Aaron Trinh was 5-foot-6, and he was unhappy.

His height was something he dwelt on constantly. In public, Trinh, 25, mentally measured himself against others. And it seemed that he was always looking up.

“I
just didn’t want to be that person sticking out in a negative way,” he said. “I just had to get this out of my head.”

Then, two years ago, he came across some videos on TikTok about height surgery, a procedure in which the leg bones are fractured and implanted with devices that slowly stretch them over several months, resulting in longer legs.

Limb-lengthening has been practised by orthopaedic surgeons for decades as a means of correcting deformities or length discrepancies. But in height surgery, also called stature-lengthening, it can be used for patients who wish to add a few inches to their height. The cosmetic procedure has grabbed more attention recently. Patient numbers are difficult to track, but four clinics in the United States said they had received an uptick in interest over the past decade.

Trinh, an engineering student and ultramarathon runner from Houston, knew the surgery carried the risk of complications. Bones could heal poorly, making them more fragile, or harden at rates that could cause discrepancies. His muscles could be tightened or weakened. There was risk of infection, fat embolism and permanent nerve damage. And he would have to avoid putting weight on his legs for several months, with a full recovery taking at least half a year or longer.

The risks have made height surgery a contentious topic, and the procedure is expensive. It can cost between $70,000 and $150,000 (NZ$117,000 – $251,000) in the United States, driving some people to seek treatment abroad. Trinh decided to consult a clinic in Florida. His father, Tan, one of the first people he confided in about his insecurity, used his savings to front the $140,000 or so his son needed for the procedure and associated costs.

Tan Trinh, who is 5-foot-2, said he could understand his son’s feelings, having struggled with his own. “It’s a kind of stigma,” he said, “and I just feel so bad.”

He didn’t want his son to go through life with the same “mental suffering”.

They booked the surgery for May 2025.

Aaron Trinh said it was an uncomfortable topic. He and his father didn’t even tell his mother about the surgery until they had already paid for it, he said.

“The biggest response a lot of people are going to get is, ‘Dude, you can’t change your height – just learn to be confident in yourself,’” said Trinh, who did not believe that psychological therapy would have helped him. “It’s easier said than done.”

Cosmetic surgery has become an increasingly mainstream topic of conversation in recent years, thanks in part to social media and a rising cultural comfort with aesthetic intervention. Public figures have acknowledged breast augmentations, face-lifts and other major procedures. Clinics have directly marketed their services to consumers online.

Height surgery has likewise attracted attention, used recently as a plot point in the film Materialists and fodder for online debate.

Even among cosmetic interventions, the intensity required to become taller has roused divisions. The idea of breaking healthy bones in pursuit of an ideal height can seem extreme, if not absurd. And the potential to alter one’s height ties into a charged conversation about its significance, particularly for many men, in dating and at work.

Trinh is one of only a few who have been fully open about their experiences, driven by the hope that others interested in height surgery might feel less shame.

At least four height surgery patients The New York Times spoke to requested anonymity to share their experience because they had not told family, friends or colleagues. One man, who went to Turkey for his surgery, explained his crutches by telling friends he’d had back surgery or an accident. After his return, issues including poor bone healing eventually pushed him to seek out an orthopaedic surgeon in Baltimore.

It felt bad to lie, he said, and he was sure his relatives had noticed he was taller. But he said he had few regrets, and planned to take his secret “to the grave”.

“I wasn’t designed to be tall, but I’d like to be normal,” said Presley St. James, 31, who lives in Pennsylvania. As a child, St. James had been diagnosed with growth hormone deficiency and his mother had decided against growth hormone therapy.

But he felt that his height, 5-foot-4, had made him a bullying target at work. He had dreams of being an actor, and worried that he was too short.

His endocrine disorder meant that insurance covered much of his procedure, he said, though he is an exception: insurance rarely covers the procedure for cosmetic reasons.

“A lot of guys like to say, Well, I’m fine with just the way that I am,” said St. James, who started stature-lengthening last August. “Deep down inside, no they’re not.”

