Proportions of Limb Lengthening -  Part 2

Proportions can and will change after limb lengthening surgery...it's a fact.

Most people focus on just gaining their height and surviving one procedure but others won't rest until their proportions are balanced.

There are 3 main proportion ratios that determine your symmetry; arm-to-body ratio (ABR), leg-to-body ratio (LBR) and interlimb ratio (which is your tibia to femurs) (IR).

The conclusion of the research paper I referenced, basically stated a leg-to-body ratio was more important than your interlimb ratio and your arm-to-body ratio, showing evidence that a slightly higher than average LBR, aka, longer legs, was more favorable in terms of physical attractiveness and appeal.

But not having perfect proportions just doesn’t sit well with some people, as you’ll hear some people say if you lengthen your femurs, your tibias may be too short, so they lengthen those. Then after they lengthen their tibias, now their legs are too long for their arm span. So they decide to lengthen their upper arm (the humerus) and now their forearms are too short and the lengthening spiral continues. 

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Now in a perfect world, where there are no risk factors to worry about, there are 3 hypothetical steps that you could take to make you taller while maintaining perfect symmetry, which would be...

1. Lengthening the femurs - They typically handle more length than the tibia, recover faster, and affect your proportions the least. 

1. Lengthen the tibias - to balance out your IR and give you max height.

1. Lengthen the arms - although I’m not a huge fan of this, it would balance your limb ratios.
2. Then the question is what about the torso...but you know what let’s not get started even if it was a perfect world.

So coming back to reality, most of you are aiming to increase your height through 1 maybe 2 lengthening surgeries and that’s understandable. 

But if you also have a worry about proportions, have your surgeon measure your pre-op proportions to determine how much length you should go for in each lengthening plan to avoid skewing your IR & LBR too much so that it won’t be a necessity to have to go for arm lengthening to adjust your ABR. 

After all, most patients are glad enough to get through LL in one piece and retain their function vs worry about their proportions, but then again there are some out there who are limb lengthening diehards and won’t stop the osteotomies until they look like a Greek god statue or the Vitruvian man himself. 

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Now, at end of the day if you are going to only do one lengthening procedure, and you have normal proportions to start, the femurs will give you the most bang for your buck height-wise and typically have the faster turnaround in terms of recovery.

Regardless of what you decide, realize limb lengthening isn’t the same as playing with legos, it’s far more complicated with all the muscles and soft tissue involved so be sure to select an experienced surgeon and lengthen wisely my friends.