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LAS VEGAS — Late at night, on long drives around his Indiana hometown, Eli Mattern would ask God why he made the teenager the way he was.
The high schooler’s 5-foot-7 stature — 2 inches below the average man in America — consumed his thoughts. An ex-girlfriend told Mattern she was glad they were breaking up because he was short. He wore shoes to make him taller at prom last year. He grew so depressed over his height he became suicidal.
He lives among tall people, in a state that embraces its towering basketball players (e.g., Larry Bird, clocking in at 6 feet 9) and that was once home to the world’s tallest woman (Sandy Allen, 7 feet 7¼ inches).
“I just started getting really insecure and comparing myself with people around me,” recalled Mattern, a high school senior. “It really started getting into my head.”
And that’s how the 18-year-old ended up on a Las Vegas operating table in December, a chisel-like surgical tool called an osteotome wedged into his femur, as Dr. Kevin Debiparshad whacked it with a mallet.
This is the art of getting taller. Cost: Around $100,000. Surgery. Pain. Months of recovery.
What might seem crazy to some — cosmetic leg lengthening — is a growing business for Debiparshad, Dr. D to patients and staff, who does more than 100 of these surgeries a year. His patients have included tech bros, finance guys, social media influencers, athletes, actors and a well-known musician.
Also among the ranks? Adam Iza, a crypto guy turned federal inmate in Los Angeles who reportedly spent more than $60,000 for Debiparshad to extend the length of his legs. A November hearing revolved around Iza wanting the rods implanted in his femurs removed, a procedure he’d put off, his lawyer said, because the recovery had been painful. They were finally taken out the week of Mattern’s surgery; a U.S. marshal was in the operating room with Iza.
Male height has long been a fixation in society, worming its way into our vernacular: “Short kings,” “Napoleon complex.” Into our music: Skee-Lo’s line, “I wish I was a little bit taller” and Randy Newman’s “I don’t want no short people.” Into TikTok videos: “I’m looking for a man in finance, with a trust fund, 6’5, blue eyes.”
Even academic studies and research have pointed to some potential benefits of extra height for men in particular, including higher pay, more career success and greater productivity.
There are possible complications from leg-lengthening surgery, including rare cases of blood clots traveling to the lungs — which Debiparshad said hasn’t happened to his patients. And critics say there aren’t enough long-term studies documenting the effect on people as they age.
For many though, the costly, painful procedure is worth the risk.
“Very similar to why people might do other cosmetic procedures, like rhinoplasty, or breast augmentation or Botox,” said Debiparshad, 43. “I think it’s just to feel more comfortable in your skin.”
Dawn Mattern wiped away tears. Her son ran to find her tissues. They had flown to Las Vegas from Indiana the day before. They were waiting in a patient room at the LimbplastX Institute to meet Debiparshad for the first time in person, ahead of what Dawn called Mattern’s “life-changing surgery.”
Dawn and her husband had adopted Mattern as a baby. He had grown into a soft-spoken teenager with an easy smile and a love of weight lifting, reflected in his muscular build. To his parents, he was perfect just the way he was. Mother and son were nearly matched in height — the right size, Dawn said, for hugs.
But over the last year, she had seen a shift in her son. Mattern became quiet. Withdrawn. Eventually, he confided in his mother that he’d grown depressed over his height. It wasn’t about what anyone else thought, he told her, it was how he felt about himself: Diminished.
As he searched for a solution, Mattern learned about leg-lengthening surgery.
“When he came to us about getting this done, I’m thinking, ‘Well, I’ll do whatever it takes to make him not be so down and depressed,’ ” Dawn said. “You just do what you gotta do as a parent for your child.”
Dawn did her own research and contacted the LimbplastX Institute last year. She said they wanted Mattern to get the surgery during his Christmas break.
Mattern’s mom had suggested he try therapy ahead of surgery. Instead, after his Monday shifts as a veterinary assistant, Mattern went across the street to his family’s non-denominational Christian church and spoke with the pastor.
