Sunday, 08 May 2022 05:59

He was 5'7". After surgery, he’ll be 5'10"

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When I first met Scott — not his real name — in early March, he was gently pushing a walker ahead of him. I had gotten lost trying to find the door to his apartment, so he had to come find me. Leaning against the door frame in a fitted T-shirt and shorts, he waved me over and then steadied himself. On a picture-perfect Los Angeles day like this one, had the circumstances been different, we probably would have met outside and enjoyed the sunshine. But he’s still getting used to his new legs.

A few weeks earlier, Scott had what he calls life-altering surgery. He underwent a procedure that will make him permanently taller. There are no concrete numbers on how many people are having this procedure (though a 2020 BBC report found that hundreds of men have it every year), but Scott is among the men who, frustrated by how they’re treated because of their height, sought out a surgeon who could permanently lengthen his legs. Before the $75,000 procedure he had in January, he was about 5'7". By the time he’s done lengthening, a weekslong process after the surgery, he will be 5'10" — about an inch taller than the average American man.

The last few years have seen a notable rise in men seeking cosmetic procedures. From facelifts to Botox, men have been increasingly turning to cosmetic interventions to appear younger in the face of a culture that fetishizes youth. In 2018, Wired called this the “Brotox Boom.” The pandemic only accelerated the trend, as work shifted to Zoom and more men spent time looking at — and worrying about — their faces.

Scott shows the scars from his procedure

But height is another matter. There are fillers for jawlines and there is Botox for foreheads, but height — a major source of anxiety for men — seems unsolvable. The struggles for short men in the dating world are well documented. To improve their odds of matching with people, men have taken to lying about their height on dating apps. This happens so frequently that the dating app Tinder once rolled out an April Fools joke about verifying height, and men got very upset. Just last week, a TikTok went viral for devising a plan to “fact-check” guys who say they’re 6 feet tall. Height is even an advantage in the workplace, where taller men are more likely to end up CEOsand shorter men are less likely to get access to career opportunities. Short men are mocked on social media. Some research suggests shorter men are more likely to be depressed.

Scott, who is 25 and works in digital media, said that before the surgery, colleagues constantly made remarks about his stature. “I was not treated with respect,” Scott told me. “At every single workplace I’ve been in, there've been several situations where people commented on my height to discredit me entirely as a person.” One disagreement at work led to a colleague snapping at him and rebutting, “Don’t be so sure of yourself, short man!” Over the years, the insults began to take their toll. “I was waking up two hours before my alarm every day just to walk around the neighborhood and cry,” he said.

For Scott, demeaning comments about height are everywhere — whether in his personal life or in pop culture. He singled out TikTok particularly, where jokes about men’s height are rampant. “I don’t know how many times I have to hit the dislike button for your algorithm to learn I don’t want to see jokes about height,” he said. He flags the TikToks as harassment and bullying, only to receive a note back that says the app reviewed the content and didn’t find anything wrong with it.

He paused our interview and pulled out his phone to show me a TikTok from @flossybaby, one of his favorite influencers. “When I see a woman that is 5'8", I’m like, ‘That’s a tall woman,’” she says to the camera. “But when I see a man that is 5'8", I’m like, ‘Look! A garden gnome!’” In the comments, users had added to the bit: “No because who let him out unsupervised.” Humiliation flashed across Scott’s face. “Before the surgery, I was 5'7". I was not even a garden gnome to her.”

These kinds of comments drove Scott to seek out limb-lengthening surgery. In this elaborate procedure, a doctor breaks both femurs and inserts a titanium rod that slowly expands inside the patient’s body, making them permanently taller.

Scott first heard about the procedure when he was in high school. He watched a few YouTube clips about it but dismissed it at the time. “I was like, ‘That’s sick, I would never do that.” But he kept researching, and about three years ago, he became convinced it was the solution he was looking for. “I felt miserable,” he said. “There were things throughout my day, every day, that would bother me. I felt attacked or unfairly criticized due to my height.” Then he had a revelation: “When I realized what was really holding me back was the obstacle of money, I was like, ‘Oh, it’s just a game. If I can get $75,000, then I’m done feeling like this.’”

