Monthly Archives: August 2012

Increase Height And Grow Taller Using Ankle Weights , Part II

This will be the second post I write about the subject of using Ankle Weights to increase height and grow taller. This method and idea was one of the most talked about ideas in the older boards like Giant Scientific and The Impartial Height Increase Board. You can find the first post about ankle weights by clicking HERE.

In the previous post I basically only copy and pasted a few ankle weight routines I found on the old forums and what exactly the ankle weight are supposed to do. On this post I wanted to add a few more ankle weight routines I have found and go slightly deeper in analyzing the method in general for its feasibility and effectiveness.

From the site Easy Nutrition Secrets, I wanted to copy and paste a section of the main article


In fact, most people who believe they are fully grown have the potential of being two more inches than they are. One way you can make this happen to you is by exercising with ankle weights.

As a child you had non-fused bones because they were still growing quickly. Your body was surging with growth hormone which caused rapid height increase. A child is very active and your body naturally stretches in a way that continually demands greater stature. Therefore, your body is forced to become taller.

When you began to pass puberty your bones began to harden, or fuse. The closer you came to adulthood the more limited your growth became. However, if you can simulate the exercises that forced your body to grow in the first place you will be able to gain height. This can best be done when you use ankle weights.

Working out with ankle weights is a great way to increase your height. As you work out, the increased resistance builds strength in your legs and lower torso. This resistance stretches the cartilage between your joints and in your spine, giving you added height. Also, ankle weights cause your bones to heal micro-fractures at a new length.

When you are doing a high-impact exercise such as jogging, the bones in your legs suffer tiny breaks called micro-fractures. These breaks are painless and normally unnoticeable. Without the proper enhancements, these fractures are simply repaired and your body does not grow. If you weigh down your legs using ankle weights, these fractures are extended. As your body repairs itself, it will fill in these micro-fractures with new bone matter and make you taller. The increased resistance improves your muscle tone to support your body as it is growing taller. Additionally, ankle weights stretch and increase the cartilage between your joints. Please remember not to wear your ankle weights during your high-impact workout as it may cause injury.

Many ankle weight exercises can help growth. These exercises should be strategically planned to optimize your periods of activity and rest. After you perform a high-impact exercise, like running, you should apply ankle weights. Sit in a chair with your legs hanging freely for about 30 minutes, always keeping your legs still. This makes your bones repair themselves in this lengthened position. You should apply ankle weights again about an hour before you sleep. Sit on a chair with your legs hanging freely and swing each leg one at a time. This gets your bones prepared to use the growth hormones while you sleep and it is a great preparation for sleeping with tension. To sleep with tension you will want to attach ankle weights and then sleep with your lower legs dangling over the edge of your bed. This method is more efficient because it puts all of the effort on your lower legs.

If we look at this method from one of the only credible resources on the internet, Height Forum, this main point was stated very clearly.


I think ankle weights were a method claimed by the so-called “shin-bone” routine. The theory was that using ankle weights with various positions, you can cause microfractures in the shin bone (the tibia, I suppose). The bone then heals itself thus lengthening itself.

The person who investigated it, I believe, concluded that it was useless. I may be speaking with hindsight, but the chances of creating even microfractures in the direction that you want would be next to zero unless it is done through limb lengthening surgery. Even then I wouldn’t call it micro-fractures. Just straight up fractures.

So the short answer is no. Ankle weights may increase the tensile load on your bones, thus increasing your bone density. What you get is stronger bones. The length of the bone, I’m afraid, remains the same.

Me: I couldn’t have said it better. The truth is that on the big legitimate boards like Giant Scientific and The Impartial Height Increase Board, there was a lot of talk about this idea or method years ago, from say 2007-2009. A guy named Sky came along and told everyone that he had a method that could help increase one’s height by using the principles of creating microfractures and then using ankle weights to stretch the microfractures so that the long bones will stretch out. In principle and theory, it made sense and seemed reasonable. This sky person made some big claims, got a group together, was trying to branch out a business model, and started testing his method, called the shinbone method. The shinbone method was a combination of using 1. Microfractures and 2. Ankle weights. In the end, this person named Sky never gave a definite answer and ran away to never speak with the other height seekers again. No one knew what happened to him or his site easyheight.com (or .org) I personally can’t find much about him or his site, or his ideas. I guess his theory and idea on how to increase height was not successful. 

 

Human Limb Regeneration And Height Increase Application

In my search through the medical research to find genetic or biomedical solutions towards height increase, there was one idea that I thought of which I felt needed to be considered. Looking through the internet space, there were very few resources available which also considered the idea, mainly because the method is VERY radical.

The idea is limb regeneration. Currently, there are research being done by scientists who are looking for a way to stimulate human limb regeneration. If we can through some form of genetic engineering turn on our genes to regrow our limbs, we can theoretically remove our limbs and let them regrow back and apply tensile force on the replacement limb which regrows back at the old one’s place there by allowing us to add the inches we need. Of course, the venture and idea is easier said then done.

The first question to ask is how much progress has already been made in even the idea of limb regeneration in general? So far, there has been progress in this venture.

There were threes main groups who did research on two types of animals, the zebrafish , the newt, and the salamander. I wanted to talk about the research with the zebrafish, which has been known to have the ability to regrow their fins and even heart muscle after injury. The resource used was the one from the Daily Mail UK

A group of researchers from the University of Konstanz in southern Germany said that they found out the reason why the zerbrafish can regrow lost parts so well. Gerrit Begemann is the head of the research group and states that retinoic acid is the critical compound used to restore the limbs. Taken from the written article..


Before the zebrafish’s fins regenerate, the wound is closed with multiple layers of tissue. The cells beneath the stump then lose their identity and form what is called blastema.

Researchers found that the fish uses a special genetic trick that allows the acid to control the formation of blastema, which means the animal is able to produce a store of cells that can rebuild the fin.

Retinoic acid is produced by animals, including humans, from vitamin A and can activate the necessary genes for regeneration.

It has been shown that pregnant women who do not take enough vitamin A in their diet can have underdeveloped foetuses (resource is Daily Mail UK)


For the second project, the animal experimented on was the salamander and the findings of this experiment had even more implications. The article on the scientific study was written for the journal Nature. Let me try to explain the findings as well as I can.

What is well established is that the way slanders can regenerate their limbs by formed a glob of cells called the blastema on the tip of the limb stump and new cells are believed to  accumulate on the blastema and then somehow de-defferentiate themselves so they revert back into pluripotent cells. embryonic stem cells are themselves pluripotent, which means that the cells have the ability to transform themselves into whatever type of cells they are instructed to become.

What the study showed was that the cells that accumulate on the blastema don’t revert completely back to such a embryonic young self but only partially. This is sort of good news for scientists who are trying to find a path to induce tissue and/or limb regeneration because it means they don’t have to push the limits of nature and genetics so far that they have to get cells to completely revert back to their pluripotent cells, but only partially.

Taken from the resource for WIRED


Having first added a gene that makes a fluorescent protein into the genomes of axolotl salamanders, Tanaka’s team removed from their eggs the cells that would eventually become legs. They fused the cells into new eggs; when these matured into adult salamanders, cells in their legs glowed under a microscope.

After the researchers amputated their salamanders’ legs, the legs regrew. Cells in the new legs also contained the fluorescent protein and glowed under a microscope, so the scientists could watch blastemas form and legs regrow in cell-by-cell detail.

Contrary to expectation, skin cells that joined the blastema later divided into skin cells. Muscle became muscle. Cartilage became cartilage. Only cells from just beneath the skin could become more than one cell type.

“People didn’t know if the salamanders were special because they forced adult tissues to become pluripotent, and whether we should look for factors that did that — or if, as we find now, we actually shouldn’t try to force cells back to a pluripotent state,” said Tanaka.

Whether this striking absence of pluripotency is universal is still unknown. The experiment needs to be replicated independently in other salamander species.

