Limb Shortening Surgery for Women: A Detailed Clinical and Financial Analysis Report

Introduction: Conceptual Framework and Fundamentals of the Surgery

Limb shortening surgery is a surgical procedure that falls under the scope of orthopedic surgery, aimed at reducing the length of bones. The primary purpose of this operation is to correct a length discrepancy in a limb, meaning to fix cases where one leg is significantly longer than the other. The surgical intervention, by reducing the bone, aims to correct disproportionate limb lengths and restore the patient’s body symmetry. In rare cases, specific operations like spinal shortening surgery can also be performed to relieve neurological issues or severe pain. However, there are also instances where this surgery is performed for personal aesthetic concerns, such as a person’s desire to be shorter.

The most significant confusion in this field is that limb shortening and limb lengthening surgeries are often confused with each other. When “limb shortening” is searched on the internet, the vast majority of results actually present content related to “limb lengthening” procedures. Both surgeries are fundamentally based on the principle of “osteotomy,” which is the surgical cutting of a bone. However, their goals, methods, and outcomes are fundamentally different. Limb lengthening surgery involves a process where a bone is cut and then slowly and gradually separated at a millimeter level each day (distraction osteogenesis), allowing new bone tissue to form in the gap. This is a gradual process that takes months. Limb shortening surgery, on the other hand, is a single surgical operation where a section of the bone is directly removed and the remaining ends are joined with implants (plates, screws, or intramedullary nails). This is a one-time, irreversible intervention. In this report, the details of only the limb shortening procedure will be discussed, keeping this fundamental distinction in mind.

Part I: Candidate Profile and Evaluation Criteria

Limb shortening surgery is a serious surgical intervention that is not suitable for every patient. The success of the surgery and the patient’s safety require the selection of the right candidate. Candidates must undergo a comprehensive evaluation, both physically and psychologically.

Physical suitability is the primary condition for the surgery. This operation can be performed in adolescents and adults who have completed their growth process. The surgery is not recommended after the age of 50-60, especially if there is no significant limb discrepancy. If there is a height issue and this condition negatively affects the patient’s quality of life, it is recommended to plan the surgery no later than the 40s. Some sources state that it can be performed up to the age of 45-50, depending on bone density. These age limits are due to the natural decline in bone health with age. For example, the risk of bone loss (osteoporosis) that starts after age 35 increases, especially for women. Therefore, it is of great importance to perform advanced diagnostic tests such as bone density measurement before the surgery and to meticulously evaluate the suitability of the bone structure for the surgery. It is also essential that the overall health of the patient is good before the surgery, as chronic diseases such as smoking, diabetes, or osteoporosis can negatively affect the healing process.

In cases where the surgery is considered for aesthetic reasons, the patient’s psychological suitability is as critical as their physical suitability. The patient must be psychologically ready for this long and difficult process, and fully understand the potential risks of the surgery and the physical and emotional challenges that may arise as a result. While the surgery can help with problems such as low self-confidence or depression related to a person’s short stature , the long and painful recovery process can also lead to new psychological stress and anxiety. For this reason, it is recommended to seek psychological support during the pre- and post-operative period to maintain motivation and to get through the process more comfortably.

Part II: Detailed Analysis of the Surgical Procedure

Limb shortening surgery is a detailed surgical procedure performed using different techniques depending on the bone structure and the amount of shortening.

The basis of the surgery is the “osteotomy” procedure, which means the surgical cutting of the bone. During this procedure, the bone to be shortened is cut transversely through one or several small incisions. The duration of the surgery varies depending on various factors such as the patient’s age, risk status, and the amount of shortening. The 2 to 5-hour durations stated for limb lengthening surgery provide a reasonable reference point for the limb shortening procedure as well. During the surgical operation, a special device called a tourniquet is used to minimize the risk of bleeding. The surgery is performed under local or general anesthesia, depending on the patient’s condition and the surgeon’s preference, so that the patient does not feel any pain.