“Are you going to be happy after this? Is this really going to fix it all for you, or are you going to find something else after this that you don’t like about yourself and get down about that?” he recalled the pastor asking.
“I think it’ll help a lot,” Mattern told him. “There’s really nothing else I’m insecure about about myself. It’s always just been my height. I guess that’s why I’ve always believed this would fix that, because I’ve only ever not liked my height.”
The Sunday before Mattern flew to Las Vegas, more than 60 congregants encircled him at church. They laid their hands on the tormented young man. They prayed his surgery would go well.
Mattern would be gone for a month, initially staying at a condo a short walk from where he’d complete physical therapy.
His mother would be with him every step of the way.
“I could not be doing this without you here,” Mattern told his mom as they waited in the patient room on that December morning.
Debiparshad, who is 5 feet 10, walked into the room with a flurry of information. The surgery would last about an hour and a half. The doctor would then try to get Mattern up and moving within four hours.
Debiparshad handed Mattern a nail like the one that would go into his leg the next day — the Precice 2.2, an FDA-cleared, implantable lengthening device made of titanium. He’d removed it from a patient who had already attained his desired height.
After surgery, Mattern would use a small device to expand the nail, which has a magnet inside, 1 millimeter a day for about two and a half months, allowing for new bone to grow in the break. Within a year, the nail would be removed, as recommended by the FDA.
“Bone’s very smart,” Debiparshad said as he tapped his temple. Brains, he said, are “dumb.”
The doctor’s voice sped up as he made the case that bones are “the best tissue in the body.” Mattern’s new bone, he explained, would be as structurally sound “as your normal bone,” but it would be “synthesized out of thin air.”
“It’s one of the only tissues that regenerates with itself,” Debiparshad said. “Bone is very clever, and that’s why I think it outlasts us all.”
Mattern took in the information silently, one gray sweatpants-clad leg hooked behind the other, his arms crossed, obscuring the cross tattoo he’d gotten recently on his left inner forearm. His hair, normally a mop of curls, lay flat under a blue baseball cap.
He had one question for the surgeon: After he’d gained around 3.2 inches, would he be able to weight lift as he does now?
Debiparshad explained there could be a mild decrease in athleticism, somewhere in the 10% range. Still, he said, he had operated on a marathon runner eight years ago. The man is in his 50s and can run a seven-and-a-half-minute mile.
Weightlifters such as Mattern, Debiparshad assured him, return “pretty close to normal” after surgery.
Debiparshad said he’d operated on many other high schoolers. Some had gone back to school on crutches or in a wheelchair. The doctor asked Mattern if he’d thought about how he would explain his height increase to his classmates.
“Everybody around me already knows,” Mattern said.
“And how was their perception of that?” Debiparshad asked.
“My friends are very supportive,” he said. “Everyone else thinks I’m an idiot.”
One friend, he said, told him not to bother with naysayers.
“‘To them, this is just 3 inches of your height, but to you, I mean, it’s everything in here,’” Mattern recalled his friend saying, as he tapped his heart. “‘I mean, it’s everything to you. And they’ll never understand that.”’
Mattern lay unconscious on a stainless steel table in Operating Room B5 at Sunrise Hospital and Medical Center.
His upper body was shrouded in a blue surgical drape, his lower body strategically taped for privacy. His tree trunk-like thighs, the stars of the show, were bare, tinged yellow from an iodine solution used to prep the skin for surgery. The rhythmic beeping of the machine monitoring Mattern’s heart filled the room. His right thigh was illuminated by a spotlight. His surgical team of seven took their positions, actors in a play they’d performed a hundred times.
“Incision now,” Debiparshad said, as he made the first of six small cuts between hip and knee on the outside of Mattern’s right thigh. These would be the only incisions he would make that day on Mattern’s right leg.
Debiparshad, perched on a stool, wedged scissors into the first incision. He cut Mattern’s iliotibial band to prevent the tough tissue, which runs the length of the femur, from impeding the leg lengthening process.
The snap of the tissue being cut sounded like the crunch of walking on fresh snow, the surgeon said. Blood trickled down Mattern’s leg. Debiparshad sopped it up with gauze.
