What Is Combined Limb Lengthening (Femur and Tibia) for Height Increase?
Combined limb lengthening refers to the strategic extension of both the upper and lower leg bones, the femur and the tibia. The procedure enables greater total height gain, typically ranging from 8 to 14 cm, depending on patient anatomy, goals, and treatment plan.
This advanced lengthening process is performed using internally implanted devices, such as the PRECICE nail, which allow for gradual, precise, and remote-controlled bone distraction without the need for bulky external frames.
Key Benefits of Combined Limb Lengthening
Maximized Height Potential: By treating both the femur and tibia, patients can safely achieve greater height increases than with single-segment procedures.
Advanced Internal Lengthening Technology: Utilizing magnetic, motorized PRECICE nails for comfort, precision, and discreet recovery.
Improved Aesthetic Proportion: Balanced lengthening of both bone segments ensures harmonious leg proportions and gait.
Customizable Treatment Plans: Procedures may be done simultaneously or in stages, depending on the patient’s physical readiness and doctor recommendation.
Minimal Scarring: Internal technique means fewer visible marks and faster skin recovery.
Less Pain and Faster Recovery: Compared to external methods, internal lengthening results in lower risk of infection and improved patient comfort.
Who Is Femur and Tibia Lengthening For?
The combined limb lengthening procedure is ideal for:
Individuals seeking more than 6–7 cm of height gain.
Patients in good general health with realistic expectations.
Candidates who have already undergone a single-segment lengthening and wish to further enhance their height.
Individuals born with limb length discrepancies or skeletal dysplasia (case-by-case evaluation required).
How the Combined Limb Lengthening Procedure Works
Comprehensive Evaluation Our orthopedic and physiotherapy team conducts full-body analysis, digital imaging, and lab testing to assess bone health, proportions, and height goals.
Surgical Planning The surgery may be performed on both segments in a single operation or in two phases with rest in between. This decision is made based on patient profile and orthopedic guidance.
Surgical Phase Under general anesthesia, motorized internal nails are implanted into the femur and tibia, guided by fluoroscopic imaging. The bones are carefully osteotomized (cut) for controlled lengthening.
Lengthening Period Beginning a few days after surgery, the PRECICE device enables daily controlled bone distraction of approximately 0.75–1 mm per day, split between both segments.
Consolidation Period After the desired length is achieved, the bone is left to heal and consolidate. This period may last several months depending on length gained and healing capacity.
Physiotherapy & Monitoring Daily stretching, mobility exercises, and muscle reconditioning are essential during both lengthening and consolidation phases. Regular X-rays monitor bone growth and alignment.
Estimated Timeline
Hospital Stay: 5–7 days
Lengthening: 2–3 months
Consolidation: 3–6 months
Full Recovery: Up to 12 months
Is It Safe to Lengthen Both Femur and Tibia at Once?
Yes, with the right technique, planning, and expert supervision, it is safe to lengthen both the femur and tibia simultaneously. However, this approach is generally reserved for highly motivated candidates in excellent health, as it demands a higher level of physical and emotional resilience.
At Estetik International, we follow strict clinical protocols to ensure your safety at every step:
✅ Full-body orthopedic evaluation before surgery
✅ Advanced surgical planning using digital imaging and 3D simulation
✅ Internal lengthening devices (PRECICE) to reduce infection risk and external discomfort
✅ Close monitoring during the distraction and consolidation phases with weekly imaging
How Much Height Can I Gain with Femur and Tibia Lengthening?
By combining femur and tibia lengthening, patients can typically achieve between 8 to 14 cm of total height gain. Here’s a general breakdown:
Femur (Thigh Bone): 6 to 8 cm
Tibia (Shin Bone): 5 to 7 cm
Total Potential Gain: Up to 14 cm
The exact result depends on several factors:
Patient age and bone quality
Pre-procedure Tips for Combined Limb Lengthening (Femur + Tibia)
Careful preparation helps ensure your body is ready for this extensive procedure and supports a smoother lengthening and consolidation process. Our orthopedic and physiotherapy team will guide you through a full evaluation before finalizing your surgical plan.
Complete a full-body orthopedic evaluation, including digital imaging and lab testing, to assess bone health and proportions.
Stop smoking and avoid nicotine products well in advance of surgery, as smoking impairs bone healing and consolidation.
Inform your surgical team of all medications and supplements; blood thinners and certain anti-inflammatories may need to be paused beforehand.
Begin building core and lower-body strength through light conditioning, if approved by your doctor, to support recovery.
Arrange for extended accommodation and mobility assistance, as recovery from combined lengthening requires several months.
