Although the information provided via email is very educational, it is preferable to be assessed in person. This helps you become as prepared as possible for the surgery. We have found that patients who do not come for a consultation are not as prepared for the surgery and have much more difficulty when they undergo the procedure.
We make exceptions to this only for patients coming from overseas and book the consultation the week before surgery. Please note that this is not optimal since these patients are less prepared for surgery than those who come in for a consultation well in advance.
The consultation starts with a specialized standing x-ray called an EOS scan. This is a low-radiation dose scan of your entire body from head to foot in a biplanar fashion (front and side at the same time). This may be done the night before the consultation if the consultation is first thing in the morning.
You will meet with our Stature Lengthening Coordinator, Angelique and one of Dr. Paley's physician assistant. They will obtain your medical history and explain the lengthening process in detail.
Dr. Paley will then come in and evaluate you and your x-rays, including a physical examination of range of motion, muscle tightness, etc. He will explain the procedure and advise the best stature lengthening strategy for you according to your specific height increase goals. This will also include consideration of your proportions. Dr. Paley will measure your bone proportions from the EOS scan. The normal proportion of the femur to tibia lengths is 0.80 +/- 0.02. If the ratio is greater than 0.82 your tibias are relatively long compared to the femurs and femoral lengthening may be preferable; if the ratios are less than 0.78 than tibial lengthening may be preferable. This must be tempered by the amount of lengthening desired, since up to 8 cm can safely be done in the femurs and usually only 5 cm can be safely done in the tibias. Dr. Paley will go into these and other aspects of lengthening in detail and try and answer all your questions.
After the consultation with Dr. Paley, the PA and Angelique will stay to answer any additional questions that may remain. They will then take you over to the physical therapy department for a tour. If possible, we will try and introduce you to other stature lengthening patients if they are around at that time. We cannot guarantee this as these other patients are scheduled for physical therapy independently of our consultation schedule. We must also request permission from them. We respect and guarantee all patients' privacy.
Booking Your Consultation
In order to book your consultation, please contact Angelique Keller at the Paley Institute at 561.371.9403, via email at akeller@paleyinstitute.org. Alternatively, you can get in touch with Angelique though WeChat ID: DrPaley.
Booking Your Surgery Date
In order to book your surgery, contact Rebeca Mones, our surgery scheduler. You can call the Paley Institute at 561.371.9403. She can also be reached via email at rmones@paleyinstitute.org. To secure a surgery date, we ask that you make a deposit at that time via credit card. You can also request a surgery date online at Request an Appointment
Privacy and HIPAA
At the Paley Institute we are HIPAA compliant. We cannot and will not release your name or medical information to anyone unless you authorize it. The only exception to this is minor patients (under the age of 18).
Preparing for Surgery
There are a number of things you can do to prepare for stature lengthening. First, you should read all the materials we provide on the website. Second, book a consultation and come with your questions written down so that you can get all the answers you need. Lastly, email us any questions you may think of later or do so via Contact Us.
It is important to be socio-economically prepared for lengthening. Organize your life so that you can put it on hold for at least three months. You will need to stay in West Palm Beach for at least nine weeks. You may not be able to go back to work since you will be wheelchair dependent when you return home for at least one month. Prepare your finances so you can not only afford this surgery but also afford any possible complications from the surgery that can arise. These are not common but can be costly when they do occur.
Be prepared to be single-minded and not distracted during the process so you can devote all your energy and attention to the limb lengthening process and rehabilitation. Visit West Palm Beach and check out where you will stay and the lay of the land. Arrange for someone to come with you or be prepared to hire home health to assist you. Organize a leave of absence from your job so that you don’t feel the pressure to return to work.
Stretches & Exercises
Stretching exercises prior to surgery may help minimize pain and discomfort during the lengthening. In addition to stretching exercises, it is important to stop smoking and limit your exposure to second-hand smoke and stop all anti-inflammatory medications. Stretches will be different for femoral lengthening and tibial lengthening.
- Femoral Lengthening
- Iliotibial Band
- Lie on your side, extend your hip so your thigh is in line with your body and flex your knee. In that position, try and bring the flexed knee towards the ground.
- You can also do cross-leg stretches with the hip straight.
- Quadriceps Muscles
- Bend your knee and straighten your hip at the same time. This can be done while standing and pulling your foot behind your rear and leaning back.
- Hamstrings
- Straighten your knee while flexing your hip.
- Iliotibial Band
- Tibial Lengthening
- Achilles Tendon
- Maximum dorsiflexion (foot up) with full knee extension (straighten the knee).
- Achilles Tendon
Psychological Evaluation
A psychological evaluation is not required before surgery. The importance of the evaluation is to ensure that we do not operate upon patients with a body dysmorphic psychosis as well as ensure that patients have realistic expectations and have the proper support required to undergo this procedure successfully. Dr. Paley initially used a psychologist for the first twenty years of performing cosmetic lengthening procedures. At this point in his career he is fairly good at doing the evaluation himself and will assess you during the initial consultation.
The Day Before Surgery
You will have a preoperative visit with the surgery team to go over consent forms and all of the paperwork. You will also have an appointment with our preoperative nurse and anesthesiologist. You will be given instructions for surgery. You should not eat or drink after midnight and you should come in two hours before your scheduled surgery to the preoperative area on the first floor of the Kimmel building at St. Mary’s Medical Center, 901 45th Street.