Me: What I personally think important to take away from this article is this part…

“This represents a parallel approach for how to make cells in regenerative medicine,” said Melton at the time. “If you’ve got extra cells of one type and need another, why go all the way back to a stem cell?”

Tanaka next hopes to decipher the genetic instructions governing blastema formation. But however the pluripotency–versus–partial-reprogramming debate turns out, her team’s development of a genetically modified axolotl as a model organism for regenerative research is significant.

(Sources are  Wired, and Scientific American)

For the last study, the newt was analyzed. A teams of researchers from Stanford looked at it. I will just copy and paste the most important parts of the article here

“”What do these amphibians have that we lack?

Some have attributed the regenerative potential, in part, to stem cells that remain in adult tissue — but there don’t seem to be enough of them in newts to get the job done. Instead, most biologists believe that, in vertebrates endowed with regenerative ability, muscle cells surrounding injured tissue temporarily regress to a more primitive state, re-entering the cell cycle and then proliferating to produce more muscle cells.

Past studies have identified a protein called retinoblastoma protein (Rb) as a key factor in getting muscle cells to differentiate, or specialize. Suppression of the Rb gene in newt muscle cells sends the cells back into the cell cycle, but this doesn’t work in mammalian muscle cells.

Blau and her colleagues proposed that, in mammals, an additional mechanism may have evolved atop the Rb pathway to confer tumour suppression. Unlocking regeneration in mammalian tissues may involve interfering with that pathway too.

The researchers homed in on a tumour-suppressor gene called Arfthat is present in mammals but not in regenerating vertebrates. Using a gene-silencing technique called RNA interference to temporarily knock down both Arf and Rb in cultured mouse muscle cells, they found that the treated cells re-entered the cell cycle and began proliferating.

When the genes’ activities were restored, the cells returned to their differentiated state. Newly generated muscle cells transplanted into living mice were able to integrate into the animals’ muscle tissue. “”

“”Ken Poss, a cell biologist at Duke University Medical Center in Durham, North Carolina, cautions that several unknowns remain in determining whether the technique will aid regeneration.

First, Poss notes, it’s still unclear whether de-differentiation is the main trick that animals such as newts rely on for tissue regeneration. Researchers aren’t sure how much of the effect can be attributed to muscle stem cells called satellite cells. Furthermore, he says, regenerating large chunks of tissue may involve recreating the connective-tissue scaffolding on which muscle cells grow — a step that’s not part of this technique. ‘”

(Source is Nature)

Me: Here is what I will conclude from looking through these 4 articles. the application of human tissue growth and regrowth is a big biotech subject that will come out in the next few decades. I wouldn’t be surprised that when I reach the age of 60 or 70 and I develop hip or knee problems that researchers would have figure out a way to allow my own body to regrow it’s own lost parts back. As for the use for the technology for human limb regeneration to be used for height increase, we can probably make the process of healing and bone regrowth go a lot faster if we get the technology go tissue regeneration figured out. We can theoretically regrow longer limbs if we wanted to grow our bodies taller. 

To learn more about human limb regeneration, please refer to the Wikipedia article on Human Limb Regeneration click HERE.

The Effect On Height And Growth Being A Vegetarian

I was listening to a podcast last night where the main speaker was interviewing this doctor about the benefits of the paleo diet when they got into the subject of what types of foods to avoid. That made me wonder what effect the Paleo diet would have on a person who has been on that type of diet when they are still young and growing. Of course the pale diet is still a very underground movement where a minority of the populate practice it as choice in lifestyle, much less know about it. So I realized that if I wrote an article about the effects of the Paleo Diet on height growth, it would not be very interesting for most people of the general population.

The biggest group to focus on was vegetarians. So the subject of this post is “What is the effect on height and growth being a vegetarian?” As always I went to google to see if there was any information on the link between between a vegetarian and one’s growth patterns. The results were few but the few answers that did show up seemed to paint a very clear picture on the effects.

One thing to remember was that from a previous article where the effects of one’s genetics was compared to one’s environmental and lifestyle influence on one’s height, it was shown that genetics played around 60-75% of the influence on one’s height. I don’t doubt that if Yao Ming was born in and grew up in an unhealthy environment where food and nutrition was in short supply and stress and other negative factors were present, he would still be very tall when fully grown.

Another past study showed the the biggest factor to one’s growth when one is still growing is the amount of HGH being released into the body by the pituitary gland. The time when the HGH is released in the highest rate was during sleep so apparently sleep was the next biggest factor that determines height. This seems to suggest that one’s diet is only the third most important factor to one’s growth and ultimate height.

Another thing to realize is that there are different type of vegetarians to consider. Some vegetarians can eat fish or eggs or milk, and other types can’t. There has been many claims that drinking milk will help the growth process and make one tall but when I did the research to find out whether getting a lot of calcium and Vitamin D will help one increase in height, some studies had concluded that the result was a negative.

The main thing to realize is that the human body is mainly made out of proteins, Proteins are compounds derived from polypeptide chains formed from cell reactions. The very function of all our genes is to make proteins. From the Wikipedia article on proteins found HERE


Proteins are essential parts of organisms and participate in virtually every process within cells. Many proteins are enzymes that catalyze biochemical reactions and are vital to metabolism. Proteins also have structural or mechanical functions, such as action and myosin in muscle and the proteins in the cytoskeleton, which form a system of scaffolding that maintains cell shape. Other proteins are important in cell signaling, immune responses, cell adhesion, and the cell cycle. Proteins are also necessary in animals’ diets, since animals cannot synthesize all the amino acids they need and must obtain essential amino acids from food. Through the process of digestion, animals break down ingested protein into free amino acids that are then used in metabolism.

Most microorganisms and plants can biosynthesize all 20 standard amino acids, while animals (including humans) must obtain some of the amino acids from the diet. The amino acids that an organism cannot synthesize on its own are referred to as essential amino acids. Key enzymes that synthesize certain amino acids are not present in animals — such as aspartokinase, which catalyzes the first step in the synthesis of lysine, methionine, and threonine from aspartate. If amino acids are present in the environment, microorganisms can conserve energy by taking up the amino acids from their surroundings and downregulating their biosynthetic pathways.

In animals, amino acids are obtained through the consumption of foods containing protein. Ingested proteins are then broken down into amino acids through digestion, which typically involves denaturation of the protein through exposure to acid and hydrolysis by enzymes called proteases. Some ingested amino acids are used for protein biosynthesis, while others are converted to glucose through gluconeogenesis, or fed into the citric acid cycle. This use of protein as a fuel is particularly important under starvation conditions as it allows the body’s own proteins to be used to support life, particularly those found in muscle.Amino acids are also an important dietary source of nitrogen.


On the wikipedia article on proteins as a nutrient found HERE

Proteins are essential nutrients for the human body. They are one of the building blocks of body tissue, and can also serve as a fuel source. As fuel, proteins contain 4 kcal per gram, just like carbohydrates and unlike lipids, which contain 9 kcal per gram.

Proteins are polymer chains made of amino acids linked together by peptide bonds. In nutrition, proteins are broken down in the stomach during digestion by enzymes known as proteases into smaller polypeptides to provide amino acids for the body, including the essential amino acids that cannot be biosynthesized by the body itself.

Amino acids can be divided into three categories: essential amino acids, non-essential amino acids and conditional amino acids. Essential amino acids cannot be made by the body, and must be supplied by food. Non-essential amino acids are made by the body from essential amino acids or in the normal breakdown of proteins. Conditional amino acids are usually not essential, except in times of illness, stress or for someone challenged with a lifelong medical condition.

Essential amino acids are leucine, isoleucine, valine, lysine, threonine, tryptophan, methionine, phenylalanine and histidine. Non-essential amino acids include alanine,asparagine, aspartic acid and glutamic acid. Conditional amino acids include arginine, cysteine, glutamine, glycine, proline, serine, and tyrosine.