Limb shortening surgery is most frequently performed on the femur (thigh bone) or tibia (shin bone) to correct a length difference in the legs or for aesthetic purposes. Shortening the femur, which is the body’s longest and strongest bone, requires focusing on exercise programs that increase muscle density and strengthen the upper leg. In shortening surgeries performed for cosmetic purposes, deliberately changing the body’s natural proportion and mechanical balance is a much different situation than correcting an existing medical imbalance. The change in the forces acting on the body’s center of gravity and the balance mechanism of the muscles can increase the load on the hip and, in the long term, lead to walking disorders such as a Trendelenburg gait. This situation places cosmetic shortening surgery in a different biomechanical risk group from a medical intervention performed to correct a limb inequality. Therefore, the surgical decision and the application of the procedure should be made by a highly specialized surgeon who is an expert in all the details of body mechanics.

Part III: Comprehensive Risk Management: Potential Complications and Long-Term Effects

Like any surgical operation, limb shortening surgery carries various risks and potential complications. Understanding these risks is vital for the patient to make an informed decision.

General surgical risks such as infection, bleeding, and thrombosis (blood clotting) are also valid for this surgery. There is a possibility of developing an infection at the surgical site, experiencing excessive bleeding during or after the surgery, and forming blood clots in the blood vessels. The use of a tourniquet during the surgery reduces the risk of bleeding. However, much more serious complications specific to the operation also exist.

The risk of nerve and vascular damage is high during surgery. In femur shortening surgery, the proximity of vital structures such as the sciatic nerve and femoral artery to the surgical area increases the risk of injury. Such damage can lead to permanent numbness, tingling, loss of sensation, or limited movement.

Problems related to bone and soft tissues directly affect the long-term success of the surgery. Problems such as muscle weakness and joint stiffness (contracture) are frequently seen after the operation. Specifically, shortening the bone initiates a complex process that requires the surrounding muscles, tendons, and nerves to adapt to the new situation. Problems in this adaptation process can lead to muscle imbalances and walking disorders. One of the most common complications in the post-operative period is problems with bone fusion. Slow or improper bone fusion (non-union) can cause persistent pain and may require additional surgical interventions.

Finally, the psychological effects of this surgery should not be ignored, as much as its physical difficulties. The patient may experience psychological stress and anxiety due to the long and painful recovery process. Psychological discomfort related to height, which is the main motivation for the surgery, can turn into new psychological problems due to the difficulties of the recovery process. This cyclical relationship makes a detailed psychological evaluation before the operation and continuous psychological support during the recovery process essential.

Part IV: Recovery and Rehabilitation Process

The success of limb shortening surgery depends as much on the surgical procedure itself as it does on the comprehensive and disciplined recovery process that follows. This process is a long-distance race that tests the patient’s determination and patience.

The hospital stay after the surgery usually ranges from 2 to 3 days. In the first few days, the patient is encouraged to get up and walk with the help of a walker or crutches. This early mobility is important to eliminate the disadvantages of being confined to bed and to ensure the patient’s active participation in the treatment. Pain management is an indispensable part of this process. The pain, which can be controlled with painkillers in the first few days after the surgery, can occasionally appear throughout the recovery process.

The most critical component of the rehabilitation process is physical therapy. Physical therapy plays a vital role in preventing joint stiffness (contracture) after surgery, regaining muscle strength, and restoring normal walking ability. According to experts, a failure to fully comply with physical therapy can lead to permanent movement limitations or require additional surgical interventions. The physical therapy program progresses gradually according to the patient’s recovery speed. While exercises to maintain joint mobility are performed in the early period , muscle strengthening, balance, and walking exercises are added in the later stages. Patients with a desk job can return to work in as little as 2 weeks, while those with heavy jobs may need to wait 6 to 12 weeks. Full recovery can take between 6 months and 1.5 years, varying from person to person. A diet rich in calcium, vitamin D, and protein is also recommended to support bone health and accelerate recovery.

