Limb Lengthening by Lengthening Over Nail (LON) – The Combined Method

Classical methods with an external fixator such as Ilizarov and Holyfix require a long period of external fixation until the full consolidation of bones. Patients must keep the device attached to their legs once the bones are completely strengthened. However, a shorter duration of external fixation has led to the development of new techniques such as Lengthening Over Nail (LON, also known as ) the combined method. This brings out a huge advantage in terms of removing the external fixator earlier. For instance, patients only spend around 2 or 3 months with external devices of LON on their legs compared to 9 or 12 months in completely external methods such as Ilizarov and Holyfix. When compared to traditional lengthening treatments, a technique focused on offering better comfort and internal bracing for the regenerated bone should have a lower complication rate, as well as simplicity of application and cost-effectiveness. In addition to all of these, Holyfix and LON (The Combined Method) apparatus have such a superior design allowing the accelerated bone formation and transferring the burden from the bone without any shortening (Dynamization).

Components of Lengthening Over Nail (LON) – The Combined Method

External Fixator;

Its role is to be scaffolding outside of the leg. Stated in other words, it is a stabilizing frame made of strong metal to keep the bone stable during the lengthening period. Metal bars are attached to the bones with pins as can be seen from the picture below. The device is kept between two to three months depending on the desired height.

Intramedullary Nail;

Intramedullary nail or rod is used as internal fixation and is made of titanium alloy. The doctor decides the size of the nail by reviewing the X-ray images. (8,5 mm, 10,7 mm, 11,5 mm or 12,5 mm) During the operation, it is surgically embedded into the bone cavity. As the nail is biocompatible, it does not contain any elements that will cause harm to the body.

Limb Lengthening Surgery Lon Method Scar
Limb Lengthening Surgery Lon Method X-Ray

2 + 1 Surgeries with LON (the Combined Method)

If LON is chosen as a surgery method for limb lengthening, there are three operations that are performed;

  1. First Surgery; An intramedullary nail is inserted into the medullar cavity of the bone, and then, an external fixator is attached to the leg. Patients lengthen the bone gradually by 1 mm per day by turning the screws. (Every 6 hours the screw is turned by a metal key / 0,25 mm x 4)
  2. Removal Surgery for External Fixator; Once the desired height is achieved, the nail is locked with screws in order to preserve the achieved length. After that, the external fixator is removed. The remaining nail in the bone’s canal will move on to provide stability while the newer bone matures and hardens.
  3. Removal Surgery for Intramedullary Nails; Intramedullary nails can be removed upon the patient’s request after the full bone consolidation is completed. It can take a year or one and half years to get rid of the nail with a short procedure. Yet, some patients prefer not to remove it.

Advantages and Disadvantages of LON Method


  • It allows the external fixator to be removed much earlier compared to classical methods. (e.g Holyfix)
  • It is more cost-friendly than internal methods such as Precice and Stryde.


  • The surgery cost is higher than classical methods because of the usage of the intramedullary nail.
  • There is a high risk of getting an infection unless the dressing is changed properly.
  • Patients’ comfort zone may be spoiled since there are external fixators attached to the legs compared to internal methods.

The ‘LON’ methodology is highly preferred by our patients for these simple reasons:

  • High reliability in LON comparison to classical external methods due to the fact that Intramedullary nails add more stabilization to the bone.
  • Early removal of external devices allows earlier return to regular daily life activities. To compare, in the Holyfix method, patients have to walk, sleep, and live with external devices for 9 to 12 months or more.
  • Most importantly, reasonable costs in comparison to other latest systems such as PRECICE or STRYDE.

For the reasons listed above, around 70-80% of our patients choose the LON method.

It is equivalent to the conventional methods ( Ilizarov or Holyfix ) in terms of postoperative scars. While some people may find the scars disturbing, others may find them too insignificant to notice and worry about. The surgical wounds are stitched with dissolvable sutures and covered with waterproof dressings. Nevertheless, the scar marks will fade away as time passes by, and will not be eyeful. Especially, our surgeon ties off stitches aesthetically. If you think you may have sensitive skin against scar marks, you may find out some useful tips for the ways of minimizing the scar marks by watching the video below.

