingly horrendous contraptions attached to my legs and spending thousands of dollars for a few inches? and how can I disappear for about 8 months or so without seeming suspicious? or explain why I'm suddenly 3 inches taller?"
In an e-mail exchange, MMT said that he had his surgery a year ago in China. Before the operation he was 5 foot 8. After the leg-lengthening procedure, he measures 5 foot 11.
"I decided it would be a good investment for my business career and I also simply wanted to be taller … but it is more involved than a straightforward cosmetic procedure — the intention is to alter one's life, rather than just to improve ones' appearance."
Shukla is 21 years now and a student at New Jersey Institute of Technology. Post-procedure he stands 5 foot 2. Shukla said the surgery is "by far" the most painful thing he has ever experienced but "as hard as it was, as painful as it was I would do it again."
"I know it seems superficial but before the surgery I think that's all people saw was how short I was. Now I think they look at me and say, well, he's not tall but he's not that short either. It really helps with my confidence."
And what's a few broken bones compared to that.