How cosmetic leg lengthening surgeries are luring patients and courting controversy

Being tall is a stature that many men have longed for and some are turning to leg lengthening surgery to enhance their looks, but the procedure has also come with controversy.

"Impact x Nightline" takes a look into the medical trend of cosmetic leg lengthening surgeries in an episode now streaming on Hulu, the people who pursue them, and the role that height plays in society, particularly for young men.

One of those men is Hugo Ramirez, who at first glance says he could be mistaken for Dwayne "The Rock" Johnson.

Ramirez says he carries many of the hallmarks of the billion-dollar box office star. His muscles protrude from his body, while simultaneously sporting a shaved head and a rich tan. The entire package comes draped in expensive designer clothing.

Ramirez claims to be about 6-foot-1 in sneakers. But that wasn't always the case: up until early last year, Ramirez says he was just 5-foot-9; the average height for a man in the United States, according to data from the Centers for Disease Control and Prevention.

"I'm not average," Ramirez told "Impact x Nightline." "I don't like to be average."

Two years ago, Ramirez says a friend first brought up the idea of cosmetic leg lengthening. The surgery promises to add anywhere from two to six inches to your height. He was sold.

Ramirez, who'd gone under the knife for previous cosmetic surgeries, says he realized this operation would be different.

"It was breaking your legs. That was a big thing to me," Oksana Ramirez, Hugo's wife, told "Impact." "I said, 'Hugo, I don't know. I'm actually very scared.' Because…you never know what can happen, right?"

Las Vegas-based orthopedic surgeon Dr. Kevin Debiparshad, known casually to his patients as "Dr. D," has performed hundreds of leg lengthening surgeries. His practice claims he performs more cosmetic leg lengthening procedures than any individual surgeon in the country. He operated on Ramirez's upper legs in late January 2023.

Debiparshad explains that, for generations, limb lengthening surgery was limited in who it was applied to, which primarily included children, patients with deformities, and those who had suffered traumatic injuries He says as the technology advanced, patients began asking whether the surgery could be used for cosmetic purposes.

Doctors perform leg lengthening by surgically breaking the bones of either the upper or lower leg, and then inserting a telescopic rod or "nail". That device expands inside the bone with the help of an external remote control.

"The bone constantly tries to heal itself," Debiparshad said. "And then you just continue that process over the next two months [or] two and a half months" until the gap between the bones fills in." The rods are surgically removed about a year later.

Jerry Agee, a traveling nurse from Mobile, Alabama, also flew to Las Vegas for leg lengthening surgery with Dr. Debiparshad, hoping to add three inches to his 5-foot-5 frame as he says his stature made him feel embarrassed.

"I think height is an extremely important thing when it comes to just life in general," Agee told ABC News.

"I want to reach stuff in the aisles of a Walmart, and you just can't 'cause you're short," he added.

Agee is nearly three months post-surgery and says despite the intense pain and long rehabilitation, he's happy to be three inches taller.

Many experts believe that culture plays a critical role in why these procedures are being sought after.

"Those who are taller and more likely to be socially accepted, or more likely to make more money," ABC News medical correspondent Dr. Darien Sutton said.

Psychotherapist Carli Blau, PhD. said she noticed the presence of height bias in her own practice.

"A lot of women that come to my practice actually set their dating app to only allowing men over a certain height," she told "Impact."

New York City matchmaker Anna Morgenstern agreed, saying, "We see men who are taller as the alpha. It's something that we've done for thousands of years."

Despite the desire to be taller, there are some big drawbacks to leg lengthening surgery– the cost starts at around $72,000 and is also potentially dangerous, with many risks of complications.

Sutton cautions that patients looking into cosmetic leg lengthening should consider the numerous risks including, which may include "damage to muscles...ligaments and tendons, and even permanent nerve damage."

But Ramirez says his surgery and grueling recovery was still worth it and claimed to be 6-foot-1 with shoes.

Ramirez plans to get a second lengthening surgery on his lower legs this year and said he hopes to reach his "dream height" of 6-foot-3.

Ramirez says after he gets his lower legs lengthened, he's "done" with elective surgery and he's looking forward to expanding his family with his wife Oksana.

"Now it's time to have a baby," he said.

ABC News' Tara Guaimano and Tien Bischoff contributed to this report.