Wanna Be Taller Patient's Lon Scar Mark Wanna Be Taller Patient's Lon Scar Mark
Wanna Be Taller Patient's Lon Scar Mark Wanna Be Taller Patient's Lon Scar Mark

As in any other surgery, there are always risks and complications that might occur. As long as the doctor applies the right technique, the hygienic environment is established at the hospital, and proper post-operative care is provided, the risks and the complications are preventable and treatable. As Wannabtaller Team, the first priority is always patients’ safety for us. Yet, every person has a unique physiology and some unpredictable conditions might occur such as non-bone union or slow bone union. You may visit our blog writing to find out more information related to this issue;  "Limb lengthening Side effects, Complications and Risks"

  • Assoc. Prof. Dr. Yunus Öç(Istanbul, TURKEY) – 19,850 $ LON method, 47,850 $ intramedullary nail (PRECICE 2.2), Precice Stryde, 16,500 $ limb shortening surgery,
  • Dr. Paley (the USA) – Bilateral femur lengthening (up to 8 cm of height; cost $97,500 USD,PRECICE-Stryde) / Bilateral tibia lengthening (up to 5 cm of height; cost $109,000 USD, PRECICE-Stryde)
  • Dr. Jacob Rozbruch (the USA) – $125,000 (Femur or Tibia) / Nail Removal Fee: $20,000 (Femur or Tibia)
  • Dr. Shahab Mahboubian (Hollywood CA, the USA) – Bilateral femur lengthening (Precise nail) – $75,000, Bilateral tibia lengthening (Precise nail) – $85,000 & Combined tibia and femur lengthening 3-4 weeks apart – $155,000

You can visit our limb lengthening surgery price post for more detail.

How many months should I stay for this procedure?

Limb lengthening is not a simple procedure to go through. Considering broken bones and the recovery process, patients should spare a considerable amount of time for it. Notably, the first 3 months are a crucial period for patients in order to get through the process healthily as much as possible. The lengthening period needs to be observed closely by the doctor apart from the recovery, the functionality, and the health condition of the patient. Besides all these, patients must take a proper physiotherapy session from a physiotherapist who is well familiar with the post-operative process of limb lengthening. Patients desiring to have limb lengthening surgery need to stay here for at least 3/4 months by taking into account all these factors.

We provide patient accommodation, post-operative care, and physiotherapy services at Kumburgaz Marin Princess Hotel. For other accommodation facilities and prices, please visit Accommodation services page.

  • Accommodation + 3 meals/day
  • Personalized Physical Therapy
  • X-rays, tests & examinations
  • Medications
  • Psychologic Counselling Service (Twice a month)
  • Dietitian Services (Twice a month)
  • Fitness, Free WI-FI internet, daily room cleaning, clean towels, and linen changes
  • 24/7 business center use for those who continue their work remotely
  • Activities outside the hotel and special tours for the patients to relax, breathe, and increase their motivation once a month

All inclusive: 4,550 $  3,580 $/ per month

(3 month-package: 10,540$)

Step by step guide from the beginning to the end with LON (the Combined Method)

Wanna Be Taller Step by Step Lon Surgery

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Jopa2023-06-02 01:33:31

Hi,I'm 18 years old from abroad, and interested in this limb lengthening surgery I want to increase 15cm. What's the shortest duration to achieve this, and get those two surgeries in a shot span because I'm short in time


