6.7cm LON tibia with Dr Quynh in Ho Chi Minh City, Vietnam

I’m writing to share with you guys the conclusion of a 3-year tibia LON journey I completed with The Limb Lengthening Centre in Ho Chi Minh City, Vietnam with Dr. Quynh, which began in earnest around January 2023, and ended with the nail removal march 2026. Concluding with a tibial lengthening of 6.5/6.7cms (there was a .2 cm natural discrepancy between my right and left leg I had corrected) going from 176cm tall to around 182.5cm.

It is my hope that sharing my experiences here will provide insights for those who are interested in this operation, and ease the stresses of those who undergo it. I speak only from personal experience and cannot say that what I have undergone will accurately reflect the experiences of others.

Background [skip if not interested in the personal angle]: I was in my early twenties and had finished a long stint of studying and working just as COVID went down, by any sane metrics, my height of 176cm tall was not at all short, but growing up in my particular region of the United States, I had many experiences growing up that made me rather insecure about my height, in western culture height is rather romanticised and viewed as a social asset much more than the rest of the world. Small experiences like not being tall enough to go on certain amusement park rides, feeling like I stunted my growth by eating so poorly as a child, friends or classmates teasing me, my girlfriend who I bonded with deeply asking how tall I was when I went in for a hug and her seeming to be disappointed at “five foot nine”, growing up in a culture where height creates real social dynamics and having all my favorite role-models and characters in media all around that “golden” height range of six foot created in me a form of longing, and all this occurred in what I consider a cognitive infancy of my life, I had developed this insecurity about my height through a lot of external comparison, self-blame, through growing up in society that is relatively dismissive of smaller stature in men, and through a lack of lived experience. I had simply gone through highschool, post secondary education, and I worked online a few years because of COVID, I didn’t quite have many mature, adult experiences and life transformations when I made this decision, and I would emphasize and encourage anyone seriously considering this surgery to search their livelihood in deeper facets than height before undergoing this, because defeating insecurity and achieving your ultimate potential can be found in fitness, in certain fields of study or work, serving your community and your family as well before necessarily resorting to surgery, which is absolutely a drastic, thought situationally viable option. Furthermore, I would hope that for anyone considering this surgery to be doing it in self-interest, because you yourself would love to be a certain height and will take honor and pride in achieving that foremost as a self-investment than a treatment for loneliness, depression or insecurity. That being said, in my personal experience, the social dynamics of height are real, subtle but very true. There is a certain confidence about walking 6-7cm taller, being that much further away from the ground as you take a stride, enter a room, look over a view, or talk to people eye to eye, and my experiences with other people have been noticeably different, in clubs, out on the street, in parties and greeting strangers, women, many, not all, have this receptiveness and curiosity that I wasn’t accustomed to experiencing prior, women seem more emotionally tuned, and they always sense your confidence, you’re naturally gonna feel more confident with a bit of height. I get noticed a lot more by girls, humans are social creatures and you can sense the observations and “chemistry” to a considerable degree, from there some serious relationships blossomed, they never mentioned height at first but they always did later. In regards to men, I struggled with comparison and insecurity, like I would always size other guys up in my interactions or even on the bus, now I disregard any considerations to my own stature and engage other men directly and with confidence and fairness. Constant comparison and feelings or inferiority are honestly a shame I would urge anyone to overcome mentally first. But now that insecurity is gone, even if another man is towering over me, it doesn’t affect me anymore, in my mind I am the stature I’m most comfortable to be living in and that is more than enough. Alongside these sorts of motivations stemming from negative experiences, I was motivated rather positively by my discovery of the YouTube channel, Cyborg4Life hosted by Victor, a channel I’m sure many readers would be familiar with. His format and background as a physical trainer and journals really demystified much of the limb lengthening experience and after binging so much of his content, the idea of limb lengthening went from an absurd thought experiment to a genuine consideration. Moreover, I scoured the limb lengthening forums, probably to an unhealthy degree, it is simultaneously the greatest resource for those interested in this procedure and a boiling pot for people’s unresolved personal struggles and volatile projections. From there I read many journals about the experiences of tibial lengthening in Vietnam, which interested me because of its relative affordability, but also my previous experience touring this country had cut through some level of aversion. Many on the Limb Length forums will immediately disregard any limb lengthening service that isn’t in the EU or North America as third world butchers, but it was always my experience that Vietnam’s modern market economy and work ethic produced strong private medial enterprises, and reading reviews, the medical institute that provided the limb lengthening service was accustomed to Lengthening over frame and nail for cases beyond aesthetic lengthening, for those who suffered injuries or deformities. My familiarity with the country and the fact that it was the most economically viable made it my immediate choice. Additionally, the journey from atrophied legs, moving around in a wheelchair, and limping around to regaining my physicality and going on hikes and ruck marches gave me an incredible respect for our bodies, I can say with confidence that I am actually more fit post limb lengthening the pre, and that is the physical consideration you need to hold if you’re going to put your legs through such a procedure, it is a grueling, immensely challenging process that you can only grasp the consequences of once you are bedridden with the Illizarov frames, and you must adopt athleticism to compensate.