The goal gave him clarity. “I was not waking up and crying every day in my mask, walking around the neighborhood. Instead, it became ‘OK, I just have to get on my grind and figure out how to get the money.’” So Scott got to work and, in February 2021, started an OnlyFans page. Within a few months on the platform, he zeroed in on a niche: financial domination, a form of humiliation kink where clients pay him to degrade them and take their money. By January 2022, by supplementing his OnlyFans earnings with some of his savings and a small loan, he had enough to pay for the procedure.

When I met Scott, he was two months into a recovery that will take the better part of a year; this week, he was given clearance to stop using the walker. He can drive now, but sports are still off the table. The recovery requires stretching and regular monitoring. For the first three months, he will attend physical therapy four times a week. But for Scott, all of this is a small price to pay. “It’s surreal to be midway through the process,” he said. Everything has changed. For one, the cruel jokes don’t ruin his day anymore. “There’ll be days where I’ll see a meme that bothers me,” Scott said. “Then I’ll remember I had the surgery done.” He breathed a sigh of relief. “It allows me to not spiral out of control and lose hours of my day anymore.”

Shahab Mahboubian, the orthopedic surgeon who performed Scott’s surgery, is a bit of a social media star. On Instagram, the 46-year-old Californian boasts more than 45,000 followers. On TikTok, another 50,000. His handle is pretty straightforward: @heightlengthening. On his social media pages, you can see him doing dances and answering questions about the procedure.

Height-increase surgery is not Mahboubian’s entire practice. He said he performs about 30–40 of these surgeries a year. “I would say most of my work is still general orthopedics. I still do a lot of sports. Patients with shoulder issues, knee issues, back issues. I still see a wide range of orthopedic problems,” he told me in his office in Burbank, California. Still, judging by the large sign that reads “Height Lengthening Institute” at the door, it’s fair to say it has become his brand. “It’s become a big part of my practice. It’s the thing most people are interested in. That’s where I get most of my consultations,” Mahboubian said. He added that he’s seen a marked increase in surgeries during the pandemic. “Since a lot of people had more time on their hands, they opted to undergo their procedure,” he told me.

Though he’s been performing the surgery for more than a decade now, stature lengthening was not Mahboubian’s original plan. He was originally interested in sports medicine, a core part of the orthopedic profession. But he soon realized that that’s what the majority of his fellow doctors-in-training wanted to do. “I didn't want to do the same things that all the other orthopedic surgeons do, which is mostly joint replacements, fracture care, or sports injuries. Those are the top three,” he told me. That’s when he found a fellowship focused on limb lengthening and deformity correction.

Surgically lengthening limbs is not new. It has existed in some form for nearly 100 years. People wounded in military service or car crashes would get the procedure, often as a way to correct mismatched length in legs. What is relatively new is the deployment of the surgery for elective and cosmetic ends — that’s only about 15 years old. In other words, people are now choosing to undergo the procedure just because they want to.

Mahboubian nonchalantly described the “minimally invasive” procedure like a man recounting his breakfast. “Through small little incisions, I cut the bone surgically,” he began. “Then I insert a rod — we call it a nail or a rod — that goes inside the bone. The rod is magnetic and it has gears. Then there’s an external device that communicates with the nail. And over time, little by little, it lengthens out the nail.” The lengthening happens gradually. “We usually say about a millimeter a day, until they get to their desired height.”

There is a ceiling on how much height a patient can gain. “The maximum is 8 centimeters, because that's the limit of the nail. Anything beyond 8 centimeters is when we see most of the complications.”

Hang on, I protested. “Minimally invasive” and “cut the bone” are not concepts that naturally go together. “You want details on how you break the bone?” the doctor asked with a laugh. “I make a small incision — a 1-centimeter incision — and basically what I do is first weaken the bone by drilling through it. Using a small drill, I make a few drill holes. Then we use an osteotome, which is kind of like a chisel.” The chisel is what cuts the bone. “It’s done surgically and very accurately,” he added.