Part V: Cost Components and Pricing

The cost of limb shortening surgery is a complex and multi-layered structure. Pricing should not only cover the surgical fee but also all expenses during the entire post-operative process.

The pricing information in the available sources is almost entirely for limb lengthening surgery. Therefore, it is not possible to give a precise price for limb shortening surgery. However, the price ranges stated for limb lengthening surgery can provide an idea of the general cost of such orthopedic surgical procedures. As of 2024, limb lengthening surgery prices in Turkey range from €8,500 to €17,000. This is relatively more affordable compared to higher price ranges such as €35,000 – €90,000 in the United States, €25,000 – €75,000 in Germany, and €20,000 – €50,000 in the United Kingdom. For specific methods, the costs are even higher. For example, prices for limb lengthening with the LON method are stated to be an average of $20,000, and for the magnetic nail method, around $50,000.

The cost of limb lengthening surgery can be higher compared to limb shortening surgery because limb lengthening operations generally require longer follow-up periods and expensive, motorized devices. However, the main components that affect the total cost are similar for both surgeries. These components are:

Surgical Fee: Varies depending on the surgeon’s experience and expertise.
Hospital and Operating Room Expenses: Includes the hospital bed fee, operating room use, and general operational costs.
Implant and Device Costs: The cost of the plates, screws, or nails used to fix the bone.
Anesthesia Costs: The cost of the anesthesiologist and the medications used.
Physical Therapy and Rehabilitation Costs: The most important and continuous cost item of the recovery process. This expense varies depending on the patient’s needs and the number of sessions.
Check-ups and Follow-up Processes: Fees for regular doctor check-ups after the surgery.

Considering all these factors, the total cost of a surgery can be much higher than the initial price quoted. Patients should include all these additional expenses and potential loss of income during the recovery process in their budget before deciding on this surgery.

Country	Price Range
Turkey	€8,500 – €17,000
United States	€35,000 – €90,000
Germany	€25,000 – €75,000
United Kingdom	€20,000 – €50,000

Part VI: Alternative Approaches and Patient Experiences

Given the irreversible nature of limb shortening surgery, it is of great importance to evaluate alternative approaches and the experiences of other patients before making this decision.

There are no non-surgical limb shortening methods. Stretching exercises, yoga, pilates, swimming, or jumping, which are recommended for limb lengthening, can help promote bone growth. However, there is no non-surgical method to reduce bone length in adults whose bone development is complete. This emphasizes that limb shortening surgery is the only definitive solution and therefore, all risks and outcomes must be carefully considered before deciding on the surgery.

Patient experiences reveal the psychological motivation behind the surgery and how personal the outcomes can be. Patient comments on traditional health websites are usually superficial and general. However, one patient’s statement reveals the deep emotional dimension behind this decision. A woman who is 170 cm (about 5’7″) tall and “always felt tall” says she had shortening surgery to reduce her height to 165 cm (about 5’5″). This shows that the main motivation for the surgery can come from a completely personal perception of body image. While such personal perceptions can deeply affect an individual’s social and psychological life, and the surgery may be thought to have positive psychological outcomes, the difficulties of the recovery process can test this motivation.

Part VII: Finding an Expert and Verifying Information

Reaching the right expert for specific and complex orthopedic operations like limb shortening surgery in Turkey requires comprehensive research. The area of expertise for such procedures is Orthopedics and Traumatology. However, on the internet lists of doctors and hospitals, experts are usually listed under the more common name of “bone lengthening surgery” instead of “limb shortening”.

This situation makes it difficult for potential patients to get direct and precise information. Therefore, it is vital to contact an expert directly and ask specific questions such as:

“Does your doctor perform limb shortening (femur/tibia osteotomy) surgeries for aesthetic purposes or to correct a limb length discrepancy?”
“How much experience do you have in this field, and how many of these types of surgeries have you performed before?”