A debated field in its ‘infancy’

Height, an attribute that is largely set by adolescence, can be a sensitive issue for those who consider themselves short. Researchers have correlated being taller with greater income, high-status jobs and positive perceptions of leadership. And it can be a thorny topic in an era of dating apps that can filter for height preferences.

Adults have long resorted to shoe lifts or high heels. Those seeking more permanent results have pursued growth hormone therapy, which can add height when prescribed for children, but is also much debated. And they have turned to the field of limb-lengthening, where equipment has advanced.

“People have been bothered by height for a long time,” said Dr Dror Paley, a surgeon and the founder of the Paley orthopaedic & Spine Institute in West Palm Beach, Florida. He began performing limb-lengthening in the 1980s after training under Dr Gavriil Ilizarov, a physician in the former Soviet Union who invented one method. “This was the beginning of being able to do something about it,” Paley said.

The technique offered a new, if painfully arduous, pathway for people to correct medical problems in their limbs. But soon, Paley said, he was approached by people who wanted the procedure for cosmetic reasons.

He did it quietly at first, he said, and made his patients undergo a psychological evaluation. Orthopaedic surgeons, he said, are trained to treat pain and disability rather than cosmetic problems. These days, he is one of a small group of orthopaedic surgeons worldwide who offer cosmetic stature surgery and believes the field is in its “infancy”.

The way people feel about their height is “really personal”, said Dr Ellen Katz Westrich, a licensed clinical psychologist in New York. And it can be influenced by early experiences, environment and personality traits.

Over the years, Katz Westrich has evaluated multiple prospective height surgery patients to help them decide what was best for them. “They’ll describe it as like the dull hum that just doesn’t go away,” she said. “I’ve heard it described to me as, ‘I’m a tall person in the body of a short person.’”

Katz Westrich said her role was to help patients, not promote height surgery. Surgery, she said, is generally not advised for people who experience body dysmorphic disorder, a mental health condition that can be better treated with cognitive behaviour therapy or serotonin-enhancing drugs.

But for patients set on it, the procedure seemed to address their chronic height-related distress, she said. “I think for some people, the concrete fix does the trick.”

There is limited research on the long-term outcomes for cosmetic height surgery patients, and orthopaedic groups have called for more rigorous studies to assess its risks and benefits. (Patients in small-scale studies have suggested psychological improvements in the short term, but it is unclear if they last.)

“This is an elective procedure with potentially lifelong consequences that are not yet fully characterised,” said Michelle Spear, a professor of anatomy at the University of Bristol in England. “We don’t quite yet know what’s going to happen.”

Still, several US clinics have reported rising interest over the past decade. In Las Vegas, Mario Moya, CEO at the LimbplastX Institute, said demand had surged in the past four years. Dr S. Robert Rozbruch, an orthopaedic surgeon at the Hospital for Special Surgery in New York, said he had observed a boom since 2011, after new equipment hit the market. Before that year, Paley said he had seen about 10 cases a year of cosmetic limb-lengthening. Last year, his clinics had 155 cases.

Dr Michael Assayag, an orthopaedic surgeon at the International Center for Limb Lengthening in Baltimore, said he was once against height surgery. Now, he sees about 45 height-surgery patients a year. He said he had changed his mind after seeing patients who came to him with tricky complications, such as poor bone healing.

“I realised people are going to get it no matter what,” he said, adding that he believed he could offer a safer environment to complete the procedure.

There is no standard protocol on height surgery, and the American Academy of orthopaedic Surgeons has not issued official clinical guidelines on the procedure. (Clinics in countries like Turkey, where procedures can cost half as much, have marketed packages to patients seeking height surgery from abroad.)

Professor Tim Briggs, a British health official, warned people against going abroad for cosmetic limb-lengthening. “Don’t gamble with your health or your life for a few extra inches without fully understanding the risks,” Briggs said.

Some patients have mixed feelings. The process has been frustrating for St. James, who said his care had taken a toll on the family. “Did I really make a good decision doing this,” he wondered, after a checkup last fall. “Or was it a big mistake?” (In February, he said in a text message that he was feeling “fairly optimistic”.)

In rarer cases, the outcomes of poor limb-lengthening treatment can be disastrous.

