This controversial elective surgery can go horribly wrong—and it often does
Key Takeaways
Industry Buzz
“Leg-lengthening surgery is a highly complex and invasive procedure. This is a life-altering intervention with real and often severe consequences.” — Ari Hoschander, MD
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In July 2024, after 5 years of suffering and spending over $100,000, Elaine Foo settled a malpractice lawsuit against her surgeon after a procedure went horribly wrong.[]
Foo, who underwent cosmetic leg lengthening in London, endured a broken femur, insufficient bone growth, and device failure following the surgery. The case resolved without an admission of liability, but it raised pressing questions for the medical community about the risks, ethics, and viability of leg lengthening as a cosmetic procedure.
Leg-lengthening surgery, known as distraction osteogenesis, has transitioned from a reconstructive option to a controversial cosmetic procedure. Despite advancements, it remains fraught with risks, lengthy recovery, and ethical concerns.
Here’s what happened
Distraction osteogenesis for leg lengthening involves breaking the femur or tibia and implanting an adjustable rod, such as the PRECICE or STRYDE nail.[] The rod is slowly extended, separating the bone segments and creating a gap that the body fills with new bone. While the goal is a height increase of 5–7 centimeters, the process is anything but straightforward.
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Foo’s surgeon, Dr. Jean-Marc Guichet, used his own design, the Guichet Nail, but complications arose early. The device in Foo’s left femur failed, breaking through the bone. Misalignment and insufficient bone regeneration followed, necessitating multiple revision surgeries and years of rehabilitation.
Clinical risks, explained
According to Ari Hoschander, MD, a board-certified plastic surgeon, “Leg-lengthening surgery is a highly complex and invasive procedure. This is a life-altering intervention with real and often severe consequences.”
Complications include delayed union or non-union, diagnosed when bone growth requires ≥50 days per centimeter; some patients experience osteolysis. Gradual bone distraction also strains nerves, vessels, and muscles, leading to chronic pain and numbness.[]
Dr. Hoschander adds, “Infections and deep vein thrombosis are also significant concerns due to the invasive nature of the surgery and the prolonged period of immobilization that often follows. This is not to mention the emotional and psychological toll, as complications can lead to extended recovery times, reduced quality of life, and even permanent physical impairments.”[]
Is it worth it?
For reconstructive purposes, leg lengthening can be life-changing, helping patients with limb discrepancies or achondroplasia achieve improved function and mobility. However, according to Dr. Hoschander, “The risks almost always outweigh the benefits when performed for purely cosmetic reasons.”
Elaine Foo and Dr. Guichet settled the case in July 2024. The settlement involved a substantial financial payout, but it did not include any admission of liability from Dr. Guichet.
Dr. Guichet rejected Foo’s accusations, stating: “Over the past 35 years I have successfully performed this surgery almost 800 times…The wellbeing of my patients is always my priority.” His defense cited Foo’s alleged non-compliance with post-operative instructions and undisclosed use of anti-depressants as factors contributing to the complications.[]
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