FAQs
Candidacy
Who is a good candidate for stature surgery?
A good candidate is a healthy, skeletally mature adult who understands the commitment involved and has realistic goals. Starting height alone does not determine eligibility. The evaluation considers your medical history, bone quality, alignment, flexibility, overall health, and ability to participate fully in rehabilitation.
Is there an age limit for limb lengthening?
There is no upper age limit. Eligibility depends more on bone quality, general health, mobility, and healing potential than on age alone. Every patient is evaluated individually. We have successfully treated adult patients into their 60s.
Procedure
What is stature lengthening surgery?
Stature lengthening is an elective orthopedic procedure that permanently increases height by gradually lengthening the femurs, tibias, or both. During surgery, the bone is carefully divided and an internal lengthening device is placed inside it. Over the following weeks, the device slowly creates space where the body forms new bone.
How does the PMax nail work?
PMax is a fully internal lengthening device placed inside the bone. A prescribed daily routine uses an external remote controller (ERC) to lengthen the device in small, controlled increments. The process gradually separates the bone while new bone develops in the space regenerates in the space. Because the system is internal, there are no external pins or frames resulting in minimal scarring and maximum comfort.
Will I be able to walk during lengthening?
PMax is designed to support greater weight-bearing than earlier-generation internal lengthening devices. Many patients begin walking with assistive devices as directed by the care team. The amount of weight you may place on your legs depends on your procedure, PMax nail size, body weight, X-rays, and surgeon instructions.
How does the PMax nail compare to older devices like Precice 2.2, FitBone or external frames (LON)?
Unlike older-generation internal nails (such as Precice 2.2 or FitBone) that restrict weight-bearing and often require patients to use a wheelchair during lengthening, the PMax nail is engineered for high-load capacity, allowing many patients to begin walking with weight-bearing as early as two weeks after surgery.
Many budget overseas centers use external fixators such as LON (Lengthening Over Nail)—which carry high risks of pin-site infections, severe scarring, and joint stiffness—the PMax system is 100% internal with no external pins.
How much taller can I become, and what are the lengthening options?
Most patients can gain up to 8 cm (about 3.2 inches) through femur lengthening or up to 5 cm (about 2 inches) through tibia lengthening. Patients seeking more height may be candidates for a combined or staged plan involving both the femurs and tibias. Your safest goal depends on your anatomy, flexibility, bone health, and how your body responds during treatment.
Our lengthening options allow make it possible to gain between 2.0 inches (5 cm) and 6.3 inches (16 cm) across five distinct treatment plans:
- Option 1 (Femurs Only): Up to 3.15 inches (8 cm) in a single procedure.
- Option 2 (Tibias Only): Up to 2.0 inches (5 cm) in a single procedure.
- Option 3 (Simultaneous Femur & Tibia): ~4.0 inches (10 cm total) via two surgeries scheduled 3 weeks apart (2" tibia / 2" femur).
- Option 4 (Staged Femur & Tibia): ~5.15 inches (13.15 cm total) via two surgeries scheduled 1 year apart (2" tibia / 3.1" femur).
- Option 5 (Two-Round Combined Lengthening): ~6.3 inches (16 cm total) using two rounds of combined femur and tibia lengthening separated by 1 year.
Can bow legs, knock knees, or rotational alignment be corrected at the same time?
Your surgeon will determine whether combined correction is appropriate for you. Typically, specialized cosmetic or structural alignment procedures can be performed simultaneously during your lengthening surgery:
Rotation Correction (Both Femurs or Tibias): +$10,000
Bowleg Correction (Both Tibias): +$15,000 (during tibial lengthening) or +$50,000 (during femoral lengthening)
IT Band / Proximal Fascia Lata Release: +$5,000
Bilateral Humerus (Arm) Lengthening: +$96,500 (using Precice 2.2)
Cost & Logistics
How much does stature surgery cost?
Baseline package pricing depends on the surgical plan you choose:
Bilateral Femur Lengthening: $114,500
Bilateral Tibia Lengthening: $125,000
Simultaneous Tibia & Femur (10 cm total): $229,500
Staged Tibia & Femur - 1 Year Apart (13.15 cm total): $239,500
Two-Round Combined Lengthening (16 cm total): $313,000
Is internal hardware removal included in the price?
No. Removal is a separate outpatient procedure performed after the new bone has fully healed and the surgeon confirms that removal is appropriate, often one to two years after the initial surgery.
