An investigative report by Jiemian News on 1/7 revealed a clandestine world of leg-lengthening surgeries operating across China and internationally. These networks involve orthopedic surgeons, brokers, and even former patients who use their own stories to attract new clients.

Brokers can earn a commission of 15,000 to 80,000 yuan (approximately 2,100 to 11,700 USD) for each successful referral, with the amount varying based on the broker's seniority and the surgical facility.

Leg-lengthening surgery involves cutting the femur or tibia, then attaching a metal frame to gradually separate the bone segments at a rate of 0.5 to 1 mm per day, stimulating new bone growth.

Patients can choose between two methods: external fixation, which uses an adjustable metal cage attached to the outside of the leg and secured to the bone with pins; or intramedullary nailing, a method that uses a metal rod inserted into the bone to extend it from within.

External fixation has a complication rate of 15-20%, while intramedullary nailing has a lower infection rate and leaves fewer scars. In China, costs typically range from approximately 100,000 yuan for external fixation to 400,000 yuan for intramedullary nailing.

Patients undergoing leg-lengthening surgery inside a rehabilitation facility in China. Photo: Jiemian News

While legal for cosmetic purposes in countries like the United States, Germany, and South Korea, leg-lengthening surgery has been banned in China since 2006. Chinese authorities only permit the procedure for medical indications such as congenital deformities, trauma, tumors, or infections causing limb malformation.

Two major underground networks in China operate in Kunming, the capital of Yunnan province, and Nanjing, the capital of Jiangsu province.

In Nanjing, Li Zhong, a well-known broker, quoted a surgery cost of 120,000 yuan, plus 36,000 yuan for three months of rehabilitation in a rented apartment. Li declined to disclose the surgeon's identity or the surgery location, citing the need for secrecy to protect the doctor from repercussions for performing illegal surgeries.

However, he revealed that the surgery takes place at "the doctor's private medical facility" and asserted that this facility possesses all necessary legal licenses.

"The operating room is supervised by the doctor himself and built to the standards of a grade 3A hospital", Li stated.

According to Li, two or three doctors collaborate with him long-term; all are trauma and neurology specialists. He claimed that doctors from these two departments are more skilled in leg-lengthening surgery, and he has collaborated with them on over 200 cases.

Qin Sihe, honorary director of the Rehabilitation Hospital of the National Rehabilitation Aids Research and Application Center of China, introduced this type of leg-lengthening surgery to the country. Working in orthopedic surgery since 1978, he has performed over 37,700 limb deformity and disability surgeries. Doctor Qin refuted Li's claims, stating that skilled leg-lengthening surgeons in China must come from orthopedics and require many years of clinical experience.

Doctor Qin noted that victims of leg-lengthening surgery seek his treatment every year. He explained that while the technique has been applied and developed internationally for over 40 years and is relatively mature, "moderate height increase is not a major problem". However, vigilance is still required regarding its complications.

"The surgeon needs a deep understanding of the mechanism of limb regeneration and lengthening, as well as the ability to dynamically control the entire post-surgical process. The most challenging aspect is not the surgery itself, but preventing and treating post-operative complications", Doctor Qin emphasized.

Liu Ming, a doctor in the Orthopedic Trauma Department at Shanghai Fourth People's Hospital, said that while limb lengthening surgery is widely used clinically, many complications still occur. These complications include: damage to blood vessels and nerves; muscle contracture and joint stiffness; dislocation or subluxation; and poor bone healing, among many others.

Li's post showcasing patients' leg-lengthening progress, with Wu's legs on the right. Photo: Jiemian News

According to Xia Hetao, director of the Beijing External Fixation Engineering Research Institute, some unqualified medical facilities still perform bilateral lower limb lengthening surgeries, causing severe complications.

"Objectively speaking, this is not an intrinsic flaw of the limb lengthening technique, but largely due to the lack of technical standards by its practitioners, incorrect procedures, as well as insufficient quality control measures and blind implementation without adequate clinical experience", Xia warned.

Doctor Qin stated that complications can be improved through a second surgery, but the extent of improvement depends on the patient's actual condition. If improvement is not possible, patients "may suffer lifelong functional disorders, even disability".

Wu Shuang, a Chinese online influencer, underwent leg-lengthening surgery in Laos earlier this year due to her insecurity about her height of 154 cm. She described the operating room as messy and medical staff not wearing masks. She suffered post-operative complications, enduring infection and pain "like needles or knives cutting through flesh and bone".

Initially, Wu was scheduled for surgery in Yunnan, where her medical records were falsified to indicate she had bow legs, legitimizing the procedure. However, rival brokers reported this surgery to authorities, forcing Wu to travel to Laos for the operation.

Brokers often operate through WeChat messaging groups, answering questions and sharing videos to attract new clients. Ironically, many brokers are themselves victims of leg-lengthening complications, unable to return to work. To make a living, they accept becoming "predators", luring clients into the procedure.

Those interviewed by Jiemian News reported feeling "enticed" by brokers into undergoing surgery. One such individual is Feng Jiqiu.

Five years ago, Feng Jiqiu was 155 cm tall and weighed 44 kg. She always loved beauty but felt that her short stature made "everything look like children's clothes". She favored long coats and hoped to cultivate a "mature and sophisticated" style to become a livestream fashion model.

"I only thought about how beautiful I would look in those clothes after leg lengthening", Feng recalled.

She was added to a WeChat group with over 100 people. Constantly seeing messages about successful surgeries and busy deposit transactions in the group gave her a false sense of security.

After her surgery in Turkey, Feng still suffers from chronic osteomyelitis. She gained 11 cm in height but at the cost of over a dozen scars, each 1-2 cm long, covering her calves, making her afraid to wear shorts or skirts outdoors.

"My calves became too big, too ugly, and my body proportions were also unbalanced. My gait and posture are not good either. Now I feel like a patient because of these scars and unbalanced body proportions", Feng lamented.

Feng also developed clubfoot and knock-knees (X-shaped legs). "The bones broken in the middle of my lower legs cause me pain when walking or carrying heavy objects", she said, adding that she is now very afraid to go out. "Even taking out the trash makes me tired; it always feels like my legs are tied with sandbags".

Osteomyelitis, a complication of limb lengthening surgery, is a purulent inflammation of the bone marrow, cortical bone, and periosteum due to infection by pathogens like bacteria and fungi, or factors such as trauma and surgery. In severe cases, it can lead to disability.

The room Wu used for recovery after her surgery. Photo: Jiemian News

Wang Kui, an expert at the Institute of Psychology, Chinese Academy of Sciences, observed that unrealistic beauty standards can lead to self-blame and irrational attribution, where people blame their failures on their appearance and believe that changing their looks will solve their problems.

Reflecting on the past, Wu admitted she could not understand her decision from years ago.

"Why would a perfectly healthy person spend a huge amount of money to have their legs broken?" she questioned.

Hong Hanh (According to Jiemian News, Sixth Tone)