Dr. Axel Becker is a specialist in leg lengthening, a specialist in plastic, aesthetic and reconstructive surgery, a specialist in orthopedics and trauma surgery and carries out cosmetic leg lengthenings in his special clinic in Freiburg. For this purpose – only here – a minimally invasive leg lengthening method BETZBONE®, developed by him and unique in the world, is used.

When people decide to have their legs lengthened, this decision is always preceded by a long educational process. Dr. med. A. Becker attaches great importance to examining all aspects of a possible leg lengthening in advance, answering questions about leg lengthening and pointing out the possibilities and risks of leg lengthening. This always happens in a personal consultation before a possible procedure. “How quickly can I reach my desired height through leg lengthening, when is the lengthening process finished and how long do I need medication?” are questions that are always asked.

Read how to stop the lengthening phase after leg lengthening surgery, when the ossification process begins after leg lengthening, and how patients should stop clicking.

The BETZBONE® implant for leg lengthening has been implanted, now the lengthening process begins using a click mechanism. This means that targeted leg movements that the patient learns trigger a mechanism that lengthens the extension nail in the thigh by 0.052 mm. We speak of “clicks” because these leg movements trigger audible clicking noises. These so-called clicks also serve to control and document the extensions carried out. An extension of 0.052 mm is achieved per click.

Desired height reached – this is how you end the extension process, the click

With the BETZBONE® leg lengthening technology, leg lengthening and height gain of a maximum of 10 cm can be achieved – no other system can do this.

This is what Dr. med. A. Becker: “The patient alone decides on his final size, how tall he wants to become within the scope of his possibilities – how many centimeters in height he wants to gain, i.e. when he wants to stop clicking.”

The last click after leg lengthening

For leg lengthening patients, the lengthening process and clicking quickly becomes a daily routine. Inside click – outside click, every leg lengthening patient is familiar with it. Once the desired height has been reached, the final click is needed – i.e. the end of the lengthening process with BETZBONE®. For this, Dr. med. To help his patients, A. Becker tells his patients what urgently needs to be taken into account and documented at the last click.

The last click in the thigh area must always be the outside click.

The last click in the lower leg area must always be the inside click.

Random clicks after the lengthening process. What to do about “random clicks”?

The desired height is achieved, the lengthening process and the clicking is finished. Still, “random clicks” happen due to leg movements – how can that be? Over time, the strong tension in the muscle – compared to the muscle tension at the beginning of the lengthening process – decreases. This makes the clicks easier. This can result in “random clicks”, i.e. clicks that were not intended. That’s not bad though. However, in the case of random clicks, the patient must ensure that an “accidental inside click” always results in an outside click – before the bone ossifies.

Bone ossification after leg lengthening – when does the bone begin to ossify?

It takes weeks to months for a bone to ossify after leg lengthening. Complete consolidation of the bone is calculated to take approximately 40 days per centimeter in the thigh area and 80 days per centimeter in the lower leg area. In plain language: A complete consolidation of the bone gap – i.e. until a bone is completely healed, ossified and newly “built over” with an extension of 8 to 10 centimeters – takes approx. a year. But please note: bone growth is highly individual and varies greatly. This has genetic, sporting or nutritional reasons.

After the lengthening process, sit cross-legged once a day in the morning – what’s the point of that?

We have learned that ossification always takes place in the external click. But how can you check whether you are in the outside click area? For this, Dr. med. A. Becker gives his patients a simple tip: This is how the external click/external position check works: for the next 3 – 4 weeks in the morning after waking up, sit cross-legged for 1 – 2 minutes. This ensures the outside position and gives the security that the leg is in the correct position. Generally, after about 4 weeks the bone is so strong that random clicks are no longer possible.

The patient question: “Accidental clicks – is this bad for the leg lengthening process?”

Dr. med. A. Becker says: No, random clicks are not bad. However, these must be counted, documented and “resolved” – see the topic of external position control by sitting cross-legged. And, if there are too many random clicks (4-5 daily), the renewal process may have to be ended before the intended date.

Accidental clicks when extending the legs – can they be prevented?

For example, random clicks can occur at night while sleeping when the muscles are completely relaxed and patients are constantly turning from one side to the other. Or when you turn quickly and put strain on your legs. But don’t worry, once the ossification begins, the bone becomes solid, these random clicks stop.

By the way: When the bone is lengthened slowly, random clicks are less common than when the bone is lengthened very quickly.

The patient’s question: Legs extended by 8 cm, but not 8 cm in height can be measured – how can that be?

Dr. med. A. Becker says: Immediately after completing the lengthening process, you will have minor functional deficits due to strong muscle tension. For example, the pelvis is slightly tilted forward, the knees are slightly bent, the thigh has a slight forward bend, and the spine is stretched a little further. This affects the measurable height.

Therefore, please note: As soon as the muscle tension dissolves and you stretch well, after 2-3 months you will be completely erect and the full lengthening distance can be measured correctly.

In other words: IMMEDIATELY after the lengthening there is a small discrepancy between the lengthening distance and the measurable body size. This discrepancy corrects itself after 2-3 months.

Why are you taller in the morning than in the evening?

did you know that? All people, not just leg lengthening patients, are taller in the morning than in the evening. In fact, all people experience height variations of up to 5mm. How can that be? Dr. med. A. Becker says: This is due to our intervertebral discs. These lose fluid over the course of the day and the vertebral discs are then closer together, which is noticeable in mm differences in body size.

Leg lengthening – taper off painkillers. That’s how it’s done

By Dr. med. Patients operated on by A. Becker report that they were able to reduce their daily use of strong painkillers relatively quickly after the lengthening process was stopped. According to Dr. med. When dosing morning-lunch-evening, Becker recommends first avoiding the lunch dose, the morning dose for the next few days and finally the evening dose. The muscle-relaxing medications should be tapered off weekly at lunchtime, morning and evening. As soon as strong painkillers are no longer being taken, the stomach protection tablet can be dispensed with. The anticoagulant medication should be taken until patients can walk normally again, i.e. show a fluid gait without forearm crutches. Calcium, magnesium, vitamin K, vitamin D3 and other prescribed supplements should continue to be taken in a reduced manner throughout the consolidation phase.

This is how long it takes for the bone to fully heal after leg lengthening

The consolidation phase lasts approximately 40 days per centimeter of lengthening in the thigh area. With an extension of 100 mm approx. 400 days, i.e. over a year. Then the area in the bone is completely overbuilt/remodeled.

In the lower leg area, the consolidation phase is twice as long. So 80 days per 1 centimeter of bone superstructure. With a lower leg lengthening of 10 centimeters, this means 800 days, over 2 years, until the bone areas are completely built up.

In summary: The 5 most important aspects after completing the extension process

• Random clicks are not bad, but they have to be counted in the extension distance.
• Pay attention to the click position: check the external rotation every morning for 3-4 weeks by sitting cross-legged.
• The final body size is not reached immediately after the lengthening, but can only be measured correctly after approx. 2-3 months.
• Pain medications can be tapered after the lengthening process. Continue taking anticoagulant medications until you can walk smoothly.
• Stretching exercises must also be performed after the lengthening phase.