In major cities like Izmir, there are orthopedics and traumatology doctors and clinics specialized in this field. Sources mention institutions such as Izmir Ekol Hospital, Medical Point Izmir Hospital, and Dokuz Eylül University Faculty of Medicine, as well as various orthopedic specialists like Op. Dr. Burak Önvural, Prof. Dr. Önder Kalenderer, and Prof. Dr. Hasan Havıtçıoğlu. However, it should be noted that the information on whether these doctors specifically perform limb shortening surgery has not been confirmed and that this list only contains potential experts. The most reliable way to get accurate and up-to-date information is to contact the relevant clinics directly.

Conclusion and Recommendations

Limb shortening surgery, especially for women, is an irreversible decision with profound effects, both physical and psychological. While the potential benefits of this operation are clear, especially in correcting limb discrepancies that seriously affect the quality of life, the risks of the operation, the long recovery process, and the high cost must be carefully evaluated.

It is vital to provide a comprehensive roadmap for individuals considering this surgery:

Do Detailed Research: Fully understand the differences between limb shortening and limb lengthening surgeries and be wary of misinformation.
Undergo a Comprehensive Evaluation: Go through a series of medical and psychological tests to determine your physical and psychological suitability. Discuss in detail with your doctor how factors such as bone density will affect the potential outcomes of the surgery.
Set Realistic Expectations: Accept that the surgery is only the beginning and that the real difficult process is the intense physical therapy and rehabilitation period that lasts for months.
Evaluate Costs Comprehensively: Do not just focus on the surgical price. Account for all additional costs such as implants, physical therapy, medication, and potential loss of income.
Find the Right Expert: Consult with a surgeon who specializes in Orthopedics and Traumatology and has experience in this field. Just because a doctor is a “bone lengthening” surgeon does not mean they are also an expert in “bone shortening.” Confirm their area of expertise by asking the right questions.

In conclusion, limb shortening surgery can be a solution that makes dreams come true, but when approached without preparation, it can also lead to serious and permanent problems. The best outcome can only be achieved with meticulous research, realistic expectations, and the patient’s full participation in the process. In this journey, accurate information, empathy, and a strong doctor-patient collaboration are the most important factors for a successful outcome.

Height Reduction Surgery with Expertise and Trust with Cure Holiday

Cure Holiday stands out in health tourism as the go-to for expertise and trust in complex and delicate orthopedic surgical procedures, especially in height reduction surgery. Our goal is to help you achieve the most accurate and successful results in the most reasonable and transparent way possible.

An Approach Focused on Expertise and Trust

Height reduction surgery is a highly specialized surgical procedure, often performed for medical necessities such as leg length discrepancies, in addition to aesthetic concerns. At Cure Holiday, we partner with Turkey’s most experienced orthopedic surgeons who are focused on achieving nothing but the best outcomes in this field. We meticulously plan every detail, from start to finish, to provide our patients with a safe and personalized treatment journey.

What Sets Us Apart

Expertise at the Most Reasonable Cost: We combine high-quality healthcare with the affordable pricing advantage that Turkey offers. Our transparent packages, which include the operation, hospital, and physiotherapy expenses, prevent you from encountering unexpected costs. This allows you to focus entirely on your recovery process without financial worries.
Success-Oriented Comprehensive Service: The surgery is just the beginning. Cure Holiday is by your side at every stage, from pre-operative consultation and travel and accommodation arrangements to intensive post-operative follow-up and physiotherapy programs. We measure our success not only by the surgical results but also by our patients having a comfortable and complete recovery journey.
100% Personal Attention: Every patient’s story is unique. We are aware of the sensitive nature of height reduction surgery and assign a dedicated consultant to each patient to ensure all their questions are answered. You’ll work with a team that understands you and is by your side at every moment of your treatment journey.

With Cure Holiday, height reduction surgery is not just a physical change; it’s a comprehensive health journey that takes place with the support of a safe, comfortable, and expert team.