Is the broken bone the most painful part of the recovery process? “When you cut the bone, you get swelling around that area, but that goes away after a few days. Then there’s the lengthening pain, which is a stretching type of pain,” the doctor said. “But it’s tolerable because it’s done very slowly.” Mahboubian is quick to acknowledge the potential complications and how he seeks to address them. Anxious about infection? He starts his patients on antibiotics right away. He puts patients on blood thinners because there’s a risk of blood clots. There’s a risk the nails could break, hence why patients have walkers. “As some patients lengthen, they could make too much bone. Others may not make enough bone.” To address that, he takes regular X-rays to monitor how the healing is going. “The majority of my patients,” he said proudly, “have zero complications. The ones that do, it’s either because they didn’t listen to me, or didn’t do the proper therapy.”

In social media posts, Mahboubian often appears in before and after pictures with his patients. He is the reference point for the height they’ve gained. He is 5’9”, the average height for men in the US. “I was a late bloomer, so I was always the shortest one of my friends,” he said. “So I got a lot of the jokes and the being talked down to during those stages of my life.” He said he had a growth spurt later in his teens, but because of his years being shorter, he knows what his patients have gone through.

Was it those years that made him interested in this surgery? “Maybe subconsciously,” he said. “My motivation to get into this field was to change people’s lives for the better.” But it helps to have a reference point for the frustrations patients are expressing. “When they tell me their stories, I can relate to them.”

Mahboubian, holds a model femur that shows how the procedure works.

In summer 2018, comedian Jaboukie Young-White coined the phrase “short king” as a way to push back against the stigma of being short. The comedian tweeted that “short gave you donald glover. short gave you tom holland.” Now the term has taken full cultural hold as a way of expressing appreciation for shorter men. It’s a “short king spring,” TikTok declared. The internet seems ready to celebrate the height differencebetween Tom Holland (5'8") and Zendaya (5'10").

But Scott is not buying the short king discourse. “It bothers me, because if they accomplished the same accomplishments but weren’t short, you’d just say, ‘You’re a king.’ So why are we bringing height into it?” I suggested that it’s meant to be celebrating them. “That brings me to another issue: Tom Holland is 5'8". That’s really not that short. There’s like 30% of guys who are shorter than 5'8"! How do you think that feels to someone who is shorter than that?” He collected himself and added, “Shout out Tom Holland, though. Holding it down and dating Zendaya.”

Scott shimmied to the corner of his couch and steadied a large gray device about the size of a thick laptop — what he referred to as a “remote control” — on his right thigh. A small target appeared on the screen. “I have these blue X’s, and there’s a finder here where I have to line it up.” He pressed a button and the machine whirred. “Each activation of this machine expands the gears by a third of a millimeter,” he told me. “And typically, you do it three times a day, so it’s about a millimeter a day.” Scott will repeat this process three times a day for 80 days. By the end of it, he will be 80 millimeters taller — a total gain of 3.15 inches.

This part, Scott conceded, is the easy part of the lengthening. It’s nothing compared to the first few days. “The hospital is tough,” he said with a grimace. Patients often have to start moving on the day they get their surgery. They’re small steps, but they’re important for healing. “They get you up a few times because you have to walk. The first time they got me up, it was three steps forward and three steps back and that’s it. That’s all you can do,” Scott said.

For the first two weeks after the surgery, movement options are severely limited. “Your legs are straight out in front of you. You can’t bend them,” Scott said. “You can’t go on your side or go on your stomach.” He recalled that Mahboubian came to visit him the day after the surgery and told him “there’s going to be times when you’re in so much pain, you’ll wonder, ‘Why did I ever do this?’” Scott said he stopped the doctor and told him: “I am never going to ask, ‘Why did I do this?’ Do you think I put this whole plan in action to ever have regrets about it?”

Scott had already known what awaited him in the hospital. He had researched everything that had to do with the procedure. By the time he walked into Mahboubian’s office, Scott had answered most of his own questions. He was, however, starstruck to finally meet the doctor in person. He’d watched countless videos and listened to his voice for hours on multiple podcasts.