Amino acids are found in animal sources such as meats, milk, fish and eggs, as well as in plant sources such as whole grains, pulses, legumes, soy, fruits, nuts and seeds. Vegetarians can get enough essential amino acids by eating a variety of plant proteins.

Protein is a nutrient needed by the human body for growth and maintenance. Aside from water, protein is the most abundant molecule in the body. Protein is found in all cells of the body and is the major structural component of all cells in the body, especially muscle. This also includes body organs, hair and skin. Proteins also are utilized in membranes, such as glycoproteins. When broken down into amino acids, they are used as precursors to nucleic acid, co-enzymes, hormones, immune response, cellular repair and molecules essential for life. Finally, protein is needed to form blood cells. Protein functions in body

Sources

A wide range of foods are a source of protein. The best combination of protein sources depends on the region of the world, access, cost, amino acid types and nutrition balance, as well as acquired tastes. Some foods are high in certain amino acids, but their digestibility and the anti-nutritional factors present in these foods make them of limited value in human nutrition. Therefore, one must consider digestibility and secondary nutrition profile such as calories, cholesterol, vitamins and essential mineral density of the protein source. On a worldwide basis, plant protein foods contribute over 60 percent of the per capita supply of protein, on average. In North America, animal-derived foods contribute about 70 percent of protein sources.

Meat, eggs and fish are sources of complete protein. Milk and milk-derived foods are also good sources of protein.

Whole grains and cereals are another source of proteins. However, these tend to be limiting in the amino acid lysine or threonine, which are available in other vegetarian sources and meats. Examples of food staples and cereal sources of protein, each with a concentration greater than 7 percent, are (in no particular order) buckwheat, oats, rye, millet, maize (corn), rice, wheat, spaghetti, bulgar, sorghum, amaranth, and quinoa.

Vegetarian sources of proteins include legumes, nuts, seeds and fruits. Legumes, some of which are called pulses in certain parts of the world, have higher concentrations of amino acids and are more complete sources of protein than whole grains and cereals. Examples of vegetarian foods with protein concentrations greater than 7 percent include soybeans, lentils, kidney beans, white beans, mung beans, chickpeas, cowpeas, lima beans, pigeon peas, lupines, wing beans, almonds, Brazil nuts, cashews, pecans, walnuts, cotton seeds, pumpkin seeds, sesame seeds, and sunflower seeds.

Food staples that are poor sources of protein include roots and tubers such as yams, cassava and sweet potato. Plantains, another major staple, are also a poor source of essential amino acids. Fruits, while rich in other essential nutrients, are another poor source of amino acids per 100 gram consumed. The protein content in roots, tubers and fruits is between 0 and 2 percent. Food staples with low protein content must be complemented with foods with complete, quality protein content for a healthy life, particularly in children for proper development.

A good source of protein is often a combination of various foods, because different foods are rich in different amino acids. A good source of dietary protein meets two requirements:

  • The requirement for the nutritionally indispensable amino acids (histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine) under all conditions and for conditionally indispensable amino acids (cystine, tyrosine, taurine, glycine, arginine, glutamine, proline) under specific physiological and pathological conditions
  • The requirement for nonspecific nitrogen for the synthesis of the nutritionally dispensable amino acids (aspartic acid, asparagine, glutamic acid, alanine, serine) and other physiologically important nitrogen-containing compounds such as nucleic acids, creatine, and porphyrins.

Healthy people eating a balanced diet rarely need protein supplements. Except for a few amino acids, most are readily available in human diet. The limiting amino acids are lysine, threonine, tryptophan and sulfur-containing amino acids.

The table below presents the most important food groups as protein sources, from a worldwide perspective. It also lists their respective performance as source of the commonly limiting amino acids, in milligrams of limiting amino acid per gram of total protein in the food source. The green highlighted cells represent the protein source with highest density of respective amino acid, while the yellow highlighted cells represent the protein source with lowest density of respective amino acid. The table reiterates the need for a balanced mix of foods to ensure adequate amino acid source.

Food source Lysine Threonine Tryptophan Sulfur containing
amino acids
Legumes 64 38 12 25
Cereals and whole grains 31 32 12 37
Nuts and seeds 45 36 17 46
Fruits 45 29 11 27
Animal 85 44 12 38

Protein milkshakes, made from protein powder (center) and milk (left), are a common bodybuilding supplement.

Protein powders – such as casein, whey, egg, rice and soy – are processed and manufactured sources of protein. These protein powders may provide an additional source of protein for bodybuilders. The type of protein is important in terms of its influence on protein metabolic response and possibly on the muscle’s exercise performance. The different physical and/or chemical properties within the various types of protein may affect the rate of protein digestion. As a result, the amino acid availability and the accumulation of tissue protein is altered because of the various protein metabolic responses.

Digestion

Most proteins are decomposed to single amino acids in digestion.

Digestion typically begins in the stomach when pepsinogen is converted to pepsin by the action of hydrochloric acid, and continued by trypsin and chymotrypsin in the intestine. Before the absorption in the small intestine, most proteins are already reduced to single amino acid or peptides of several amino acids. Most of peptides longer than four amino acids are not absorbed. Absorption into the intestinal absorptive cells is not the end. There most of peptides are broken into single amino acids.

Absorption of the amino acids and their derivatives into which dietary protein is degraded is done by the gastrointestinal tract. The absorption rates of individual amino acids are highly dependent on the protein source; for example, the digestibilities of many amino acids in humans, the difference between soy and milk proteins and between individual milk proteins, beta-lactoglobulin and casein. For milk proteins, about 50% of the ingested protein is absorbed between the stomach and the jejunum and 90% is absorbed by the time the digested food reaches the ileum. Biological value (BV) is a measure of the proportion of absorbed protein from a food which becomes incorporated into the proteins of the organism’s body.

Newborns of mammals are exceptional in protein digestion and assimilation in that they can absorb intact proteins at the small intestine. This enables passive immunity from milk.

Dietary requirements

An education campaign launched by the United States Department of Agriculture about 100 years ago, on cottage cheese as a lower-cost protein substitute for meat.

Considerable debate has taken place regarding issues surrounding protein intake requirements. The amount of protein required in a person’s diet is determined in large part by overall energy intake, the body’s need for nitrogen and essential amino acids, body weight and composition, rate of growth in the individual, physical activity level, individual’s energy and carbohydrate intake, as well as the presence of illness or injury. Physical activity and exertion as well as enhanced muscular mass increase the need for protein. Requirements are also greater during childhood for growth and development, during pregnancy or when breast-feeding in order to nourish a baby, or when the body needs to recover from malnutrition or trauma or after an operation.

If enough energy is not taken in through diet, as in the process of starvation, the body will use protein from the muscle mass to meet its energy needs, leading to muscle wasting over time. If the individual does not consume adequate protein in nutrition, then muscle will also waste as more vital cellular processes (e.g. respiration enzymes, blood cells) recycle muscle protein for their own requirements.

According to US & Canadian Dietary Reference Intake guidelines, women aged 19–70 need to consume 46 grams of protein per day, while men aged 19–70 need to consume 56 grams of protein per day to avoid a deficiency. The American and Canadian guidelines recommend a daily protein dietary allowance, measured as intake per kilogram body weight, is 0.8 g/kg However, this recommendation is based on structural requirements, but disregards use of protein for energy metabolism. This requirement is for a normal sedentary person.

Several studies have concluded that active people and athletes may require elevated protein intake (compared to 0.8 g/kg) due to increase in muscle mass and sweat losses, as well as need for body repair and energy source. Suggested amounts vary between 1.6 g/kg and 1.8 g/kg, while a proposed maximum daily protein intake would be approximately 25% of energy requirements i.e. approximately 2 to 2.5 g/kg. However, many questions still remain to be resolved.