Operation Day: Step by Step for Combined Limb Lengthening (Femur + Tibia)
On the day of surgery, our surgical team follows a precise, well-established protocol to safely implant the internal lengthening devices and set the stage for controlled bone distraction.
General anesthesia is administered, and vital signs are monitored continuously throughout the procedure.
Using fluoroscopic imaging for guidance, the surgeon carefully osteotomizes the femur and, if performed simultaneously, the tibia.
Motorized, magnetic PRECICE nails are implanted inside the bone segments to enable gradual, remote-controlled lengthening.
Incisions are closed with minimal external scarring, since the lengthening device is fully internal.
You are transferred to recovery for observation before being moved to your hospital room for the initial healing period.
Post-procedure Tips for Combined Limb Lengthening (Femur + Tibia)
Recovery from combined femur and tibia lengthening extends over several months and requires close cooperation with your medical team. Following these guidelines supports safe bone growth, proper alignment, and a comfortable healing process.
Attend all scheduled physiotherapy sessions, including daily stretching and mobility exercises, to maintain joint flexibility during lengthening.
Keep all follow-up appointments for X-ray monitoring so your surgeon can track bone growth and adjust the distraction plan if needed.
Avoid smoking and limit alcohol, as both can slow bone consolidation and delay healing.
Take prescribed pain management and any supportive medication exactly as directed by your care team.
Use mobility aids, such as crutches or a walker, as instructed, and gradually increase weight-bearing activity under medical guidance.
Patient stories
Breast Implants & Tummy Tuck · DKFrom Beautiful to Gorgeous!As a fitness model, Mia needed to keep her body in the best shape. She contacted Estetik International to give her the right touch to her gorgeous body. Check out her journey.Watch on YouTube 
Secondary Rhinoplasty · FRA Moving Story!After an unfortunate accident that broke her nose and altered her facial features, and after being rejected by many doctors in France due to her complicated case, she chose Estetik International and came to Turkey to have her nose fixed by our amazing surgeon Prof. Dr. Cenk Şen. She finally got her beauty and happy life back. Check out her full story here.Watch on YouTube 
Organic Hair Transplant · DEGorgeous Hair Loading!As a young man, baldness can make you look older. Our dear patient Andreas, decided to say “stop” to baldness and chose Estetik International to get his organic hair transplant done by our experts. Check his story and see how he decided to come with his friend to Istanbul to get their new hair.Watch on YouTube Frequently asked questions
Combined limb lengthening extends both the femur (thigh bone) and the tibia (shin bone) using internally implanted, motorized nails, allowing for greater total height gain than lengthening a single segment. It is best suited to healthy adults seeking more than 6-7 cm of height increase, patients who have already completed a single-segment lengthening and want further gains, and individuals with limb length discrepancies, evaluated case by case. Realistic expectations and good overall health are essential.
The procedure is performed under general anesthesia. Using fluoroscopic imaging for guidance, our orthopedic surgeons carefully osteotomize (cut) the femur and tibia and implant magnetic, motorized PRECICE nails inside the bones. Depending on your anatomy and overall readiness, both segments may be lengthened in a single operation or staged as two separate surgeries with a recovery interval in between. Your surgical plan is customized after a full orthopedic evaluation and digital imaging.
Recovery unfolds in stages. Expect a hospital stay of about 5 to 7 days, followed by a lengthening phase of 2 to 3 months, during which the internal device gradually distracts the bone by roughly 0.75 to 1 mm per day. A consolidation phase of 3 to 6 months follows, allowing the new bone to harden and stabilize. Daily physiotherapy, mobility exercises, and regular X-ray monitoring continue throughout, with full recovery generally achieved within about 12 months.
Yes, once the lengthened bone segments have fully consolidated and healed, the added height is permanent. Patients typically gain 6 to 8 cm from the femur and 5 to 7 cm from the tibia, for a combined total of up to 14 cm, depending on age, bone quality, and commitment to physiotherapy. Because the result is a true increase in bone length rather than a temporary adjustment, ongoing physical activity and healthy bone maintenance help preserve long-term function and alignment.
Because internal PRECICE nails are used instead of external frames, scarring is minimal, limited to small incision points, and skin recovery is faster than with older external fixation methods. Risks are similar to other orthopedic procedures and may include infection, delayed consolidation, joint stiffness, or alignment issues, all of which are minimized through careful surgical planning, weekly imaging, and structured physiotherapy. Estetik International offers combined limb lengthening at competitive prices compared to many other countries, backed by accredited facilities and comprehensive aftercare.
Considering Combined Limb Lengthening?
Share a few details and a patient coordinator will plan your consultation with the right surgeon.