One of them, simply called Limb Lengthening Podcast, features host Victor Egonu, a Baltimore bodybuilder who had limb-lengthening surgery when he was 23. He interviews guests who’ve recently had it or surgeons who perform the procedure. Egonu, 33, is something of an evangelist for limb lengthening. A car accident when he was 9 and an injury when he was 11 resulted in one leg being longer than the other and caused significant pain. Though the purpose of the surgery was to even the length of his legs, he ended up with a little added height, going from around 5'7" to just under 5'9".

Egonu is frustrated with the stigma that men who seek the procedure face, a stigma that made reporting this story a challenge. Many of the men I reached out to for this story didn’t want to talk on the record. “I’m trying to show that, for the guys who the surgery means a lot to, it should be as accepted as a woman getting a boob job or a nose job or something like that,” he told me. “If the world can see and not necessarily empathize, but sympathize with some of the pain these guys may be going through, maybe people can not judge them for what they’re doing to fix their lives.”

On Egonu’s podcast (and matching YouTube channel), guests share knowledge and tips about what to expect, and how they handle the aftermath of the surgery. They share which doctors they picked and why. In one episode, a Japanese man who got his surgery in Istanbul (“Most Japanese men get theirs in Armenia,” he explains, “but I wanted to go to Turkey because it’s a bigger country”) says that he was prescribed pain medications like Voltaren to deal with the pain and it didn’t help much. Only the epidural he got after the surgery provided effective pain relief.

On occasion, when Egonu tapes his conversations live, he directs the conversation while listeners send questions about bone alignment issues (monitored through frequent X-rays), the best stretches during recovery (a gentle squat), and the best positions for sleeping after the surgery (on your back). They talk about whether tattoos will get stretched (not noticeably). Guests detail the surprise problems they ran into. “The biggest issue I didn’t expect was sleep,” one German guest says. “People are thinking about physical complications, but for me, for six months, I just wasn’t able to sleep,” he tells Egonu. “At the rehab center, I did six days a week of physical therapy, for two or three hours each day. And sometimes I’d close the curtains and cry for 10 minutes, then open the curtains to continue. It’s such a big mental challenge.” Mostly, though, the people who have had the surgery stress the importance of having someone there, a person to lean on when recovery gets tough.

For Scott, that person was his mom, who came down from the Northeast. “She flew here for the surgery and stayed for 12 days after the surgery,” he told me. They stayed in an Airbnb with just one floor, because his apartment had two, and the shower was on the second floor. Then they moved to a hotel room for another few days, until he felt comfortable climbing up the stairs.

At first, Scott said, his parents didn’t understand why he wanted the surgery. “But I told them, the next time you’re watching TV, just keep an ear out and when you hear anyone bring up someone’s height, tell me what the fucking context was — was it a compliment or an insult?” That’s all it took. “They got what I meant. They came around.”

Scott’s parents don’t know about the OnlyFans, though. “They asked about the money, and I just told them it’s not illegal, it’s not drugs,” he said. These days, while he is still recovering, he has taken leave from his job, and OnlyFans is his only source of income. It brings in about $4,000 a month. “It’s to the point where, even if I have a little drop off in numbers, my rent is paid for, my car payment is paid for. I’m good,” he said. Before his surgery, Scott spent a few weeks banking new content to post intermittently over the recovery period.

Though Scott gets sheepish talking about his page, it’s clear he’s proud of what he’s built. “One guy has sent me like $400 in a day just for messaging him. I never even had to send him a picture or a video or anything!” Another superfan eagerly waits for Scott to send a picture of meal receipts and immediately reimburses him. “For a month, this one guy bought me dinner like every single day,” he said.

I pressed Scott on whether he’s connected his online dom persona with the way he’s been treated in real life. He demurred. “I’ve definitely pieced that together in my head,” he said shyly. “That this is what I’m annoyed about in my actual life, but online it’s the opposite.” He’s the one in charge. “It makes total sense that I would create this platform that entices…” He trailed off with a giggle. “I don’t want to use the fucking terminology!” Then he lowers his voice. “That entices these subby guys to follow me and do what I want.”

Dr. Mahboubian holds a sample rod that’s inserted into the leg.

