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  • Writer's pictureDr. Yuksel Yurttas

Choosing the Right Limb Lengthening Strategy: Femur vs Tibia Lengthening

Are you thinking about cosmetic limb lengthening surgery? It's a big step, and knowing what to expect is key. You need to choose the right method, find a reputable surgeon, and decide which part of your leg to lengthen for the best results. This article is here to help you. We'll look closely at two options: lengthening your femur (upper leg) and your tibia (lower leg). We'll talk about how much taller you can get with each one and what the recovery looks like. And, of course, we'll guide you on how to pick the best option for you, keeping in mind what you want and need.

Choosing Your Method

In deciding on a limb lengthening technique, it's important to weigh up the pros and cons of each method. Precice 2 (P2.2) and the LON method stand out for their distinct advantages. Precice 2, known for its precision, offers a less invasive procedure without the need for external frames, leading to fewer scars and a lower chance of infections. It's a big relief for many. On the other hand, the LON method is more budget-friendly while still being safe. It mixes internal nails with external frames, letting you move and even walk during the lengthening phase. Each method meets different needs, based on what matters most to you, like less visible scars, lower infection risks, or your budget, without having to compromise on safety or the results you get.

Femur or Tibia: Which Bone to Lengthen?

When it comes to leg lengthening, you have two main choices: the lower leg (tibia) or the upper leg (femur). Each option has its benefits and challenges.

Femur Lengthening: Pros and Cons

The femur is not just any bone – it's the longest and strongest in your body, stretching from your hip to your knee. It's essential for standing and moving and supports many crucial muscles and blood vessels.

In femur lengthening, the surgeon cuts the femur and puts in a special device. This device slowly moves the bone parts apart, giving space for new bone to grow.


  • More Height in One Go: Because the femur is bigger than the tibia, you can gain more height in one surgery. This means less time in treatment and quicker to your goal height.

  • Fewer Risks: The femur's size and good blood flow make complications like infections less likely.

  • Faster Recovery: The femur's strength lets you start moving and bearing weight sooner after surgery.

  • Quicker Healing: A good blood supply means the femur heals faster than the tibia, shortening your overall recovery time.


  • Early Recovery Challenges: The first week after femur lengthening can be tough. You might feel more pain and find it hard to walk. The femur is big and bears a lot of weight, so it's more sensitive at first. But after a week, things usually get easier, with better mobility and less pain, similar to tibia lengthening recovery.

  • Post-Surgery Adjustments: Another aspect to consider with femur lengthening is the adjustment period after surgery. Due to the femur's central role in your leg's structure, it might take some time to get used to the new length. This can affect how you walk or run in the initial phase.

Tibia Lengthening: Pros and Cons

The tibia, along with the fibula, forms the lower part of your leg, connecting your knee to your ankle. It's a key player in your leg's structure. Tibia lengthening, a surgical procedure where the tibia bone is carefully cut and a special device is used to slowly pull the ends apart, can make you gain up to 5-7 cm.


  • Reduced pain: Tibia lengthening is often less painful than femur lengthening as the tibia is a smaller bone and is located further from the hip joint.

  • Aesthetically pleasing outcome: Because of its position near the knee and away from the hip, changes in the tibia's length are less noticeable. This means a more natural look after surgery.

  • Shorter treatment period: Patients can typically gain up to 6 cm in 60 days through tibia lengthening. This results in a shorter lengthening phase and earlier completion of treatment.

  • Correct bowlegs (genu varum): Tibia lengthening can correct bowlegs by lengthening the tibia, improving overall leg alignment.


  • Slower healing process: The tibia takes longer to heal compared to the femur due to its location and the fact that it carries less weight during movement.

  • Ballerina Syndrome (Achilles tendon tightness): Another disadvantage of tibia lengthening is the risk of developing Ballerina Syndrome. This condition occurs when the lengthened tibia puts excessive strain on the Achilles tendon, causing it to become tight and limiting the range of motion of the ankle. This can result in difficulty with activities such as walking, running, and jumping and may require additional physical therapy and rehabilitation to manage. The Achilles tendon can be lengthened for greater tibial lengthening. Surgical lengthening of the Achilles tendon can lead to permanent muscle weakness. For this reason, we do not recommend lengthening the Achilles tendon to allow greater lengthening.

Your Lengthening Options

Option 1 – Bilateral Femur Lengthening

Maximum Lengthening Amount: 8-10 cm / 3.25-4 inches

Femur lengthening is often recommended as the first procedure for those seeking maximum height gain with a single surgery. The femur, being the larger bone, not only allows for a significant increase in height but also tends to heal faster compared to the tibia. This makes the recovery process more manageable for the patient.

femur lengthening

Option 2 – Bilateral Tibia Lengthening

Maximum Lengthening Amount: 5-7 cm / 2-2.75 inches

Bilateral tibia lengthening is a viable option if you have shorter lower legs compared to your femur and desire a more proportional look. This procedure can also be suitable if your height gain goal is within 5-7 cm range. In addition to lengthening, this procedure can also address certain deformities. For instance, it can correct bowlegs (varus deformity) or knock-knees (valgus deformity), where the legs are not straight but deviate to the sides. It can also help with rotational deformities, where the foot points inward or outward excessively.

tibia lengthening

Option 3 – Sequential Lengthening of Femur and Tibia

Maximum Lengthening Amount: 14-17 cm / 5.5-6.7 inches

If you are considering two lengthening surgeries to achieve a more proportional look or to gain the maximum possible height, you can choose to have either tibia lengthening first and then femur lengthening, or vice versa. We generally recommend starting with the femur first; however, the sequence depends on your circumstances and preferences.

Femur + Tibia lengthening

Option 4 – Quadrilateral Lengthening of Femur and Tibia

Maximum Lengthening Amount: 13-15 cm / 5.1-5.9 inches

Quadrilateral lengthening is a comprehensive and coordinated approach to limb lengthening that involves both the femur and tibia. This method is designed to maximize height gain while minimizing the overall recovery time. The process begins with surgery on the femur. Approximately 2-3 weeks after the femur operation, while the lengthening process continues, the tibia is operated on. Both legs are lengthened in the same time range and the lengthening process finishes together.

How Can I Choose the Lengthening Option For Me?

Before making a decision on a this procedure, it's key to first talk about what you're looking to achieve, your height goals, and your expectations with your surgeon. After you decide to proceed, you'll need to go through several tests and checks. One important test is the Ortho X-ray (orthoroentgenogram), which accurately measures the lengths of your tibia and femur. Additionally, your height and body proportions will be evaluated during your physical examination. This detailed information allows you and your surgeon to figure out the best plan for lengthening that looks natural and proportional to your body's framework.

We understand that this is a significant decision, and we’re here to support you. You can book a free consultation with us to discuss your options and get guidance on choosing the right strategy for you. You can contact us via e-mail at or via Telephone/WhatsApp at +905339735289.


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