Height Surgery: What It Is, What It Costs, and How to Choose a Surgeon.

The result is permanent. The new bone that forms during the procedure is your own natural bone, and once it hardens, it is as strong as the bone you were born with. The technique, distraction osteogenesis, has been used by orthopedic surgeons for decades to treat limb length discrepancies and reconstruct bone after trauma. What has changed is the hardware. Modern height surgery uses an internal telescopic nail placed entirely inside the bone, replacing the external metal frames that once defined the procedure.

This page explains how the procedure works, what it costs, who qualifies, and the specific questions to ask before choosing a surgeon. For a detailed look at exactly how many inches you can expect, see our guide on how many inches you can gain. For the companion overview of the leg lengthening procedure, see our dedicated page.

How Height Surgery Works

Height surgery works in four phases: the surgery itself, a gradual lengthening period, a bone-hardening period, and eventual nail removal. The full process takes 6 to 12 months per bone segment.

The Surgery

The surgeon makes a controlled cut in the bone, called an osteotomy, through small incisions, then inserts an internal telescopic nail into the marrow canal and secures it with screws. The procedure is performed under general anesthesia and typically takes 1 to 2 hours per bone. There is no external hardware after surgery. Most patients are discharged the same day but some stay one night in the hospital.

The Lengthening Phase

Lengthening begins about 7 to 10 days after surgery. The patient holds an external remote control device against the skin, which activates the internal nail to extend approximately 1 millimeter per day, roughly 1 inch per month. As the two bone segments separate, the body grows new bone in the gap. This phase lasts 2 to 3 months and requires physical therapy throughout to keep muscles and joints flexible.

The Consolidation Phase

Once the target height is reached, the new bone hardens over 3 to 6 months. Patients gradually return to full weight-bearing during this time. Most are walking without crutches within 3 to 4 months of finishing the lengthening phase.

Nail Removal

The internal nail is usually removed 12 to 18 months after the original surgery in a short outpatient procedure. Removal is recommended, though some patients leave the nail in place if it causes no discomfort.

Who Qualifies for Height Surgery

Candidates are healthy individuals who have finished growing, confirmed by an X-ray showing closed growth plates. There is no minimum height requirement. Patients range from those who are clinically short to those of average height who want a meaningful change. The procedure is not appropriate for people with active infections, uncontrolled medical conditions, severe osteoporosis, or a history of smoking, which impairs bone healing. Only a consultation with the operating surgeon can confirm candidacy.

What Height Surgery Costs

Height surgery is a significant investment, and the total varies by surgeon, technology, and what the quote includes. The most important question is not the price. It is what the price covers. Some practices quote a base surgical fee that excludes the implant, anesthesia, hospitalization, physical therapy, and follow-up. Others publish all-in pricing covering everything from consultation through nail removal.

Premier Limb Lengthening publishes transparent all-in pricing for every procedure type, including both PRECICE Max and PRECICE 2 options. Insurance does not cover cosmetic height surgery. Financing is available for qualified applicants.

PRECICE Max vs. PRECICE 2: Why the Nail Matters

Not all internal nails are the same, and the difference affects both your result and your cost. The two devices used in the United States are the PRECICE Max and the PRECICE 2, both made by NuVasive. The PRECICE Max is the current-generation nail, with a larger diameter, greater lengthening force, and improved durability. The PRECICE 2 is a previous-generation nail that remains in clinical use and costs less.

Both are legitimate options. The right choice depends on your anatomy and your surgeon’s assessment. What matters is knowing which nail a quote is based on before comparing prices between practices. A lower quote may reflect the older nail rather than a better value. Premier Limb Lengthening offers both and recommends the device suited to each patient’s clinical situation.

Risks of Height Surgery

Height surgery is major surgery, and complications are possible. The most common are joint stiffness, muscle tightness during lengthening, and slower-than-expected bone healing, all typically managed with physical therapy and monitoring. Less common but more serious risks include nerve injury, infection, and hardware failure. Risk rises with greater lengthening distances, which is why experienced surgeons recommend conservative targets of 2 to 3 inches per bone. For the complete picture of benefits weighed against risks, see what you gain and what you risk.

The single most important way to reduce risk is surgeon selection. A surgeon with fellowship training in orthopedic trauma has managed hundreds of complex bone injuries and reconstructions before performing a cosmetic case, which is exactly the depth of experience needed if a complication arises.

Questions to Ask Before Choosing a Height Surgery Practice

The surgeon matters more than any other factor. Ask every practice you consider these questions:

• Who performs the surgery? At some practices a consulting surgeon evaluates you while another operates. Ask whether the same surgeon handles every phase.
• What is the surgeon’s fellowship training? General orthopedic training does not include the depth of limb reconstruction this procedure demands. Fellowship training in orthopedic trauma or limb reconstruction is the relevant credential.
• Does the practice accept revision cases? A surgeon willing to correct complications from other practices signals real clinical capability. Practices that decline revisions may lack the experience to manage the full range of outcomes.
• Which nail is in the quote? Confirm PRECICE Max, PRECICE 2, or another device, and which price reflects which nail.
• What does the price include? Ask for an itemized breakdown and compare what is bundled versus billed separately across every practice.

Height Surgery in Southern California

Premier Limb Lengthening is located in Upland, California, serving the Inland Empire, Los Angeles, Orange County, and greater Southern California. For patients traveling from out of state or internationally, the practice runs a concierge program that coordinates flights, accommodations, physical therapy, and recovery through a single point of contact. International patients receive the same concierge support as domestic, including medical appointment letters for visa applications when required. Virtual consultations are available as a first step for patients anywhere in the world.

About Dr. Basmajian

Every procedure at Premier Limb Lengthening is performed personally by Dr. Hrayr Basmajian, a dual fellowship-trained orthopedic trauma surgeon. He completed fellowship training at Sonoran Orthopedic Trauma Surgeons and at Hannover Medical School in Germany under Prof. Christian Krettek. There are no associates and no rotating surgeons. To schedule a confidential consultation, call (951) 620-5663.