Protein deficiency

Protein deficiency and malnutrition can lead to variety of ailments including mental retardation and kwashiorkor.Symptoms of kwashiorkor include apathy, diarrhea, inactivity, failure to grow, flaky skin, fatty liver, and edema of the belly and legs. This edema is explained by the action of lipoxygenase on arachidonic acid to form leukotrienes and the normal functioning of proteins in fluid balance and lipoprotein transport.

Although protein energy malnutrition is more common in low-income countries, children from higher-income countries are also affected, including children from large urban areas in low socioeconomic neighborhoods. This may also occur in children with chronic diseases, and children who are institutionalized or hospitalized for a different diagnosis. Risk factors include a primary diagnosis of mental retardation, cystic fibrosis, malignancy, cardiovascular disease, end stage renal disease, oncologic disease, genetic disease, neurological disease, multiple diagnoses, or prolonged hospitalization. In these conditions, the challenging nutritional management may get overlooked and underestimated, resulting in an impairment of the chances for recovery and the worsening of the situation.


Quite possibly the first thing and most important thing a person learns when they first become a vegetarian is that humans need to get proteins to live. Meat often makes up the bulk of the protein we humans get in our diet since the grain based food we eat like rice, wheat, corn, and noodles are carbohydrates. I personally have heard many people say that carbohydrates are just bad for the human body and I should just remove all carbohydrates from my diet but I could counter argue their point by showing that throughout human history, many civilizations and nations feed most of their citizens through only bread and cheese and almost no meat. That would beg the question to the modern nutritionists who talk about the evils of carbohydrate of whether one can really survive on bread and carbohydrates alone.

As we see above, proteins have too many functions that are too important. One thing that man Paleo dieters reveal is that most vegetarians are usually low on energy and get weak and tired easily. I am not sure if that is true but the need for protein is very clear. To make up for the lack of eating meat, vegetarians replace it with soy based products like tofu, beans, lentils, mushrooms, etc.

The key in my opinion is whether the vegetarian can get enough protein through the substituted source. As long as they can get the right types and amount in quantity of proteins from the meat substitutions they consume, then they should have no issues with growth at least from the diet factor since they are getting all of the essential minerals and vitamins they need.

To support this theory, we have to remember back to the multivitamin dietary supplements that are sold on the internet as a type of magic bullet to help one gain height even after the growth plates are fused. Even though they don’t work , the general theory and claimed nutrients in the supplement are accurate. Most of those types of “height increase” products are a combination of amino acids aka proteins. They are often L-argiine, L-orthonine, L-lysine, L-glutamine, and another amino acid which I can’t remember at this time.

One has to note that there are 3 main types of product that a person can ingest or inject tint their system which are believed to increase one’s height.

1. Steroids

2. Growth Hormones – (some times the growth hormones are used as steroids, but not all steroids are growth hormones)

3. Proteins – (some steroids and growth hormones are classified as proteins but not all proteins are steroids and growth hormones)

What do other people say about the growth rate and height of people who are vegetarians? answers come from resource 1 (Yahoo Answers), resource 2 (Yahoo Answers), resource 3, resource 4 (National Institute of Health).

– “No, it should not. Not eating enough does not help facilitate bown growth, but if you’re eating a well-balanced vegetarian diet, you’ll be just fine. A nutritionally deficient diet, whether vegetarian or not, will result in problems.”

– “No, your height is almost exclusively determined by your genes. Malnutrition in childhood *can* stunt your growth, but children raised on a healthy vegetarian diet achieve the same average adult height as children raised on the standard American diet.”

– “Diet has very little to do with height, unless you are malnourished. But if you’re eating adequate quantities of food and getting enough protein through beans, nuts, soy milk, etc., then not eating meat shouldn’t affect your height.”

– “You’ll grow as tall as your genes let you as long you get all the nutrients you need. I was raised as a meat eater but I’ve been a short vegan for over 10 years now.”

– ” well if your paren’ts arent tall u wont be either. just make sure you are eating some protein, such as peanut butter or supplemental drinks. you need protein.”

– “Being a vegetarian does NOT —nor will stunt your growth…Be sure to eat food that are rich in protein, calcium, and all essential vitamins and minerals.”

– “It does not. But you must consult a person very knowledgeable in vegetarianism before you fully plunge into it. This is because you must know about things like ‘ protein complementation,’ sources of vitamin B12, sources of iron and zinc etc. etc. Once you are an expert on these matters, you will find that a vegetarian diet is much healthier than a meat diet. I’ve been a vegetarian for many years, and when I ask people to guess my age, they normally guess about 20 years younger ! Go for it.”

– Resource 3 above which talks about a scientific study done on children who were on a vegetarian diet quite clearly states this quote – “These data show that a vegetarian diet is quite adequate for growth in height. The vegetarians were trimmer. They weighed on average more than a kilogram less….Another significant factor for vegetarian girls is timing, the growth spurt of adolescence is delayed in vegetarian girls. (2) This delay of the growth spurt may be beneficial”

– Resource 4 is an actual article written about a scientific study done to see the effects on height and growth rate of kids who are on a vegetarian diet which was posted on the National Institute of Health database website. The conclusions of the study is quoted here – “children from The Farm averaged 0.7 cm and 1.1 kg less than the reference median, representing only 0.1 and 0.3 SD from the reference. Thus, these children have adequate attained growth, even though it was modestly less than that of the reference population.” So there might a slight effect on dampened height if one was on just a vegetarian diet ,at least up to age 10 for the studies children.

Me: The general consensus is that genetics is more important than diet. As long as one can get the right nutrients and find a protein substitute where they can get enough protein quantity, they will grow just as tall (if not taller) than their meat eating counterpart. On average, vegetarians are thinner than meat eaters but that does not mean they have less energy than meat eaters (this claim still needs to be checked for sources that can validate this type of claim). 

What is clear is that there are some types of vegetarians who don’t eat either fish, eggs, milk, or other animal derived produced may not get enough proteins as they should and they do end up shorter than the meat eaters. 

Height Increase Through Head Implantations

There was a recent article post about how some people are choosing to add implants into their feet heels so that they can gain 2-4 extra cms in height. I had found out about this method off of the Make Me Taller boards and in the same section, there was another article that talks about some people who are also adding implants in the opposite direction, in their skulls to add a few cms.

The resource links were found HERE.

One thing to note whether the resource is even valid and whether there are medical professional who perform this type of surgery is to note that two other resources who cite this article and content are the Daily Mail UK and Switched both published the same exact article on March 31st, 2008. If we take into consideration the time differences, we see that the article are written on April 1st, so it could be that the whole thing is just an April Fools’ Joke, which it really does sound a lot like. I always try to refrained from making judgements too quickly but this method that they talk about seems a little too extreme and crazy to believe and it just seems so much reasonable to assume that the people who wrote the original article did it as an April Fools joke, and also to make fun of the former French president Sarkozy’s small stature and the claims that he tries to compensate his insecurity of his size by wearing lifts, or getting some form of surgery to correct for his height

However, when I did some more research on this doctor Luis De La Cruz, it turns out that there is some information on him and that he is part of a clinic in Madrid, Spain so maybe the guy really did develop a height increase method for potential patients by inserting head implants.

From this resource link HERE, I take a passage posted below


“…Spanish physician, Dr. Luis De la Cruz, is on the cutting edge of head transplants.

De la Cruz has invented a procedure which can add up to 2 inches to a person’s height. De la Cruz claims he has successfully completed head transplants on 17 patients.

The procedures are performed in the doctor’s clinic in Madrid, Spain. The Clinica La Luz is the only clinic in the world where patients can undergo the 90-minute operation where a small incision is made on the side of the head allowing a silicon implant to be placed between the skull and the scalp. The average implant measures 1 inch while the maximum allowed is 2 inches with the need for 2 operations. The first procedure is needed to stretch the scalp.

De la Cruz says his procedure has helped patients who are small in stature achieve enough height to qualify for professions they would otherwise be excluded from, such as stewardesses and soldiers. Unfortunately those who have long, thin heads are advised that the silicon head transplant would likely make them look too “odd”.


