This was partly stoked by recent reports that China has banned the procedure, which is in fact not true--the country's health ministry is just cracking down on unauthorized clinics. It also came after seeing ads all over the web--and Betterhumans--for lotions, potions, devices and exercises that purportedly make people taller. Most of these, of course, are scams; for adults whose growth plates have fused, limb lengthening is the only thing that works.

My interest in the subject is both personal and intellectual. I stand between 5'3" and 5'4", depending on whether it's morning or night (gravity compresses your spine over the course of a day), and whether I've been sitting in a chair all day or hanging from a tree. I've been short my entire life, and can remember having an opportunity to take growth hormone as a child, although for some unclear reason didn't push for it. Probably in part because, in spite of my height or because of it, I'm a confident and ambitious person (some might say swaggeringly arrogant) who fights hard to achieve his goals.

Yet I know that humans value height. The majority of CEOs are over six foot, the taller US presidential candidate tends to win the election, and people earn more money, on average, with each extra inch of height. Some might argue that this is simply a cultural rather than biological artifact. But as with our notions of beauty, I think it's quite clear that there's something ingrained. And it makes some sense: as a sign of strength, tallness would be a desirable trait to our ancestors on the savannah. Of course, I also think that our society, for evolutionary or other reasons, has come to associate tallness with confidence and capability, which is self-reinforcing; short people tend to get short shrift, hence tend to have lower confidence. (Although I have met many tall people with low levels of confidence; it cuts across height.) And I by no means think that short people can't be successful; on the contrary, I think that such traits as intelligence, confidence, creativity, enthusiasm and ambition are far more important in the long run, since they allow you to create your future.

But I find myself in a bit of a conundrum. On the one hand, I recognize that height is a positional good; if everyone started increasing their height, nobody would really be better off. This is opposed to, say, health and longevity; if everyone started living longer and healthier, everyone would be better off. (Illogical arguments to the contrary aside.) Yet this doesn't quite help with the fact that short people do face discrimination. While we can fight against such discrimination, I also feel that we should give people greater control over their body in all aspects, including the right and ability to healthily increase their height as they see fit.

Which brings me back to limb lengthening surgery.

Buy the inch

The surgery was pioneered by a Russian doctor named Gavril Ilizarov. Ilizarov discovered by accident that, contrary to common misconception, you can get bone to grow after puberty. The trick is to break it and slowly stretch the broken pieces apart by less than 1mm per day. New bone grows in between, and nerves and soft tissues stretch and grow to accommodate the change. This necessitates the use of a fixator to hold the bones steady while stretching them apart. Ilizarov used an external frame for this, while some newer methods use an internal nail-like system.

While 1mm per day may not sound like a lot, it adds up. And because both the lower (tibia and fibula) and upper (femur) legs can be lengthened, height increases of 5 inches aren't uncommon, while height increases of a foot--typically for people with various forms of dwarfism--have been accomplished. Height increases of about 2.5 inches appear to be most common, typically by performing the procedure on the lower legs alone. And such increases have lower risks of complication, including lower risks of making people look disproportionate.

The cost for the procedure can be as little as US$20,000 for reputable treatment in China. This includes surgery, two months worth of lengthening (called distraction), several months of accommodation (it can be six months or more before you're walking properly), physical therapy, medication and nursing. There are just a handful of reputable locations, with those in more developed nations costing far more--in the US, it costs about US$85,000 for two inches, not including accommodation or physical therapy.   

Tall order

So, would I do it?  As someone who believes in human enhancement, I'm already over most of the ethical and intellectual hurdles that might give others pause. And to me, there's nothing to be ashamed of in trying to take more control of and responsibility for your life in as many areas as possible. The key issues for me are:

1. The pain: This obviously isn't a pleasant experience. While different people who have undergone the procedure report different levels of pain, nobody has reported a walk in the park. So if I were to decide in favor of limb lengthening, I'd really need to prepare myself mentally for the experience. I would hope that my general level of fitness and flexibility would help keep pain levels lower. There should be less nerve and soft-tissue stretching, for example, thanks to years of martial arts training and stretching.


2. The cost: US$20,000 isn't that much money for a possible lifetime of benefit. But tack on the possibility of six months without full-time work and it might cost far more. Even US$30,000 total impact isn't unreasonable. But it might not make sense if the money could be better spent elsewhere. Is the benefit worth the cost?


3. The career speed bump: I currently feel very good about my career and career path. Putting my career on hold for six months isn't something I really want to do.


4. The risks of the procedure: There are, of course, risks with the limb lengthening procedure. Complications such as infections tend to be manageable. But despite having a success rate in some cases as high as 99%, as a surgical procedure, there are still concerns. I don't want to do something damaging to my body in the pursuit of something potentially enhancing.


5. The potential long-term health implications: Long-term, there can also be risks, such as arthritis, although it's hard to find long-term reports given that this is a fairly new procedure that's not very widely practiced.


6. The impact on activities: Reports say that you can resume normal sports activities within a year to two years after having limb lengthening surgery. I've practiced martial arts for about 10 years now, and one of the things I'd hate to do is take a two-year pause. Also, I'm not so keen on being largely confined to bed and a wheelchair for two months or more.


7. The social ramifications: Family and friends would know what I'd done. (I'm obviously not keeping my thoughts on the matter a secret.) I think that most people who are close to me would disapprove. Such responses, however, haven't stopped me from undertaking other actions that met with reproach and quizzical stares, such as signing up for cryonics. So in many ways I'm prepared for such reactions, and I think many people around me are prepared for slightly eccentric behavior.


8. The potential for better interventions: Another major factor to consider is the potential of future interventions to offer a more holistic and less painful growth. People are already researching other biomedical methods of increasing height, and advances are regularly being reported in the area of tissue engineering and bone regeneration. It would surely suck to go through an expensive, painful procedure only to have something better come on the market in a few years--and, perhaps worse yet, to be excluded from taking advantage of it due to having a previous, incompatible procedure.


9. The potential future irrelevancy: Finally, there's the fact that technological advances might make such a procedure irrelevant. To be a bit radical, for example, imagine that in 20 years from now we're regularly downloading our consciousness into robotic bodies, or conducting many of our activities virtually--Second Life is just the beginning. Height might become far less of a concern in such situations. For   this reason and the fact that future technology might offer better height-increasing solutions in the future, it might be best to invest in life extension research, which could provide a better chance that I'll live long enough to see leg lengthening surgery become irrelevant or be overtaken by better technology.