Wanna Be Taller - Makbule2023-06-02 13:14

Hello, first of all, with a single surgery, you can gain up to 8 cm (3 inches) from Femur, and 7 cm (2.76 inches) from Tibia. These are the maximum safe limits and it is not advised to exceed them in terms of health and proportionality. Quadrilateral surgery is not performed by our doctor because it is too risky. For example, there is a high risk of embolism, and long duration of anesthesia and there can be multitrauma in the legs. Thus, the second limb lengthening surgery can be done ideally 6/12 months after the first surgery. The amount of lengthening that can be safely achieved in a single surgery depends on various factors, such as the age and overall health of the patient, the location of the bone that needs to be lengthened, and the surgical technique used. It's important to note that pushing the limits of safe lengthening can increase the risk of complications, such as nerve damage, joint stiffness, infection, muscle contracture, and bone healing problems. It's essential to consult with a qualified and experienced orthopedic surgeon who can assess your individual case and provide guidance on the safe and realistic limits of lengthening for you. The minimum time to achieve between 12-15 cm is 6 months and the maximum is 12 moths. Regards, Jana

Lomax2023-05-28 06:20:34

I like to get the LON method surgery on femur since my legs are short for my height. Do I get to pick how many cm I want in length or do the doctor tell me how much cm I can get.


Wanna Be Taller - Makbule2023-05-31 11:32

Hello, if you can provide us Orthoroentgenogram image with its original files in advance, our doctor can measure each segöent and calculate the discrepancy. Accordingly, he states how much you should lengthen per bone. Or you can visit him, have the detailed X-ray and get the bones measured here. Then, you can discuss the further steps with the doctor in detail. Regards, WBT.

Mohamed Nasri2023-05-17 23:13:44

I want to lengthen my stature


Wanna Be Taller - Makbule2023-05-18 11:31

Hello, thnaks for your comment. Limb lengthening is a surgical procedure that aims to increase the length of your limbs, typically the legs. It involves the careful and controlled breaking of the bone and then gradually separating the bone fragments over a period of time. This process stimulates new bone formation, which leads to the lengthening of the limb. If you have specific questions or would like more detailed information about the procedure, the recovery process, potential risks, or anything else, feel free to ask! We're here to provide you with the information you need to make an informed decision. Regards, WBT.

Chris2023-05-16 22:45:54

What is the current price for Lon method?


Wanna Be Taller - Makbule2023-05-17 12:20

Hello, the --current LON surgery fee-- is 19 850 USD. To be noted, the surgery quotes may change depending on the price hikes of the manufacturing companies. For more details, you can get in touch with a patient consultation expert via WhatsApp or Email. WP Number: +90 531 988 30 90 Email: Regards, Wannabetaller Team

Andreas 2023-05-11 18:05:46

I'm interested in the LON method surgery! I'm looking for 5 inches of extra height! I live in Canada!


Wanna Be Taller - Makbule2023-05-13 12:45

Hello, thank you for your interest. You can gain up to 6 inches by undergoing two separate bilateral surgeries with a considerable time gap advised by the doctor. I have sent detailed information regarding the quotes, process, and methods. Best regards, WBT.

Manisha2023-04-17 00:26:43

Hi, How much is the LON for leg (femur)? What is the package fir the surgery including stay? What if any complication / infection occur? Is it covered in this cost? Removal of intramedullary nail is done After 1 year not before? For how long the stay will be for that?


Wanna Be Taller - Makbule2023-04-19 14:54

Hello, thanks for oyur comment. **Current* Accommodation Package Fees: *2 450 USD (1-Month) , *7 150 USD (3-month.) There are some potential risks (infection, non-bone union, fast or slow bone union, muscle contractures, etc.) to be considered, but being paralyzed is out of the question. Unless an experienced doctor performs the surgery, you shall have complications. With our company, your surgery will be done by a surgeon specialized in this field and potential risks will be minimized with our team. For more details: Currently, we have made a new contract with an insurance company. We officially offer an insurance policy for complications, which costs 500 USD. If you face any of them within 6 months after the surgery, the insurance will cover most of the expenses. For more details: Internal nail removal surgery is performed roughly 1-1,5 years after the initial surgery. Patients stay for 2 days at the hospital afterwards. On the 3rd date, they are discharged. Regards, Wannabetaller Team

MJ2023-04-12 02:12:20

Hi do you do arm lengthening? If yes what is the cost? Is it both humerus and the radius/ulna? Also what is the cost of lengthening the femur 1.5" inches & the tibia 2.5" using the Precise 2 method? Thanks


