Size does matter to some men, like New Yorker ‘Apotheosis.’ He has a big name – a pseudonym- and a small problem…literally. At five foot, six inches, the 37-year-old was shorter than most men and opted for a costly, cosmetic and incredibly painful limb-lengthening procedure so that he could add six inches onto his frame.

Turns out surgery to help men grow is becoming more prevalent than, you know, shoe lifts. Only a handful of doctors perform the procedure in the United States, with Dr. Dror Paley, an osteopathic surgeon at the Paley Institute at St. Mary’s Medical Center in West Palm Beach, Fla., being one of those precious few. He performed 650 leg-lengthening surgeries last year.

Of those 650, patients were a mixed bag. Some had deformities or were dwarves, but the majority of procedures he performed were of the cosmetic variety. It’s usually men who battle with a psychological condition called height dysphoria, which seems similar to body dysmorphic thoughts that women with eating disorders experience.

“The majority who come for cosmetic limb lengthening have what we call, height dysphoria,” the good doc said. “They’re unhappy with their height. It’s one of the few psychologic-psychiatric disorders that you can actually cure with the knife.”

So it’s not mind over matter. But going under the knife hurts in multiple ways.

The surgery is no joke and those who elect to have the procedure will endure serious pain akin to torture. The surgeons break the leg bones in half (that’d be reason enough to have us back out of of this surgery) and implant telescopic rods between the broken bones, which in turn pull the bones apart at a rate of a millimeter per day. Sounds like being drawn and quartered, no? Nevertheless, new bone grows, while muscle tissue, nerves, arteries and skin regenerate. Recovery is lengthy, including rigorous physical therapy.

Tack an $85,000 cost onto the pain and we’re left to wonder if being tall is worth all this.

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