Inside Australia's booming leg lengthening industry.

"At 12, I was taller than most girls," said Elaine Foo in an interview with the BBC. "By 14, I was suddenly shorter than everyone. Over time it became an obsession. Taller means better. Taller means more beautiful. I just felt that taller people had more chances."

Dreaming of growing from 5ft 2in (157cm) to 5ft 5in (165cm), the 49-year-old voluntarily underwent one of the most extreme cosmetic procedures available — having both her thigh bones surgically broken, then fitted with expandable metal rods that would slowly stretch her legs by several centimetres over the coming months.

While it might sound extreme, she's not alone.

In an interview with Mamamia, Professor Munjed Al Muderis — one of Australia's preeminent orthopaedic surgeons — confirmed what his operating theatre has been witnessing firsthand: women, not men, now dominate the patient list for this brutal path to extra height.

"Interestingly, we get more female clients than male clients asking for cosmetic lengthening," he told us.

Watch: Here's what happened when we asked Naomi McCullum, a cosmetic physician, everything she'd do to our face. Post continues below.

This growing trend represents a significant shift in cosmetic surgery preferences amongst Australian women, who are increasingly willing to undergo a complex, painful procedure to gain those extra centimetres.

What exactly is leg-lengthening surgery?

While the procedure may sound like something from a horror movie, it's very real and has been evolving since the 1960s.

"In the old days, we used to use a frame, which is like a mechano set that sits outside the skin and is connected with bolts and wires into the bone," Professor Al Muderis explained. "Then we made a cut in the bone in a certain area. Using Allen keys, we would then jack out the bone by lengthening it gradually."

*Shudders*.

However, today's technology is far more sophisticated, said Professor Al Muderis, involving internal magnetic lengthening nails.

"There is a magnet inside the nail and that magnet is connected to multiple gearboxes inside the nail. The nail has a telescopic mechanism where it lengthens and expands," he said. "It's controlled externally without cutting anything, without any wounds. It's controlled by a big rare earth magnet that sits on the leg, and you press a button and that turns the magnet."

The surgery itself involves small incisions on the outer side of the leg, boring a canal inside the bone, and inserting the magnetic rod, which is locked at both ends. After allowing seven to ten days for initial healing, the lengthening process begins at a rate of approximately one millimetre per day, with regular X-rays to monitor progress.

"The body thinks that it's a fracture that is trying to heal. So it starts healing," Professor Al Muderis told Mamamia. "As the bone lengthens, the bone formation forms in that cavity, and it keeps forming bone intrinsically by itself until it consolidates and forms brand new bone."

The result? "That brand new bone, if you come back two years later, is no different to the normal bone. It's absolutely normal bone. Same strength, same quality and same material."

Why are women seeking to be taller?

So, why is this such a growing cosmetic phenomenon for Australian women? According to Professor Al Muderis, the motivation behind women's decisions to undergo this procedure are complex and varied.

While many might assume it's purely aesthetic, Professor Al Muderis noted that career advancement is a significant factor. "I have a patient who wants to be 190cm... because that person wants to be a model. For example, they will be disqualified if they are shorter than that. So in order to pass their job tests, they need to be at a certain height."

There's also a significant psychological component related to past experiences. "When you look at psychological history, you see a lot of short people get bullied at school," Professor Al Muderis explained. "It's much harder to bully a taller person."

The confidence that comes with height is something Professor Al Muderis has observed even in children: "I have a daughter who plays soccer on weekends, and she's three years old. She plays with kids who are five years old, and she's the tallest among them. And you see the interaction between them. She's very confident because of her height."

Other careers where height requirements might come into play include flight attendants, who need to meet a minimum height to be able to reach the overhead bins and safety equipment.

What are the risks?

A thing you need to know: Leg lengthening is not a procedure to be undertaken lightly. Professor Al Muderis emphasised the importance of understanding what's involved and the potential complications.

"By lengthening the person, we are making them not normal," he stated candidly. "Your body is normal for that size. The shape that you have, the shape that you grew up with, is the shape that you're designed to have."

The risks fall into two categories: standard surgical risks and those specific to the lengthening process.

Standard risks include:

• Infection

• Blood clots

• Fractures of implants

• Failure of lengthening

• Premature consolidation

Additional risks from the lengthening itself include:

• Contractures (reduced range of movement)

• Stiffness

• Pain in joints above or below

• Dysmorphia if only certain bones are lengthened

"The bone can be lengthened very easily, but the nerves, the tendons, the muscles, the soft tissue are much harder to lengthen," Professor Al Muderis explained. "So it needs to be done sensibly, needs to be done by experts in the field, by people who do it on a daily basis."

Why do some patients go overseas?

In Australia, cosmetic leg lengthening comes with a significant price tag, as it's not covered by Medicare.

"If it is a pure cosmetic lengthening in Australia, then it will not attract any Medicare rebates," Professor Al Muderis emphasised. "The patient has to pay out of pocket for the procedure, and that can be very, very expensive."

Like many other areas of cosmetic surgery, this expense drives many Australians to seek the procedure overseas in countries like India or Turkey, where costs are lower. However, Professor Al Muderis told us this decision often leads to complications that ultimately cost more.

"People choose to go overseas because it's much cheaper, but that can be on certain occasions at the expense of quality," he warned. "When they come back with a complication, the health system has to cope with it because it falls under the umbrella of a complication of surgery."

Should perfectly healthy legs be broken?

As Professor Al Muderis shared, the procedure remains controversial within the medical community, particularly among orthopaedic surgeons.

"It is very frowned upon by the medical fraternity, especially the orthopaedic fraternity, because some people are strongly against it, and they say that it should not be allowed," Professor Al Muderis shared.

However, he argues that there's another perspective: "The flip side of the argument is that if you don't offer it here, then we are putting these people at risk because they will do it anyway. And if they go and do it in a less favourable environment, then are we providing these people with the best opportunity?"

By offering the procedure in Australia with proper screening and expert care, he suggested, "you minimise the risk, you minimise the burden on the taxpayers, and you minimise the burden on the healthcare system."

Who can have leg lengthening?

Not everyone. Professor Al Muderis emphasised that his clinic doesn't advertise cosmetic leg lengthening and employs a rigorous assessment process for potential patients.

"We go through a very robust assessment with them, and that includes assessment from the surgical point of view, nursing assessment, psychological assessment, pain management assessment," he explained. "It's not that if you wish to be taller, you just go and buy a ticket to get surgery. It doesn't work that way."

This careful screening aims to ensure patients understand the "intricacies and the ins and outs" of the procedure and process, which is lengthy and carries significant risks.

The future of height enhancement in Australia.

While Professor Al Muderis receives about one inquiry per week regarding cosmetic leg lengthening, he noted that many patients still aren't aware that the procedure is available in Australia from experienced surgeons.

As awareness grows and technology continues to advance, we may see this controversial procedure become more mainstream, following the path of other once-controversial cosmetic procedures that are now commonplace.

For now, Professor Al Muderis believes the most important thing is providing Australians with safe options: "We are very qualified to perform the procedure safely and sound and with a high level of efficacy and efficiency and with good outcomes."

Whether you view cosmetic leg lengthening as an extreme vanity procedure or a legitimate means of addressing psychological and practical concerns, one thing is clear: the desire to stand taller is no longer just a male pursuit, and Australian women are increasingly willing to break their legs to gain height.

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Would you consider leg lengthening surgery? Have you experienced discrimination based on your height? Share your thoughts in the comments below.

Feature image: Getty.