Will insurance cover stature surgery?
Stature surgery is considered an elective cosmetic procedure and is not covered by health insurance. However, our patient coordinator team can assist you with third-party medical financing options and payment guidance.
What is included in the base price of surgery?
Base surgical packages include your PMax implants, surgical suite fees, anesthesia, inpatient hospital stay with internal medicine oversight, clinical imaging/X-rays through the lengthening phase, mobility equipment/orthotics, and daily physical therapy at the Paley Institute. Travel, local accommodations, food, extended personal care, and hardware removal are not included.
How long do I need to stay in West Palm Beach?
Plan to remain near the Institute throughout the active lengthening phase which is typically about 11 to 14 weeks, depending on the bones being lengthened and your goal. Staying locally allows you to attend required physical therapy and regular clinical follow-up. Your team will give you a personalized estimate before surgery.
Patient Journey & Recovery
What does the recovery timeline look like?
Recovery happens in stages. You will first recover from surgery in the hospital. After a short waiting period, you begin gradual lengthening and frequent physical therapy. When the target is reached, lengthening stops and the new bone continues to harden during the consolidation phase. Follow-up X-rays guide each increase in activity. Full recovery varies by procedure and patient.
The patient journey spans several phases such as the following:
- Surgery & Hospitalization (Week 0): Inpatient hospital recovery for 3 to 4 days post-op following PMax nail insertion.
- Active Lengthening (Weeks 1–12): Daily distraction using the handheld ERC device, expanding the nail by up to 1 mm per day alongside daily physical therapy.
- Early Mobility (Week 2): PMax patients begin walking with weight-bearing as tolerated using crutches or a walker.
- Consolidation Phase (Months 3–6): Once target height is reached, you return home while new bone mineralizes and hardens. You submit biweekly X-rays for remote clinical review.
- Full Functional Recovery (Months 9–12): Most patients regain 90% of functional capacity by Month 9 and return to full unassisted athletic activity, running, and higher level activity by Month 12.
How painful is stature lengthening?
The answer depends on your procedure, mobility, pain medication use, job demands, and healing shown on X-rays. Many patients can perform remote or desk-based work earlier than physically demanding work. Driving and exercise require individualized clearance. The team will provide milestone-based guidance rather than relying on a fixed calendar date.
What happens after I return home?
After active lengthening ends, the new bone continues to strengthen. You will continue prescribed exercises or physical therapy and submit follow-up X-rays on the schedule provided by your care team. Activity increases only after the surgeon reviews your imaging and confirms that healing is progressing safely.
When can I return to work, driving, and exercise?
Pain varies from person to person and changes throughout recovery. Discomfort is usually greatest soon after surgery and is treated with a personalized pain-management plan with prescribed pain medications and typically resolves within 7 to 14 days. During the active lengthening phase, patients report feeling tightness or muscle soreness similar to an intense workout rather than sharp bone pain. Custom daily physical therapy is designed to stretch soft tissues (muscles, tendons, and nerves) to keep pace with bone growth and maintain joint flexibility.
When can I run or return to sports?
Return to running and sports is based on bone healing, strength, flexibility, balance, and surgeon clearance, not a guaranteed month on the calendar. Many patients require approximately a year or longer to return to unrestricted high-impact activity, depending on the procedure and individual recovery.
Safety & International Location
What are the risks of stature surgery
Potential orthopedic risks include joint stiffness, nerve tightness, delayed bone healing (non-union), or infection.
Why choose the Paley Institute over other clinics?
Unlike general orthopedic hospitals or cosmetic private practices, the Paley Institute is a world-renowned specialized center. Dr. Dror Paley and Dr. Craig Robbins have performed more stature and limb lengthening surgeries than any team globally. Backed by specialized protocols, custom daily physical therapy, and decades of surgical innovation, our center maintains complication rates under 1% across every major category.
Can I undergo stature surgery with the Paley Institute outside the U.S.?
Yes. In addition to our flagship center in West Palm Beach, Florida, patients can receive treatment using identical surgical protocols and trained teams at our international satellite institutes:
Do I need to stop smoking or vaping?
Yes — completely, for at least 3 months before surgery. Nicotine can reduce blood flow, slow new bone formation, and increase the risk of complications. This includes cigarettes, vaping products, nicotine pouches, patches, and other nicotine-containing products. Patients must follow the Institute’s nicotine-free requirements before and after surgery.