Next, he held a ruler in one gloved hand and a pen in the other, positioning them over a meaty thigh to measure the exact place where he would break Mattern’s femur. The measurement is based upon the implant length, as well as how many millimeters patients are hoping to gain.
The scrub technician passed Debiparshad a 5-millimeter drill. The doctor sent it whirring into Mattern’s bone. He was creating a line of perforations circling the femur to make it easier to break the strongest bone in the body, akin to the small holes that help tear a paper towel. When the doctor removed the drill to cool it down in the tech’s waiting cup of water, steam-like wisps of smoke radiated off.
At the top of the bone, near Mattern’s hip, Debiparshad cut a small window in the femur. He inserted a reamer, essentially a handheld drill, down into the bone to clear out the inner canal to make room for the 12.5-millimeter-diameter nail.
The clicking of the drill soon mingled with Nat King Cole’s “The Happiest Christmas Tree.” There were five days left until Christmas.
Soon, Debiparshad worked the razor-sharp osteotome into one of the incisions on Mattern’s thigh.
“Are we ready?” Debiparshad asked, before starting to whack the osteotome with a mallet, the way one would hammer a nail into a wall. He repeatedly called for an X-ray,to ensure the osteotome was positioned correctly in the bone to complete the break.
“Wow, really good Indiana bone,” Debiparshad observed with a chuckle. Mattern, he later said, had “been drinking his milk.”
Soon, Debiparshad had hit the femur more than 60 times. After pulling out the osteotome, the doctor moved Mattern’s whole leg to the right until there was a loud “snap,” like a wishbone breaking.
Debiparshad inserted the nail through the small window he’d created at the top of the femur and secured the nail inside the bone with four screws.
The surgery on Mattern’s right leg took less than an hour. Next up, the left. The OR smelled like a dental office exam room when teeth are being drilled. A member of the surgical team called Dawn. Everything, they said, had gone perfectly.
The technology has come a long way since Debiparshad’s four-week rotation in a Vancouver pediatric orthopedic clinic in the early 2000s. There, surgeons employed the so-called Ilizarov method — named for Gavriil Abramovich Ilizarov — a technique that uses a kind of external cage to gradually separate and lengthen bones.
Distraction osteogenesis, as limb lengthening is officially called, was once primarily used on trauma patients, who may have lost part of their leg in an accident, or on kids with congenital deformities.
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Debiparshad, a second-year medical student, worked with Dr. Ken Brown, who specialized in pediatric leg deformity, watching him “grow kids’ legs.”
“It seemed almost magical, it seemed almost unreal that I could tell you, ‘Well, I could grow you 3 inches of your leg if you need it,’” Debiparshad said. “When I saw that, I knew that I had to do this somehow. I didn’t know how, but I was going to be involved in this type of work, because it was miraculous.”
Debiparshad studied medicine at McGill University in Montreal, completed a fellowship in complex limb lengthening and deformity reconstruction at the Paley Advanced Limb Lengthening Institute in West Palm Beach and then a second fellowship at Harvard University.
As the years passed, Debiparshad’s experience grew and more minimally invasive methods developed. Hence, he said, “this kind of boom in the cosmetic part of what we see.” Each year, he does 100 to 200 cosmetic surgeries alone.
Debiparshad estimates that 20% of his patients getting the cosmetic leg-lengthening surgery are women and 80% men. His patients include people who are married with children. Some are as young as 12; another was 71.
“People think about breaking a bone and sticking a rod inside and slowly stretching you out, it sounds like a torture chamber in some ways,” Debiparshad said. “I do think it is a lot more palatable than people think.”
The cost of the procedure depends on where the Precice 2.2 nail is placed, around $78,000 for the femur and $84,000 for the tibia. The full price includes the two-day registration at the hospital, anesthesia time, surgeon time, OR time, 10 consecutive visits to physical therapy and all follow-up visits, including X-rays. The rod removal is an additional $15,000. And cosmetic surgery isn’t covered by insurance.