I do remember reading a wikipedia article about sumo wrestler potentials who supposed get head implants so that they reach the minimum height limit to become professional sumo wrestlers because  they just are below that cut off point in height. Further research turns up a few sites which seem to offer information on the surgery like the resource located HERE.

Head Implant To Increase Height

Height is of great importance in Asia-Pacific and is a major factor in employment discrimination in many governmental positions and almost any private sector job. Applicants to become flight attendants, for instance, are routinely turned down because they are a half inch too short. Apart from cosmetic leg lengthening, an extreme and risky operation now banned in most East Asian countries, there has been no solution.

head implant

In the end, I am not sure what to think or believe about this idea. It just sounds unbelievable but I guess when there is a need or problem, someone will come up with a solution no matter how weird or out there it is to make money.

Grow Taller Using Steroids – Genotropin, Somatropin, HGH, Anavar, Part II

In a recent previous post I had written about the use of steroids to increase height and grow taller (located HERE). I reread the post and realized that it was lacking a lot on true content and useful facts.

I wanted to focus on the various types of steroids and growth hormonest that are in the market today being sold legally or illegally as some solution to the height increase seeker. For the person who still have their growth plates unfused, some of the products will work and some won’t. For the person who has their growth plates fused, most of the steroids and growth hormones types won’t work. For the adult who have the fused bones, the desire to use steroids or growth hormones to increase height is far more difficult. Most people who are questioned state that it is not possible to use steroids or hormones to gain height.

Let’s first go down the list to name all of the steroids which has already been said to contribute towards height. They were anavar (oxandrolone), dianabol (Methandrostenolone), synthroid, winstrol (stanozolol), and primobolan (methanolone acetate). Almost all of these compounds are known as non-estrogenic compounds. The general consensus between steroid users and endocrinologist is that the real hormone that causes the growth plates to close is estrogen. However ,most of the other hormones in our body can aromatize into estrogen, including testosterone. While testosterone have shown in some studies to increase one’s growth rate (because it really does accelerate one;s rate of bone growth) at least when it is first used, the extra amount of testosterone in one’s system can lead to an increased amount of estrogen from aromatization causing a premature closure of one’s plates.

(Note: My recent findings have shown that for men, Testosterone seems to have only positive benefits and little negative benefits while Estrogen is linked for men to only negative benefits and little positive benefits. So the message is to create a lifestyle where one has a high level of testosterone in ones body and a low level of estrogen)

The most commonly cited non-estrogenic steroid that does not aromatize into estrogen which leads to height increase claims is anavar. There have been scientific studies where the group administered with anavar over time did grow taller than the control group. Winstrol is supposed to be also non-estrogenic and can give a rise in calcium deposition. A stronger anti estrogen such as Arimidex will be much more effective as suggested by some people.In additon, Dianabol – methandrostenolone – has been prescribed to children and toddlers and made them gain weight and grow in height while they were on. I think they would have gotten the height anyway, but Dianabol – methandrostenolone – accelerated the process. I think that steroids that do not aromatise, does only accelerate the growth till the point of your biological maximum – quote from someone else. Steroids would work if you have lower then normal test levels but if its genetics or estrogen levels thats a cause for your height extra test will just speed up the plate sealing process.

One suggestion if one uses testosterone and letrozole at the same time, they could speed up height growth until they decide they are tall enough and want their plates to close.

Another suggestion was to take an AI to lower their estrogen levels, which would keep my growth plates open for longer. AIs have been used to increase height in early mid teens and should even work in late teens provided growth plates are not sealed. An AI with a couple IUs of HGH might get you a couple inches if ran for a year.

The last suggestion was that best bet would be to combine human growth hormone – somatropin – + aromatase inhibitor so you can try to grow past your limit. will cause internal organs to grow at large doses that you need, also larger bones, and will activate any pre dormant cancerous cells. hormones and height/size are totally different – quote from some guy

The list for growth hormone names are genotropin, somatropin, Omnitrope, Nutropin, Norditropin, Humatrope, HGH (human growth hormone), IGF-1.

Natural human growth hormone is produced from the pituitary gland. The hormone goes into the human liver to release the Insulin like Growth Factor complex (IGF-1s).

The human created and manufactured version of natural HGH is called somatropin made through recombinant DNA. Genotropin is a type and brand of somatropin which is rDNA derived received in injection form for used for the the purpose of assisting children who are in the extreme lower percentile of size and growth rate to push them closer to the average size range of the general population If taken daily for over a few years, the children’s growth rate increases and they often add a few extra inches. I had previous written a post about humatrope and linked to its website. Humatrope is used as a growth rate assistant for children who are still growing but are of the size in the extreme low percentile of the general population.

One of the hardest things about trying to get genotropin or somatropin by oneself is that a lot of fake HGH is sold on the internet. It is very difficult to get the real thing. Most people who want to get real synthetic human growth hormones choose to get them from places like Switzerland or South Korea. Even then, the cost of somatropin and genotropin is usually very high. A yearly usage of the HGH compound can run one up to $30,000 and one’s insurance policy will almost never cover the treatment so it is all out of pocket for the person who wants to try the therapy themselves. Most clinical dosages for somatropin and genotropin is around the 2.5-3.9 IU but some people try to take 10 IU dosage of genotropin to see what effect there is. One person stated that “3 IUs ED and a 1mg dex EOD for 6 months should result in a height increase of an inch or more if your growth plates have not calcified.

Me: The conclusion is this. From a paper written about a 6 year study done by Stanford Medical School where kids with Turner Syndrome were administered somatropin and/or oxandrolone, the conbinative effect of the growth hormone and steroid gave the most increase in height. The point is that the the steroid and growth hormone does work in increasing height, at least with children who are still growing and who are given real stuff and treated carefully with regular checkups. As for adults who can not go through traditional bone growth anymore, that is still inconclusive. Most bodybuilders and people who use steroids strongly push young children away from using steroids mainly for fear that the non fully developed bodies will have their endocrine system ruined for the rest of their life. 

PRECICE System For Limb And Leg Lengthening Surgery

There are indeed new developments and innovation that occur in this small area of study for height increase. The main strategy at this stage that ensures that one will increase height is through limb or leg lengthening surgery but the procedure has always been rather expensive, painful, and requires a lot of time for healing and recovery. Within this year a new type of limb lengthening device was approved by the FDA and it has already been used by orthopedic surgeons in their practices.

The device is called the PRECICE System and it is developed by Ellipse Technologies Inc located in Irvine, California . The link where the press release was found on the Business Wire website located HERE. The webpage for the actual device is located HERE. The article or press release is below


Press Release:

IRVINE, Calif.–(BUSINESS WIRE)–Ellipse Technologies, Inc. (“Ellipse”) announced today that it has received FDA marketing clearance of the Company’s PRECICETM Limb Lengthening device in the United States. Limb Lengthening procedures are used to treat a number of medical conditions, including legs shortened due to congenital abnormalities, major fractures of one of the legs and shortened leg bones due to other medical diseases, such as cancer.

“Our remote control technology was a huge hit among attendees. The PRECICE System is easily recognized as a game-changer for patients suffering from limb deformities”

Ellipse has initiated clinical use of the PRECICE devices and plans an international product launch during the first half of 2012.image

Commenting on the PRECICE technology, Stuart Green, M.D., Professor of Orthopedic Surgery, University of California, Irvine, said, “The PRECICE Technology will make it possible to use externally controllable implants for patients who require bone lengthening. In the future, this technology will likely be adapted to many other orthopedic applications.”