WannaBeTaller - Makbule2023-04-13 12:44

Hello, thanks for your comment. Yes, our doctor performs arm lengthening. The surgery is only performed on the upper arms (humerus) and daily distraction is 1 mm. There are two methods performed for arm-lengthening; *LON *Precice 2 The minimum height achievement is 4 and the maximum is 6 cm. The lengthening may take 1-2 months, and using the arms freely may take roughly 4/5 months after the lengthening is over. The total bone healing takes 5-8 months after the lengthening. For the quotes, an email has been sent to your email address. Regards, Wannabetaller Team

Ly vathna 2023-04-11 21:08:18

I want to know more detail about leg lengthening


WannaBeTaller - Makbule2023-04-13 12:39

Hello, thanks for your comment. Limb lengthening is achieved by utilizing the principle of distraction osteogenesis, which means that height is gained by distracting the cut bone, which creates new bone tissue and causes the bone to expand in length. The basic concept is to break the bone surgically (osteotomy) and then progressively extend (distract) it using an internal or external fixation device. External (i.e Ilizarov), internal (i.e Precice 2), or hybrid fixator systems (i.e the LON) can be used for this purpose, but the underlying idea remains the same. If you are interested in receiving more details regarding the surgical procedure and post-up, you can contact our patient consultation expert and require a "Complete Guide File" or an online consultation. For fast communication, you can reach us via Whatsapp or Telegram - +90 531 988 30 90 Regards, Wannabetaller Team.

Naëlie Florimond2023-04-02 02:05:41

Can I get 15 cm with the LON method ?


WannaBeTaller - Makbule2023-04-03 11:33

Hello, thanks for your comment. Given the time, effort and flebility of your muscles, you can achieve between 12-15 cm by undergoing 2 separate bilateral surgeries. The advised minimum time gap between 2 operation is 6 months. Please feel free to get in touch with us. WhatsApp/Telegram +90 531 988 30 90 or e-mail Regards, Wannabetaller Team Regards, Wannabetaller Team

Noah2023-03-14 01:31:35

How much to have both surgeries & reach 14cm?


WannaBeTaller - Makbule2023-03-14 12:33

Hello, thanks for your comment. The surgery prices may vary depending on the surgery methods. The current prices may range from 20 000 USD to 48 000 USD. If you are interested in the online consultation, you can book your free online consultation below: For fast communication, you can reach us via Whatsapp or Telegram - +90 531 988 30 90 Regards, Wannabetaller Team

Dee2023-02-24 15:02:11

If I'm 5'9" can I gain 14cm total and how long would you need to wait between operations?


WannaBeTaller - Makbule2023-02-24 15:04

Hello, thanks for your comment. Second lengthening surgery can be performed 1 month apart if the doctor deems it appropriate. Ideally, the doctor recommends doing 3-6-12 months apart. Please feel free to get in touch with us. WhatsApp/Telegram +90 531 988 30 90 or e-mail Regards, Wannabetaller Team Regards, Wannabetaller Team

Antonio2023-01-30 17:13:30

Hi i live in U.s , im 5'5 interested in this surgery very soon . How much for LON method , no accomodation stay . & Can this surgery be paid for through a non finacning installment plan? I have money saved up but my best bet would be a installment plan if you all at "wanna be taller" offer that service to make it easier for new individuals who cant pay full amount right away.


WannaBeTaller - Makbule2023-01-30 18:14

Hello, thanks for your comment. The current LOn surgery cost is 19 850 USD only including external device removal surgery without accommodation. Normally, the full amount of the fee is paid before the operation, yet we offer an installment plan. Accordingly; 1. 10 percent deposit payment of the surgery cost is sent in advance 2. 60 percent of the surgery cost is paid before the surgery via money wiring or cash 3. 30 percent of the remaining money is paid in installments. It can be divided into 5/6 months. Accommodation and other expenses are not included in the installments. Regards, Wannabetaller Team

darya2023-01-27 15:35:46

Hello, How much does the LON method cost + including the accommodation? and do you offer financing?