Getting surgery to increase height may be elective, but Mahboubian is reluctant to put it in the same category as other cosmetic surgeries. “This is life-altering,” he said. “It really changes people’s lives. Their whole outlook on life, the way people perceive them, the way they feel about themselves. It really affects all aspects of their life.” He shared that he’s had patients in their 60s, who have been waiting their whole life to have the surgery.

But not everyone who asks for the surgery is automatically in. “I’ve had people who are 6' and they just want to be 6'2" or 6'3",” he said. Normally, he tries to dissuade those people from pursuing the surgery. The tallest patient he has accepted? 5'11". “But everybody around him was much taller. His father was taller, his brothers were taller, his friends were taller, and his girlfriend was taller,” he clarified. “So he felt short relative to the people around him, and he needed to take some kind of measure to stop that feeling of inferiority.”

There is no standard way to determine suitability for the surgery. Ellen Katz Westrich, a clinical psychologist in New York, works closely with a stature-lengthening surgeon in New York to help determine whether a patient is a good fit for the procedure. “I don’t decide whether a patient can or can’t have the surgery,” she told me. Instead, her role is to assess whether the patient will benefit from the surgery. “What I am really interested in is: What are the person's expectations? If you have the surgery, what about your life do you think will be different? Are these realistic expectations?”

Westrich said lengthening surgery carries significant taboo. “There’s not a lot out there about stature lengthening as a cosmetic elective procedure,” she said. “People will say, ‘I got a tummy tuck, I’ve had Botox, I had a facelift,’ but not many will say, ‘I had stature- lengthening surgery.’” Westrich said many patients will instead tell people in their circle that they needed a procedure for another reason. “Many people will say, ‘I am going to tell people I had a hip problem,’ or, ‘My knees were the problem.’”

I asked Westrich to describe the most common experiences that patients shared with her. “One I hear quite often is ‘I don’t get the same respect as others. I’ve accomplished so much and I’m still often treated like a child.’” Dating is another arena. “I often hear people say, ‘I went on a date, and the person said, I really like you, but you’re just not tall enough, I’m looking for somebody taller.’

Can’t therapy help with this? “Therapy can certainly help the person better understand their own relationship to their body,” Westrich said. But patients who seek surgery may run into professionals who aren’t sure how to treat them. “I think sometimes patients can feel pathologized when a therapist says, ‘Oh, we have to get rid of your desire for surgery.’ If a therapist can pull back and see the desire for surgery not so much as a pathology, but as a means of trying to correct something that doesn’t feel right, I think that’s a useful approach.”

Mahboubian is not sure to what extent therapy can help solve the problem. “You can do as much therapy as you want,” he said, “but you can’t change people’s perception of you.” In this sense, he’s right: Therapy can perhaps better prepare a person for the frequent comments, but it’ll never affect the physical reality. “It’s not going to stop the jokes,” Mahboubian said. “This is the one type of surgery that can actually get rid of the psychological impacts that come with being short.”

The doctor’s comments echoed Scott’s perspective. “No amount of anti-anxiety medication or verbal talk therapy could get the world to stop treating me like this,” he said. “I could have a great session for five hours, and I would still go on the internet and see ‘Men below this height shouldn’t have rights.’” That’s the best-case scenario, if he could even find a therapist who can help. “A lot of therapists I saw said, ‘I never thought about it like that.’ I’m paying for them to help me, and a lot of times, I would be opening their eyes to the whole situation.”

Scott supports himself in a walker he uses during recovery from the procedure.

Next winter, Scott will have the rod taken out. He’s been closely keeping track. On the day we talked, he had lengthened his legs by 62 millimeters — he had 18 more to go. “It’s a little over 2 inches of difference, and it’s definitely noticeable,” he said. “Just looking at my bathroom mirror, I can tell the vantage point is different. In the shower, I was making eye contact with one row of tiles, but now it’s a different row of tiles.”

But the biggest difference, he said, is standing next to people he’s known for his whole life. He notices that they’re not casting their eyes downward to meet his. Instead, they look straight at him, their eyes level, their chins upright. “I’ll notice our eye-level difference, and I’ll really get caught off guard and almost start crying.”

 

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