PRECICETM Remote Control Limb Lengthening System

The initial PRECICE devices will be used in leg limb lengthening procedures of the femur and tibia bones. Rather than using adjustable external fixation systems which are attached to the leg bone through long-term openings in the skin, the PRECICE REMOTE CONTROL TECHNOLOGY provides an internal implant adjusted to lengthen the leg bones via non-invasive methods from outside the body. Ellipse and its scientific advisors believe the PRECICE devices will not only provide a less-invasive approach to these procedures but also significantly reduce the potential for complications (e.g., infections) during the healing and recuperation period.image

The PRECICE System was recently unveiled at the Limb Lengthening and Reconstruction Society (LLRS) Annual Meeting in Chicago. “Our remote control technology was a huge hit among attendees. The PRECICE System is easily recognized as a game-changer for patients suffering from limb deformities,” said Ed Roschak, Ellipse Chief Operating Officer.

Ellipse is continuing to develop the PRECICE technology for orthopedic fracture management and trauma applications.

MAGECTM Remote Control Spinal Deformity System

Ellipse has developed the MAGEC (MAGnetic Expansion Control) Technology for minimally invasive, and ultimately non-invasive, orthopedic deformity prevention and management. MAGEC Technology is a breakthrough medical device technology capable of non-invasively adjusting implants within the human body from outside the body via remote control. The adjustment of the device can also be reversed. The first application for this technology is for the treatment of spinal scoliosis in children.

With the MAGEC Technology, a single minimally invasive surgical procedure is completed. Then, during a series of routine outpatient visits, the physician will dynamically adjust the MAGEC Technology from outside the body via the MAGEC System’s External Remote Controller (“ERC”), thus eliminating the need for multiple highly invasive surgical procedures which are required with currently marketed, conventional products.

The MAGEC System is CE-Marked and Ellipse recently initiated a product launch at the International Meeting for Advanced Spine Therapies (IMAST) in Copenhagen, Denmark. Commenting on this launch, Mr. Roschak said, “The response to MAGEC from the international spine community at IMAST was profoundly positive. The vast majority of physicians told us the Ellipse breakthrough technology will be of great benefit to their patients with spinal deformity. Now, we can move forward with the international rollout of the MAGEC System.”

Ellipse Technologies, Inc. is a privately-held medical device company located in Irvine, California. The Company is focused on developing its implantable remote control technology platforms to include innovative and state-of-the-art treatments for a broad spectrum of spinal and orthopedic deformity applications, orthopedic trauma and fracture management.

The MAGECTM System is not currently available for distribution in U.S.

Contacts

Ellipse Technologies, Inc.
Tracy Pearson
949-837-3600, ext 112


Me: This new development in limb lengthening surgery is definitely a step forward for people who want to get the limb lengthening surgery for cosmetic reasons. Many of the old complication that came from the traditional device for limb lengthening is gone. It would appear that Dr. Dror Paley has already started to change his practices and methods to accommodate for this new device. One of the board member on the Make Me Taller forum sent the doctor a set of questions and Dr. Paley answered back. You can find his answers through the link HERE or by reading below.

A couple of days ago I sent an email to Dr. Dror Paley requesting an update on his pricing and information for the 2012 approved doctors list. As part of his update for 2012, he sent me the following article explaining his switch to the PRECISE system from ISKD. I hope this answers any questions that potential patients have about PRECISE.

Cosmetic Stature Lengthening: A New Breakthrough
By Dr. Dror Paley, Director Paley Advanced Limb Lengthening Institute, West Palm Beach, Florida.

In August 2011, a new implantable lengthening device, the PRECISE,  was approved by the FDA. It was developed by Ellipse Technologies, out of California in conjunction with a team of orthopedic surgeon consultants, myself included. Ellipse used an internal lengthening mechanism that they had developed for use in the spine. The major advance of this device is that it has complete rate control and can even go reverse (shortening). Inside the lengthening nail there is a magnet, which is connected to a gear box which in turn is connected to a screw shaft. Rotating the magnet rotates the screw shaft and lengthens or shortens the telescopic nail. To rotate the internal magnet there is an external actuator that is held by hand and applied to the limb. The actuator has two magnets that are rotated by a motorized system while they are held against the leg at the level of the internal magnet in the nail. It takes hundreds of revolutions of the external magnet to effect a 1 mm change in length of the nail. The actuator lengthens the nail if it is facing one way and shortens it if it is facing the other way. It takes 7 minutes to achieve 1mm. The nail is designed to be able to lengthen against a force of 80kg (176 lbs). The forces that need to be resisted inside the limb have been reported to be up to 50 kg (110 lbs). Therefore this nail is more than strong enough to lengthen the limb.

Although each nail is for one time use, the actuator can be used for many patients.  At present the FDA approved the use of the actuator only for the physicians office. This means that the patient must come in to the office daily to have the lengthening performed, including on weekends and holidays. The Precice can lengthen up to 6.5cms, although this amount may increase in future models. Our orthopedic technologist performs the lengthening for each patient daily. If there is any problem he alerts the clinical team, and the patient is seen by a physician assistant or doctor the same day. Since patients undergo daily physical therapy (PT) sessions at the Paley Institute, we coordinate the lengthening session with the physical therapy schedule. Patients have an x-ray every week to monitor the lengthening.  The x-rays are measured to confirm that the amount of lengthening that the actuator did has in fact been achieved. After the x-ray they are seen by one of our doctors or PA’s.

The PRECISE heralds in a new era for limb lengthening but especially for cosmetic limb lengthening. We now finally have a device that can be implanted with minimal incision surgery and which can perform lengthening by a remotely controlled mechanism without rate control problems. The safety factor with this device is excellent since it can be lengthened at any rate and can even be reversed to shorten the limb. Rate control should eliminate most of the complications we saw with the ISKD. At present we are the only center in the US to implant this device but we expect other centers to start using it.

Despite the ease of insertion and use, the limb lengthening process remains the same and the risks associated with limb lengthening remain unchanged. For these reasons it is still essential that a surgeon experienced in limb lengthening and in the treatment of lengthening complications be he one performing the procedure and following the patient. (see complications section below)

Recovery from Implantable Limb Lengthening

The typical recovery from bilateral femoral or tibial lengthening is as follows:

1)   surgery and hospitalization: 3-4 days
2)   distraction phase (weight bearing (WB) for transfers only; daily PT) = one day for each mm of lengthening (65 mm = 65 days);
3)   consolidation phase until full WB permitted = 1 month  in most but can be longer. The end of this phase is when the bone on the x-ray appears to bridge the lengthening gap at least on one side. WB is progressed from transfers only to full WB.
4)   Rehabilitation phase: full WB without crutches. Regaining of muscle strength and joint range of motion to normal. Usually 1-3 months.
5)   Return to sports usually by 4-6 months after surgery.

Removal of Implant

The implantable lengthening device should be removed. Although it is made of inert metal (either titanium or stainless steel), there are also other materials including rare earth magnets, etc. The moving parts also can lead to wear and even corrosion. For these reasons it is preferable to remove the device. The device can usually be removed as early as one year after surgery. There is no urgency in the timing of removal but it should be done. The removal is an outpatient procedure but does add some cost to the total costs of this surgery. It can be deferred for more than one year.

Historical perspective on implantable limb lengthening devices

I have been performing Limb Lengthening Surgery since 1986. The two main indications for such surgery are limb length equalization for limb length discrepancy (LLD) and stature lengthening for short stature. Since 1986 I have performed 13,000 limb lengthening surgeries. This is probably more than any other surgeon worldwide. The majority of these surgeries were for LLD. Over 1000 were for short stature related to dwarfism and about 300 for cosmetic reasons.

Many have asked me why over the course of the past 25 years I have not performed more cases for cosmetic reasons.  The primary reason was that the magnitude of the procedure and its complications were out of proportion for a cosmetic procedure. I therefore was very selective and careful and worked out the safe parameters and methods for achieving stature increase for cosmetic reasons.  That has all changed now with the Precise device. The rate control offered by this method finally makes the procedure more in proportion to a cosmetic height gain.