Part 1, contact and landing: I had made contact with Thao, the chief consultant and manager from the Limb Lengthening Centre over email, I described to him my background, considerations for the procedure, and an ideal height of 7cm, to which he provided the cost of a Lengthening package. Lengthening was provided for both tibia and femur, and tiered in different prices by accommodation, there are larger rooms available, both at two different apartment buildings, towards the latter end of my stay, I actually transferred to the other apartment, and both have their own advantages. The larger accommodation is spacious and private, with enough room to pace back and forth as a soft exercise. You have your own washroom which is nice, but I found the communal bathroom of the other apartment to be clean and not often in use. The apartment with the communal bathroom and smaller rooms also has a very strong benefit of a courtyard and swimming pool. The courtyard has a fair bit of tree coverage and a circuit which can be walked through in circles, and I would spend many hours walking back and forth rain or shine when my frames were removed, and the swimming pool was good to perform weightless stretches as deep as possible with. I landed in Vietnam at SGN airport and after going through customs, I greeted Thao who was waiting for me and we entered a taxi to their office located at one of the apartments. There I also met Dr Quynh who would be performing my surgery. There they had me read through the documentation and insurance, where they would perform the operation in two phases, the attaching of the frame and nail, and the frame removal, and that they would bare medical responsibilities for any complications for 10 years, provide services like meals, bandaging, rooms, wifi, laundering, xrays, etc. They also introduced me to the Illizarov frame, of which they utilised a 3/4ths design where the frame did not encompass the backside of your leg. This made it easier to lay in bed or be seated. The frames had bolts that distracted certain lengths with turns and this was all done manually, on the clock by patients. I was given a room to stay at a local motel whilst my documentation was completed, and in the meantime, Thao and at times another assistant took me out to local areas for leisure. This was to build more of a connection between the company and the patients, as the limb lengthening process is a long and arduous process. I believe it was also to create a few positive experiences preceding what would be many months of difficulty. These excursions took the form of a ferry ride down district 1, the south’s main tourist/financial hub, and and the nightlife is very impressive. A few dinners, usually at the patient’s choice of western or local dishes, and all the while Thao would answer any questions or concerns in detail. These were also punctuated with trips to hospitals, where blood chemistry, xrays, and tests were all done to ensure you were fit enough for both the general and local anaesthetic, as well as the surgery.

Part 2, nail and frame: The time came for my scheduled surgery, the hospital they do this at is a modern hospital that treats many different patients, it is clean and uses modern technology and the professionalism is evident, but this doesn’t make the medical procedures any less daunting, one of the worst parts was the spinal anaesthetic, essentially I was bent forward sitting, whilst a needle was driven into my lumbar area to deliver anaesthesia, most of it is mental, and the best you can do is breath deeply and stay still, Thao is always supervising and there to guide you through it, he’s seen this hundreds of times before and isn’t too worried because he knows it’ll be okay, but for you yourself experiencing it for the first time, the fear becomes very real, the sensation and experience was rather uncomfortable for me, another needle goes into your arm to deliver IV fluids, but this was nothing compared to the spinal. Then the mask goes over you and you count, and you lose consciousness. I don’t recall anything in between then and waking up in a holding area, looking down I saw the silhouette of the frames with a blanket overtop, you’ll feel cold as the room is kept at a low temperature for medical reasons, and you are kept there for awhile before being transferred to your room on a gurney. During this time, I don’t think I was completely lucid, the drugs they use to provide anaesthesia and the constant IV fluids are strong and have an effect on your psyche. In your own room, you have an assistant to keep an eye on your 24/7, they will be there beside you for the next few days, helping you. They provide meals, but I often only ate a few bites, and would vomit out what I ate because the medications have a strong effect on your appetite and ability to keep food down. Getting the first good look at your legs post surgery is mortifying, the sight of metal pins going through your legs is wild, and the osteotomy creates gigantic purple bruising that runs the middle of your calf. During this time you do little easy exercises to promote blood-flow, like lifting your legs up and down, but mostly you rest. I was cleared a few days early to move to the apartment in an ambulance and after a bit of time, the Lengthening process began.

