It's hard to believe that cosmetic surgeries still have the ability to elicit shock from the general public. We’ve seen many trend cycles—from Kardashian-inspired Brazilian butt lifts (BBLs) to bombshell breast enhancements and face-enhancing buccal fat removal. The latest cosmetic enhancement trend might be a bit extreme for some, but it has steadily climbed in popularity. What might this trend be? Leg lengthening.

Dr. Shahab Mahboubian, an orthopedic surgeon located in California, and specializing in limb lengthening and deformity correction surgery, describes leg lengthening as breaking the bone and implanting a precise nail. This nail interacts with a magnet that is held on the leg three times a day for three to four months. A person's height lengthens one millimeter each day until the desired height is achieved. Nails are removed after a year.

Limb lengthening procedures have commonly been used to correct deformities, but  Dr. Mahboubian claims “the main reason now is for cosmetic reasons.” After the surgery, patients often have to recover using a wheelchair and undergo months of physiotherapy to help muscles adapt. The procedure was first developed in the 1950s by Soviet orthopedic surgeon, Gavriil Ilizarov, in a bid to treat complicated bone fractures and deformities. The first cosmetic leg-lengthening surgeries began to appear in the late ’80s across Europe. Today, Dr. Mahboubian alone is performing twice as many of these cosmetic surgeries as he was three years ago. As of 2020, centers in the US, Germany, and South Korea carried out the procedure between 100 and 200 times a year, while Turkey, India, Spain, and Italy performed between 20 and 40 a year. In the US, procedure prices range from $75,000 to $280,000.

From 2019 to 2021, a load-bearing nail constructed out of stainless steel that enabled patients to walk immediately post-surgery was used for the procedure. However,  these were recalled after evidence emerged that the steel might corrode. Multiple problems can occur when getting the surgery. Speaking to this, Dr. Kevin Debiparshad of the LimbplastX Institute in Nevada, claims the “rate of complications ranges between 2% and 3%,” however, they can be severe—ranging from infection, nerve damage, joint stiffness, delayed bone healing, deep vein thrombosis, and pulmonary embolism. China even outlawed leg-lengthening surgeries in 2006 after a spate of botched operations was reported.

The pursuit of cosmetic limb lengthening is driven by various individual motivations. Dr. Debiparshad explains that for many of his patients “height is often considered an important aspect of beauty and attractiveness, and by achieving a desired height, individuals may feel more confident and satisfied with their appearance.” Dissatisfaction with height can affect a person's psychological well-being. For example, Leon, a 21-year-old man from Germany, who has shared his experience with leg-lengthening surgery with his 82,900 followers on TikTok (@le_tremba), has undergone three surgeries on his upper legs and is scheduled to undergo three more on his lower legs. Before undergoing the surgery Leon stood at 5’7.9" and is now 6’. His goal is to reach 6’2.8". When BeautyMatter spoke to Leon, he explained that “I was depressed about my height” and he acknowledged “In life, there are worse things like cancer, but for me, height was a problem.” Despite the “very painful, very hard” process and having “to learn everything again, walking and standing,” Leon is happy with his decision to undergo these surgeries, saying that changing his height will help him to “reach everything in life” because “you have to be healthy in your brain; not depressed.”

Dr. Debiparshad states that some people “view cosmetic limb lengthening as an investment in their professional lives.” Healthcare network BodyLogicMD surveyed over 1,000 professionals and found that height can influence how people feel about work. Men who said they were taller than average men, or at least 5'11", as well as taller than average women, said they were taken more seriously at work than their shorter colleagues. “By increasing their height, individuals may believe they can improve their chances of career advancement, command more respect in the workplace, and enhance their overall confidence and assertiveness in professional settings,” he adds. Historically, height and stature are aligned with the perception of masculinity. When speaking with Leon, one of the main reasons for his desire to undergo surgery was because he was depressed because “in my world, a man should be tall.” A study conducted in Sweden and published in the American Journal of Psychiatry found for every two-inch increase in height in men, the risk of suicide decreased by 9%—suggesting that men are undergoing this surgery, to  "better" themselves.

The cosmetic surgery is dramatically more popular among men than women. Dr. Mahboubian claims the ratio of those receiving the surgery is 80% men and 20% women, and one main reason for this is that “women often look for a tall man, but men don’t mind if women are on the shorter side.” This could indicate why the amount of men versus women opting for the procedure is larger. The claim is backed up by the National Library of Medicine, which argues that “body size in men can index dominance and resource-holding potential,” and that “women generally indicate preferences for men taller than themselves.” Linking back to human biology, shorter-than-average men “exhibit the lowest rates of both social and reproductive success,” claimed by the National Library of Medicine. According to a study on online dating, shorter men need to earn more money to be deemed as equally attractive as taller men. On dating apps such as Hinge, users have to include their height and can adjust settings so that only people of certain heights appear as match options. There has been an ongoing debate around men lying about their height, with GQ finding in 2023 that 27% of men have lied about their height on dating apps.

The pursuit of manliness is often a factor in men seeking out leg-lengthening cosmetic surgery; they undergo extreme pain, spend large sums of money, and face months of recovery so that others, as well as themselves, can perceive them to be more manly. A driving force for people who want to go through leg-lengthening cosmetic surgery can be attributed to the positive accounts by those who have undergone the process—like Leon who posts positive and motivational content, and Dr. Mahboubian who says that he “always asks patients if they would do the surgery again all over again, and they always say yes. It's worth the time commitment and the physical investment because you get taller forever!”

For many, undergoing this extreme surgery is akin to getting a nose job or a breast augmentation—they are making a change that will increase their confidence. It seems that the desire to undergo the procedure is only increasing as it gains more mainstream media attention. Could this be the next big cosmetic surgery trend