My history with cosmetic lengthening for stature 

I started with the Ilizarov method for lengthening of both tibias in 1987 and soon after switched to the lengthening over nail method I had developed in 1990. Although my results were excellent, the scars, the pain, the suffering, the pin site infections were not conducive to a cosmetic procedure. I sought a fully implantable lengthening solution.  When the Alibizzia nail, developed by Guichet became available I worked with the French company that made the nail to develop a tibial lengthening Albizzia for stature lengthening. I started using this in 1996.  The severe pain experienced by patients from the 15° rotation of the thigh through the break in the bone, as well as several implant failures lead me to stop using this non-FDA approved device. In 2001, when the ISKD, developed by Cole was approved by the FDA and marketed by Orthofix became available, I was the first surgeon after Dr. Cole to implant this device. I thought that this was going to be the panacea for cosmetic lengthening. I have since performed over 350 ISKD implantable limb lengthenings, more than anyone in the world. Many of these patients were ISKD’s for cosmetic stature lengthenings.  The surgery was minimally invasive with few scars. The problem was rate control. The ISKD lengthening is dependent on movement. Therefore it can lengthen too quickly, too slowly or at the desired rate of 1mm per day. Over 50% of cases lengthened too quickly, 20% too slowly and only 30% at the desired rate. I was a consultant for Orthofix and advised them since 2001 that they need to redesign the mechanism to achieve rate control. Lack of rate control lead to most of the complications such as muscle contractures, nerve injury, poor bone formation, etc. Furthermore there were many malfunctions of the mechanism, which for unexplained reasons would fail to lengthen in the middle of the distraction phase.  This lead to increased numbers of procedures to treat complications. For stature patients this also meant increased costs. I learned to work with the ISKD to minimize complications and became an expert at the treatment and prevention of these complications. My final results due to my diligence were excellent in almost every patient. The ISKD was the only FDA approved device and was the best implantable lengthening device that we had in the USA. The ISKD, the Albizzia and the Fitbone are all what I call first generation lengthening nails. They all suffer from significant mechanical and other problems.
On December 1, 2011, I implanted the first 3 Precice nails. Although it is too early to tell the results, I can attest to the perfect rate control in these three cases and the complete lack of pain compared to the ISKD and Albizzia. While the procedure for implantation was the same with few and very short incisions (minimal scars) the postoperative course thus far has been much more comfortable for the patients. I think this difference is due to two factors: rate of lengthening control and no rotatory movement through the osteotomy site. I will continue to post up to date results for this new technology.

Cosmetic Stature Considerations and FAQs about Implantable Limb Lengthening

(the following represents the author’s opinion based on his personal extensive experience with limb lengthening in general and with implantable limb lengthening)

Overview of Costs

Cosmetic surgery of any kind is not covered by medical insurance. Therefore cost is probably the number one limiting factor for most individuals seeking cosmetic stature lengthening. Costs vary by country, center, surgeon and technique. The cost of the device contributes a lot to the cost of the procedure. External fixators while expensive when new can be reused. Therefore the cost of reused external fixators is very cheap. The remaining costs are related to the cost of healthcare in the hospital where the surgery is to be performed. For this reason many patients choose to go overseas for treatment. Although there are some credible and safe centers for stature lengthening in other countries, there are also many centers where you put yourself at risk of disaster and permanent disability. I have kept silent for many years while patients from many centers all over the world have made their way to me to fix the complications they developed in some of these international centers. Keep in mind that since this surgery is very lucrative it is open to abuse all over the world including in the US. It is very difficult for the consumer to discern where to go. All limb lengthening surgeons or centers are not the same. Just because it is cheaper does not mean that the patient will get the desired result. I have come to the conclusion that in many cases you get what you pay for. While the cost in the US is higher the safety factor is also proportionally higher. In the past 5 years I have seen and operated upon 20 American and foreign patients who went to have cosmetic stature lengthening at overseas less expensive centers. The cost to reconstruct and ‘rescue’ their limbs was as high or higher than the cost to undergo the procedure in the US in the first place. The final result although improved after I operated upon these patients is not as good as if I had done the original surgery.

Implant costs

The implant cost of the ISKD in the US costs is $13,000 per unit. The Precice currently costs the same amount. That is subject to change. Therefore just the cost of the implants for bilateral implantable lengthening implants is $26,000. Please note the cost quoted is not the cost of the surgery. It is the cost of the implants alone.

Surgery cost

The cost of a bilateral femoral or tibial lengthening at our center can be obtained by contacting us at www.PaleyInstitute.org or www.limblengtheningdoc.org
The medical costs of bilateral implantable limb lengthening surgery is broken up into inpatient costs, outpatient costs, and rehabilitation costs. Inpatient costs is the actual cost of surgery and hospitalization. This includes: the surgeon’s fees based on the list of surgical procedures done; the surgical assistant fees; the hospital fees for the operating room, recovery room, and the number of days in hospital which also includes the implants used (including drugs such as Botox), the type and duration of postop analgesia (e.g. PCA or epidural), inpatient physical therapy and other miscellaneous charges. Outpatient costs include the number of clinic visits and the x-rays taken at each visit. Rehabilitation costs include the number of daily outpatient physical therapy sessions. These inpatient, outpatient and rehabilitation charges vary from patient to patient and from technique to technique.
For example: with the ISKD it is necessary to do additional procedures to prevent complications in case of a runaway nail; e.g. we routinely lengthen the fascia lata and the biceps tendon, decompress the peroneal nerve and injected Botox into the quadriceps muscles to prevent muscle spasm and pain. With the Precice we do not need to do any of these prophylactically, with the exception of lengthening the fascia lata in some cases.

Amount of stature gain

Most patients desire 3 inches (7.5cms) of stature gain and some more than that. The Precise can lengthen up to 2.55 inches (6.5 cms) at present. This may change in the future. Patients who want more than this should consider a second lengthening of the other bone (femur 6.5cms and then tibia 6.5cms). The total height gain with this strategy is 5.1 inches. Of course the cost of two lengthenings is twice that of one lengthening. With the ISKD it was not safe to lengthen more than 5cms because of the risk of too rapid lengthening. The limits with the Precice will be the patients soft tissues. As long as patients can maintain good range of motion they can continue lengthening until the maximum of the nail (6.5cms). A major advantage of the Precice is that the lengthening can be stopped at any time without additional surgery. With the ISKD the lengthening cannot be stopped without surgery until the total lengthening of the nail has been achieved.

Height requirements

I used to restrict stature lengthening according to maximum height criteria. I currently don’t have a maximum height threshold. The reason for this is that the risks and complications are independent of starting height. Furthermore the motivation to do this surgery, which in most people is called Height Neurosis or Height Dysphoria is also height independent. I have seen patients who are 5’10” just as bothered by their height as those who are 5’ tall.  Psychological profiles of such tall and short patients were the same and the final result was the same. Therefore I don’t feel there is a reason to restrict this surgery by height.

Psychological Considerations

I also used to use a psychologist to evaluate all my patients before surgery. After more than 20 years I have gotten fairly good at doing this evaluation myself. The purpose of this evaluation is to make sure we are not operating upon patients with a body dysmorphic psychosis as well as to make sure that patients have the proper support required to undergo this procedure. Research we did on the psychological evaluation before vs after lengthening, showed that patients were happier after the lengthening and that the body image problems they had before surgery went away. Based on these results I am now making this surgery more available to prospective patients.

Disability during lengthening

Unlike other cosmetic procedures this stature lengthening is temporarily disabling to the patient. Furthermore the risks of this procedure can leave a patient with a permanent loss of function, range of motion and disability. During the lengthening the patient is in a wheelchair and dependent on others for many functions. Therefore cosmetic stature lengthening patients need support from friends or family or else need to hire a caregiver.

