Who requests this operation?
The majority of people who seek this surgery are unhappy with their body image. Body image is the way we perceive ourselves. As it relates to height, it is the way we perceive our own height and our body proportions (limb length relative to trunk length).
The psychologist that I worked with for over 20 years and who evaluated almost all of my patients with this condition between 1988 and 2008, Dr. Walter Windisch, called this condition Height Dysphoria (Dysphoria literally means unhappy, the opposite of euphoria). In other words unhappy with your height. Another term that has been used is the name Dr. Paley gave it: Height Neurosis.
Some patients also have Body Dysmorphic Disorder. They usually also need psychological support and medication but may be candidates for this surgery. Psychiatric consultation may be warranted in this group.
What is the relationship of height to Height Dysphoria?
While a person’s actual height is related to the condition there is no height threshold under which you cannot suffer from height dysphoria. Most of us would assume that you could only suffer from Height Dysphoria if you are ‘short’. The problem is that the perception of who is short varies from person to person. That threshold differs along racial, national and cultural lines: 5’10” (178cm) is tall in India but short in Holland.
The following anecdote illustrates the point: A man flew all the way from Holland to see me regarding stature lengthening. He was 5’11” (180cm) tall. He said that since he was a teenager he has suffered from feeling short. He is the shortest male in his family and even his sister is his height. All of his friends are much taller. He reminded me that the Dutch are the tallest people in the world. He is the same height as me. I have never perceived myself as short nor have any of my family or friends. I, therefore, had difficulty considering him for stature lengthening. I sent him for psychological evaluation. The psychologist report showed he suffered from the same body image problem as all of the other patients we had evaluated. Despite his seemingly tall height, he suffered from Height Dysphoria.
When we studied the relationship of starting height to the diagnosis of Height Dysphoria we found that patients starting height varied from 4’10” to 5’11” (147 – 180 cm) for males and 4’6” to 5’8” (137 – 173 cm) for women. While more of the patients were at the lower end of this spectrum, the fact that some were at the upper end clearly demonstrated that height is not the primary problem. The primary problem is the psyche’s perception of height and proportion. We call this body image. Stature Dysphoria is a body image disorder. The patient perceives himself or herself as short irrespective of the actual height and irrespective of how others see them.