WannaBeTaller - Makbule2023-01-27 17:20

Hello, thanks for your comment. The current LON surgery cost is 19 850 USD. The current 3-month accommodation is 7 150 USD. When it comes to financing, we don't provide such a service. Please feel free to get in touch with us. WhatsApp/Telegram +90 531 988 30 90 or e-mail Regards, Wannabetaller Team Regards, Wannabetaller Team

Ath2023-01-02 00:44:40

Hi, I want to ask if how much for all expenses including the surgery via ion method? Thank you


WannaBeTaller - Makbule2023-01-02 18:02

Hello, thanks for your comment. The current LON surgery fee is 23 850 USD (external device removal surgery is included.) Adding a 3-month accommodation package, the price would be 35 400 USD. Please feel free to get in touch with us. WhatsApp/Telegram +90 531 988 30 90 or e-mail Regards, Wannabetaller Team Regards, Wannabetaller Team

Joshua2022-12-22 20:12:48

Hi i would like to ask if how much for all expenses including the accommodation? Thank you!


WannaBeTaller - Makbule2022-12-23 11:29

Hello, thanks for your comment. Based on the current prices, the total cost would be 24 000 USD (including the main surgery, external device removal surgery, and 3-month accommodation) Please feel free to get in touch with us. WhatsApp/Telegram +90 531 988 30 90 or e-mail Regards, Wannabetaller Team

canon2022-12-18 14:02:35



WannaBeTaller - Makbule2022-12-21 13:57

您好,請用中文聯繫我們的患者代表以獲取更多詳細資訊。 電郵位址: 電話號碼:+90 533 193 6500

Donovan Cage2022-12-10 17:38:13

Do you offer financing for the LON and accommodation package?


WannaBeTaller - Makbule2022-12-13 11:50

Hello, thanks for your comment. An installment plan can be offered only for the surgery cost, but for the other expenses, it is not. Please feel free to get in touch with us. WhatsApp/Telegram +90 531 988 30 90 or e-mail Regards, WannaBeTaller Team

Almo2022-11-27 09:53:30

Merhaba, ameliyat ücreti ne kadar? Ve size yakın yaşıyorum, bu yüzden bir otele ihtiyacım, ortak bir oteliniz var mı yoksa tek başıma mı aramalıyım?


WannaBeTaller - Makbule2022-11-28 10:21

Hello, thanks for your comment. Please contact our Turkis patient consultation expert to get more details regarding the surgery and the process. PN: +90 505 091 66 09 Regards, Wannabetaller Team

Marty2022-11-27 09:09:26

Hello, I would be interested in LON surgery. What does it cost? And what is the waiting time for it? Thank you Marty


WannaBeTaller - Makbule2022-11-28 10:27

Hello, thanks for your comment. Patients need to give us notice at least a month ago, and in order to reserve the surgery date, they need to send a 10 percent deposit payment. For the quotes, the information has been sent to your email address. Regards, Wannabetaller Team

Anonymous 2022-11-07 17:40:01

Does the cost of the surgery cover both limbs, or is it a individual fee


WannaBeTaller - Makbule2022-11-08 11:59

Hello, thanks for your comment. A single surgery fee covers both legs (either femurs or tibias) Regards, Wannabetaller Team

D. Powers2022-11-06 01:45:56

Can the LON method be performed on femur? And what the is total cost including 3 months stay and removal?


WannaBeTaller - Makbule2022-11-07 10:38

Hello, thanks for your comment. Yes, the LON method can be applied to the femurs. Though it can be challenging compared to Precice 2, most patients go for it and achieve their desired height. With current prices, the quote for a single LON surgery and 3-month accommodation is 24 000 United States Dollars. Please feel free to get in touch with us. WhatsApp/Telegram +90 531 988 30 90 or e-mail Regards, WannaBeTaller Team

Ahmad 2022-10-27 13:19:55

What is the cost of all 3 surgeries


WannaBeTaller - Makbule2022-10-28 12:40

Hello, all the necessary details regarding your inquiry have been sent to your email address. Regards, Wannabetaller Team

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