Weightbearing

During the stature lengthening with an implantable device, the patient should not be full weightbearing (WB). The rod inside the bone needs to support the entire weight of the patient while allowing the bone to heal. Once the bone is healed there is no problem with WB. Irrespective of which implantable nail is used the consideration regarding WB should be the same. All of the implantable nails are about the same strength. I have seen several nail failures as well as failure to heal related to premature WB. I permit WB with a walker for transfers from bed to chair and chair to toilet, etc. Once the lengthening is completed I do not allow full WB until the lengthening gap shows bony bridging on the x-ray. I hear all the time about other surgeons who permit full WB with crutches earlier. I also have seen the failures I described above sometimes because premature WB was permitted.

Unexpected problems, complications and costs

No one wants unexpected problems, complications and costs. For these reasons I am very conservative regarding many aspects of the limb lengthening process. I try and anticipate problems and prevent complications. Many complications lead to additional surgery and therefore to additional costs. The following is a list of the more common complications:
Premature consolidation: in this complication the patient bone bridges the gap and prevents further lengthening. Premature consolidation (PC) can occur with any method if the patient is a very rapid bone healer. The patient in these cases is able to make bone faster than the speed at which the bone is being lengthened.  The only way to prevent this is to speed up the lengthening intentionally for a week or two. The Precice nail with its rate control allows the surgeon to do this. If premature consolidation does occur it requires an outpatient small surgery to rebreak the bone through a tiny incision.
With the ISKD and Albizzia premature consolidation was a well recognized complication due to the lack of control of rate of lengthening. Since lengthening in both of these devices occurred by movement through the osteotomy site and since movement through the osteotomy site can cause pain and muscle spasm, the patients muscles sometimes would prevent the movement and therefore the lengthening from occurring. In other cases both the ISKD and the Albizzia have had broken mechanisms that fail to lengthen during the distraction phase leading to PC.  The treatment in these cases was to not only rebreak the bone but also to change the device to a new device. Although in each such case the company provided a new device at no additional cost, the patient still had to bear the cost of an additional outpatient surgery.

Delayed or failure of consolidation

Slow or failed bone healing can occur with any lengthening surgery. This complication can usually be prevented by making drill holes at the level of the planned osteotomy before reaming the bone. This is a technique I introduced in 1990 with the lengthening over nail method. Stable fixation is also important so the choice of nail length and diameter are important as well as the level of the osteotomy. Even the type of osteotomy affects the rate of bone healing. Cutting the bone with multiple drill holes and an osteotome is the most minimal invasive way while using an intramedullary saw or performing an open osteotomy have higher failure rates. All of these are surgeon controlled parameters and are based on surgeon knowledge and experience. Choosing the wrong level or method of osteotomy or the wrong diameter or length of implant can significantly impact the result. Perhaps the most important parameter however is the rate of distraction. Lengthening too quickly can lead to delay or complete or partial failure of bone formation.

Too rapid distraction is the most common cause of poor bone formation with the ISKD. This is not a problem with the PRECISE since it has complete rate control. Poor bone healing can be recognized during the lengthening process. Once it is recognized the rate of distraction should be slowed. Slowing the distraction is difficult with the ISKD. It requires the patient to stop physical therapy, get into bed and decrease mobility and wear a brace from the hip to the ankle. With the Precise the lengthening can be reduced to any level or even stopped. If despite these changes the bone healing remains poor, the lengthening can be reversed until better bone formation is seen. The bone can then be relengthened. This can only be done with the Precise. Going reverse is not possible with the ISKD, Albizzia or the Fitbone. This is a huge advantage that was only possible before with external fixation.

Delay or failure of bone formation can delay weightbearing and increase the period of disability and recovery. Furthermore it can lead to the need for surgery to get the bone to heal. Such surgery requires a bone graft and is not a small operation and can be quite costly. Therefore having a device like the Precice that can prevent or treat the problem is a major advance.

Nerve injury

Nerve injury can occur with any lengthening surgery but is usually uncommon if the rate of distraction does not exceed 1mm per day and if the amount of lengthening is restricted. Rate control is the most important factor to prevent nerve damage. Recognition of nerve symptoms is important. The lengthening should be stopped or slowed in such cases. If any motor symptoms (weakness or paralysis of muscles) occurs a nerve decompression should be done as soon as possible. This is a small outpatient surgery. In most cases it is the peroneal nerve that gets into trouble. It is important that the surgeon know how to decompress this nerve to prevent foot drop. Delay in decompression can lead to permanent foot drop.

The ISKD too rapid distraction has lead to nerve complications in some patients. For this reason I will not lengthen more than 5cms with the ISKD. With the Precice and complete rate control, nerve injury should be much less common.

Muscle contractures

Muscles normally get tight with lengthening. A muscle contracture occurs when a muscle gets tight enough to prevent a joint from moving through its entire range of motion. To prevent muscle contractures physical therapy (PT) is essential. The patient should do daily stretches of the muscles and joints at risk. E.g. knee joint and quadriceps muscles for femur lengthening and ankle joint and Achilles tendon for tibial lengthening. In addition to formal PT the patient should do their own stretches at home several times per day. PT is essential to the lengthening process. It is however expensive. I will not consider doing a lengthening if a patient is not willing to do PT. This is not an option for reducing cost. Too rapid distraction with the ISKD made PT even more difficult. We frequently had to suspend PT to slow the distraction. We also had to fight muscle spasm due to the constant bone movement with the ISKD. For this reason we started using Botox to prevent spasm with ISKD. Botox is very expensive. It is usually not necessary if the rate of distraction is controllable. Once again the controlled rate of lengthening with the Precice makes the risk of muscle contractures and muscle spasm less. I do not routinely use Botox with the Precice which is another cost savings. The Precise does not obviate the need for PT.  Maintaining range of motion and preventing contractures during lengthening decreases the rehabilitation time to return to normal function after the lengthening is finished. A fixed contracture of the knee or ankle can lead to disability and the need for more prolonged PT and the expenses associated. If despite additional PT the contracture does not resolve additional surgery to lengthen muscles, tendons and fascia may be required. I try and anticipate this and prophylactically lengthen certain soft tissue structures to prevent contractures. If this is done at the initial surgery the additional cost is small. If soft tissue lengthening surgery is required at a later date the cost is much higher since one also has to pay for the hospital costs.

Fibular complications

With tibial lengthening the fibula has to be lengthened too. The implantable lengthening device only lengthens and fixes the tibia. The fibula has to be fixed to the tibia so that it lengthens together with it. If the fibula is not fixed or not fixed adequately it will not lengthen as much as the tibia and will lead to severe consequences including subluxation and arthritis of the ankle and flexion contracture of the knee. The method of fixation is critical. Many surgeons only fix the lower end of the fibula to the tibia. This can lead the fibula to prematurely consolidate and to pull down and dislocate from the tibia at its upper end. It is important to fix the fibula at both ends. With external fixation the fibula can be fixed with the wires of an external fixator. With implantable lengthening the fibula must be fixed with screws to the tibia; one screw at the upper end and one at the lower end. The angle, level, position, diameter, and type of screw are all important. E.g. a common mistake is to put the screw in horizontally between the two bones. This is not strong enough to prevent the fibula from pulling away from the tibia at the ankle. This is very subtle and even a few millimeters of difference in length of the fibula at the ankle lead to short term and/or long term consequences for the patient. Removing a segment of the fibula to prevent the fibula from not separating is another common method that should be abandoned. It leads to a nonunion of the fibula which can lead to a stress fracture at a later date in the tibia. Furthermore it usually does not prevent the fibula from pulling away from the tibia. Therefore fibular complications have nothing to do with the type of implantable lengthening device but rather with the method the surgeon chooses to fixate the fibula to the tibia and the method of cutting the fibula bone.

Me: I sincerely wanted to thank the guys on the Make Me Taller boards for being so proactive and inquisitive on finding out about the latest developments in limb lengthening surgery. They have made my life a lot easier when I am scouring through the internet to see what methods and techniques are available at the current time. They really know what they are talking about and are probably the best group of people to talk to if one decides to go with the route of increasing height by going through with the limb lengthening surgery. Total cost is said to be $90,000 US dollars.