Last month, a leading children’s hospital in London apologised after it said that substandard care from an orthopaedic surgeon who specialised in limb-lengthening and reconstruction had harmed 94 patients. Some children, who were treated between 2017 and 2022, were left with chronic pain or deformities, according to British news media. The surgeon, Yaser Jabbar, has reportedly left the UK; a representative declined to comment.

Three inches taller

On the day of surgery, Aaron Trinh said, his hands shook so much that it was hard for nurses to put in an IV drip.

It was his first time in surgery. Over less than two hours, a surgeon would break his femurs and, through small incisions, implant rods inside the bones.

The pain came when the nerve blockers and epidural wore off, in his thighs and at the incision sites. It would be weeks before he would sleep well.

But that was only the beginning. A week after the surgery, he began “lengthening” – using a magnetic apparatus on the outside of his legs to separate the bones. The goal was to do it four times a day, a quarter of a millimetre each time, alongside a rigorous regimen of physical therapy.

At the Paley Institute Stature Center, patients must stay locally for several months to attend regular checkups. Trinh booked himself into a nearby hotel popular with other patients. On weekdays, a pink bus shuttles patients at various stages of healing – some using crutches and others in wheelchairs – from the hotel’s lobby to their appointments.

Challenges come in the post-operative stage, Paley said, adding that surgeons needed to anticipate and respond to potential complications.

“Patients are greedy for length, and they will push you to keep lengthening at the risk of losing function,” he said. “The doctor has to be steadfast in resisting that.”

Trinh had ways to pass the time during his many hours of recuperation. He began a long-distance master’s degree at Texas A&M University. He joined a chat group with other hotel guests who were also patients. “The outside world will think that you’re crazy for doing this, but here you’re meeting people who have the same goals,” he said.

And he meticulously logged his progress and his symptoms, sharing them for other members of a Discord server dedicated to limb-lengthening.

Its creator, Victor Egonu, a former limb-lengthening patient, said he wanted his platform, Cyborg 4 Life, to help prospective patients understand the realities of height surgery.

For most patients, the procedure was a “private thing”, Egonu said. “That’s where they can congregate and talk to each other about it and socialise without doing it in person.”

Though uncomfortable, Trinh seemed to be healing well at first. “Day 29,” he wrote. “Sleep continues to be all over the place.”

But the discomfort crossed into agony on Day 56, when his left shin was burning. “NERVE PAIN IS THE WORST,” he wrote.

By then, he had lengthened each of his femurs 47 millimetres.

Trinh paused the regimen. Lying in a hotel room with ice on his leg, he felt low. It was not yet his goal – an extra 7.5 centimetres – but he feared doing permanent damage to his nerves.

Others on the Discord chat said that they, too, had experienced nerve damage, and encouraged him to stay positive.

To his relief, the burning subsided after a few days. He pushed on.

By August, about three months after his surgery, he had extended his legs by nearly 7.6cm.

Life After Surgery

Five months after his surgery, Trinh went for his final checkup with Dr Craig Robbins, the surgeon who had overseen his lengthening. He was still using crutches, but he could walk.

And he was now exactly 5-foot-9, around the average height for an American man.

Trinh was not yet fully finished with the process. The implants in his bones needed to be removed. His left shin, he said, was still partly numb, which he had accepted could be permanent. He still felt tightness in his pelvis when he jogged.

In January, eight months after his surgery, Trinh went for a 35-kilometre hike at a forest in Texas. And he was surprised at how much better he felt in cargo shorts.

His recovery, he said, had gone particularly well. (Some patients on the same timeline were still working their way up to jogging, he said.)

People who knew him noticed, of course, that he was taller. He was truthful with some, and he held back with others. But the “itch” in his mind about his height, he said, was gone.

“I’m just perfectly average, where I need to be,” he said. ”It’s a nice feeling.”

He wondered sometimes whether his legs still looked proportionate. He had not yet ruled out a second surgery, this time on his tibias, to correct his bow legs.

It would be a bonus, he said, if it made him even taller.

This article originally appeared in The New York Times.

Written by: Isabella Kwai

Photographs by: Matthew Leifheit

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