Part 3, apartment life and lengthening: at the apartment, you begin what will be routine for the next many months of your life. You eat, sleep, and lengthen your frames, a fraction of millimetres at a time, the shock of seeing your legs in these contraptions eventually fades and you get to work. Naturally I am a side sleeper, and I found that placing a pillow in between the frames made it cushy enough to sleep on my side, laying on your back is the least complex, and the frames can sit flat on the bed with it’s 3/4ths design. I had hauled my computer with me in the idea that I can get so much work done whilst lengthening, but in truth it is very difficult to focus on anything whilst these frames are on you. In this stage of your surgery, the thrust from being able to walk, run and explore the world on two feet is rendered down into a sedentary regimen, it is very easy to get depressed or feel hopeless at this time, because the shock is fresh and the you will be beginning the long journey of lengthening and recovery from the beginning. I would advise you be open with Thao about your mental health as well as your physical, and being in contact with other patients going through tje same rigours also helps. For me homesickness was a profound hardship, as I had elected to do this operation in secrecy, none of my family knew I was doing this. It’s not all doom and gloom however, there is always that reminder that this process is timed, the frames are temporary, there is a method and an end goal to this. You lengthen, you exercise, you make phone calls to your loved ones with the camera always facing away from your legs, you catch up on shows or maybe a game. When I was very depressed I even asked Thao for a set up of pencil crayons, and found some solace in drawing. The meals provided to you come 3 times a day, they alternate between many dishes, usually a protein, a serving of veggies, and some carbohydrates made from whole ingredients, you scarf it down with supplements provided freely to you. The process makes you hungry as your body craves the nourishment to rebuild your body with. As a westerner you may feel cravings for something else, before the surgery, Thao took me to a grocery store to stock up on snacks, but I would recommend you ask your caretaker to help you obtain some extra nourishing food items like eggs, yogurts, cheeses and meats, rich leafy greens if possible. Grocery prices are pretty affordable in Vietnam, and I knew many other patients to utilise Grab (Vietnam’s version of Uber) to constantly order meals, just remember to prioritize the quality of what your absorbing, because I believe Thao told me a patient had developed some health concerns from feasting daily on fried chicken ordered through Grab. On the topic of medication, after you are discharged from the hospital you are taking painkillers, Paracetamol was what I took for the majority of my lengthening, it is a mild-moderate painkiller we often know under the brand name as Tylenol. I was worried about developing dependency, but honestly after I finished my blister packs and no more were issued to me, I never had any urges or noticeable withdrawal. I did like the painkillers best when combined with my exercises, I would take them then try to hammer out my stretches, leg lifts, and later my squats and my bicycling when the frames were removed during the timeframe when the drug was most active in your system. During the lengthening phase, a large focus was spent on stretching your calf muscles, with your foot bent upwards and leg straight. This is to prevent “ballerina foot” or tendonitis, as for tibial lengthening, all the muscles, fascia and tendons in your leg get stretched out of their organic proportion, and a big player in your return to walking normally is getting all of that adapted to your new proportions. During this time, your legs atrophy fast from their lack of use. Muscle will return later, but stretching those legs is what you have to work towards. If at first you can’t stretch your leg, you lay it down on the bed and try to work your leg flat, and this warm tightness runs down your calf and you hold it as long as you can, often with the help of your personal massage therapist, until eventually you can lay your leg on the bed flat, from here you can use these big rubber bands over your feet to pull and stretch your leg further, and there is a standing version of this exercise you learn to practice often. It’s beautiful in its simplicity, all you need is a brick or a dedicated angled stand, but you stand straight with your feet pushed up on the object, and that stretching burn is felt. You start to equate that burn with progress and it can even feel good at times. The routine goes on and on. The length of the frame is initially marked with a piece of medical tape, and as you turn the bolts on the frame it lengthens a fraction of a millimeter at a time, and the gap between the tape and the frame increases until you’ve made noticeable strides. Sometimes you slow down on your lengthening or take a break if the pain catches up to you. As you lengthen more and more, the stain on your legs gets tighter and tighter. Checkups are routine, and so are bandage replacements. The frames are held to you through these thin, rigid pins that enter near your ankle and by your knee. They’re literally going through your bones, and this yellow fluid often exudes from them. They also scab over in ways that need to be picked out during cleaning. To keep from infection, this dark amber disinfectant solution, I believe iodine, was applied to the wounds and rebandaged. The nurse that did my bandages was rather cheery and attentive. During this time, I simply could not walk without a stroller, you utilise a stroller to get to the washroom, to try to move around and get some blood flowing in your legs as best you can.

Part 4, ending the lengthening: The time had come where I had reached my desired length. I had opted to go from 7cm down to 6.7, because this was around 20% of my original tibial length. There were however patients who went very much upwards of 7cm, I had met one and we got along quite well. You then stay in your frame for a while longer as the callus (the regenerative structure of your bone) continues to heal. Xrays at this time revealed it as mostly translucent compared to the strong milky white color of the developed bone around it. Eventually I was cleared for frame removal. I knew it’d be a relief to get these things off, but as I was prepped for my second surgery, I ended up crying, I was really fed up with the whole ordeal. The hospital setting, and going in again for another operation really brought the weight and considerations back, but I knew the most challenging parts were behind me. I’ve got to say, the freedom from the frames is amazing, you’re not worried about bumping them into anything, you can roll around in bed, sleep easier, and you start to make the jump from stroller to crutches. From here you gain a whole new degree of freedom, everyday I spent time strolling back and forth with the crutches. Around this time I was transferred to the apartment with the pool and courtyard, and that courtyard became my little slice of heaven. I’d just walk it with crutches around and around, the security guard got so accustomed to my little outings that he introduced himself and told me I was making good progress. One night I had a breakthrough, I was sitting on my bed, practicing these little squats when I stood shakely up, and from there took a step, and then another, sure my gait and posture was far from normal, but my steps felt steady enough that I could just keep on moving on even flooring, I smiled so much just being able to go back and forth without tools for the first time in what felt like forever, and I knew the end was around the corner.

-continued-