Debiparshad is the face of the procedure in the U.S. He’s been featured in magazine and news articles and a Hulu documentary, “Short Kings: The Big Business of Getting Tall.” At a Los Angeles federal court hearing in the fall, a defense lawyer called him the “premiere, No. 1 leg-lengthening surgeon in the world.”
The doctor said his complication rate is about 3%, probably half due to nails that have been damaged. One patient cracked a nail tripping over his dog and had to fly back to Las Vegas for Debiparshad to replace it.
Debiparshad has also operated on patients who want to be shorter. Last year he did six or seven leg-shortening surgeries, including that of Emily, a 46-year-old Bay Area resident. Emily, who is transgender, asked to be identified only by her first name.
She was 5 feet 11¾ and felt her height made her stand out. Since the surgery, she is 2 inches shorter and no longer fixates on her height as she had before.
Although she’d like to lose another inch or so, Emily said she doesn’t want to go through the rehabilitation a second time. For a while, she said, “I really couldn’t walk ... and even when I could my mobility was still limited for a while.”
But nearly a year after her surgery, she has gone scuba diving, rappelled down volcanoes and taken long hikes.
“You just need to be ready to go through that rehabilitation process,” Emily said.
Mattern was up and walking within hours of his surgery. That’s when the hard work began.
Two days before Christmas, Mattern, still wearing his yellow hospital “fall risk” bracelet, was wheeled to his first physical therapy session in the same building as Debiparshad’s office.
Three other patients were doing hamstring, quad and other stretches. They hailed from different backgrounds and states but were united in their desire to be taller.
“Welcome, man! First two weeks, first two weeks is bad,” a man called out to Mattern from where he lay stretching. “After two weeks, it’s a lot better.”
That patient, a social media influencer with hundreds of thousands of followers, had gotten the surgery more than two months earlier. He agreed to be interviewed as long as his name was not included.
He’d been embarrassed by the fact that his friends, male and female, were taller than him. He’d lost a few gigs because of his height — 5 feet 4¾ inches — although he wouldn’t go into detail. He referenced the “6’5, blue eyes” TikTok video.
“For taller people, you’ll have a better chance of being more successful,” he said. “If you’re taller, people automatically have more respect for you.”
His friends, many of them doctors and surgeons, had told him not to get the procedure, saying there was not enough documentation of what would happen as he aged. But he figures that “if I’m 60 or 70 years old, I’m not going to be running around anyways.”
There have been some challenges, he said, like the tightness in his legs that comes from not stretching enough. The first day out of the hospital, he had to yell for help after a food delivery driver left his order on the ground. He could not bend to reach it.
But he’s excited at the idea that he will be around 5 feet 8 by the time this is over.
Mattern faced his first challenge getting out of the wheelchair and up onto a walker. Kim Bozart-Dow, the physical therapy director, had him scoot to the edge of the chair and placed a hand on his lower back to help propel him forward.
“One step at a time,” Bozart-Dow told him, grasping his hips as he took each tentative step. “Left foot, right foot.”
Once he reached the treatment table, Mattern used his arms to guide himself onto it.
Around the room, everyone was facing their own challenges. The influencer did hill slides, pulling his knee back as he lay on the table to get it to bend. A 30-year-old grasped either side of the treatment bed as he lifted his left leg, trembling with the effort to keep it up.
As patients left for the day, the scrapes of their walkers mingled with the Christmas music: “Run, run Rudolph, Santa’s gotta make it to town.”
None of these patients would be running anytime soon.
As the influencer prepared to leave, he appeared to glide along with his walker.
“I can’t wait until Eli gets around that easy,” Dawn said.
The influencer reassured her: “Time will go by very fast.”
Not long after Mattern’s surgery, the teen and his mom were settled in a Las Vegas hotel. They had spent Christmas and New Year’s away from Mattern’s father and were ready to head home. Mattern planned to attend school remotely after winter break finished.
“Just a couple days,” Mattern said proudly of his progress, and “I’ll be half an inch.”
On the way to his ultimate goal: 5 feet 10.
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