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Why some people are purposefully having their legs broken by cosmetic surgeons

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Would you willingly have your legs broken, the bone stretched apart millimetre by millimetre and then spend months in recovery – all to be a few centimetres taller?

This the promise of limb-lengthening surgery. A procedure once reserved for correcting severe orthopaedic problems, it has now become a cosmetic trend. While it might sound like a quick fix for those hoping to make themselves taller, the procedure is far from simple. Bones, muscles, nerves and joint all pay a heavy price – and the risks often outweigh the rewards.

Limb lengthening is not new. The procedure was pioneered in the 1950s by Soviet orthopaedic surgeon Gavriil Ilizarov, who developed a system to treat badly healed fractures and congenital limb deformities. His technique revolutionised reconstructive orthopaedics and remains the foundation of current practice today.

While the number of people undergoing cosmetic limb-lengthening surgery each year still remains relatively small, the procedure is growing in popularity. Specialist clinics in the US, Europe, India and South Korea report increasing demand – with procedures costing tens of thousands of pounds.

Reports suggest that in some private clinics, cosmetic cases of limb-lengthening surgery now outnumber medically necessary ones. This reflects a cultural shift, where people are willing to undergo a demanding, high-risk medical procedure to meet social ideals about height.

Surgeons begin by cutting through a bone – usually the femur (thigh bone) or tibia (shin bone). To ensure the existing bone stays healthy and that new bone can grow, surgeons are careful to leave intact its blood supply and periosteum (the soft issue that covers the bone).

Traditionally, the cut bone segments were then connected to a bulky external frame which was adjusted daily to pull the two ends apart. But more recently, some procedures have adopted telescopic rods placed inside of the bone itself.

These devices can be lengthened gradually using magnetic controls from outside the body – sparing patients the stigma of an external frame and reducing the risk of infection. However, they’re not suitable for all patients – especially children – and are considerably more expensive than external systems.

A digital drawing depicting a leg bone with a metal frame screwed into it.
The device is gradually adjusted each day to encourage bone growth.
Love Employee/ Shutterstock

Regardless of whether the device sits outside or within the bone, the process is the same. After a short healing period, the device is adjusted to separate the cut ends very gradually, usually by about one millimetre per day. This slow separation encourages the body to fill the gap with new bone – a process called osteogenesis. Meanwhile, the muscles, tendons, blood vessels, skin and nerves stretch to accommodate the change.

Over weeks and months this can add up to a gain of five to eight centimetres in height from a single procedure – the limit most surgeons consider safe. Some patients undergo operations on both the femur and tibia, aiming to gain as much as 12–15 centimetres in total. However, complication rates rise sharply with each centimetre of additional growth. Complications include joint stiffness, nerve irritation, delayed bone healing, infection and chronic pain.

Intense pain

The underlying challenge of limb-lengthening surgery is the same: the body must constantly repair a bone that is being pulled apart.

When a bone breaks, a blood clot rapidly forms around the fracture. Bone cells (ostoblasts) create a callus (soft cartilage) that stabilises the break. Over weeks, osteoblasts replace this cartilage with new bone that gradually remodels to restore strength and shape.

In limb-lengthening surgeries, however, the fracture is continuously pulled apart. This means the body’s repair process is constantly interrupted and redirected, generating a column of delicate new bone where hardening is delayed.

The process is intensely painful. Patients often require strong painkillers. Physiotherapy is also essential to maintain movement. Yet, even when the surgery succeeds, people may still be left with weakness, altered gait or chronic discomfort.

There’s also the psychological burden that comes alongside the procedure. Recovery can take a year or more – much of it spent with restricted mobility. Some patients report depression or regret, particularly if the modest gain in height does not deliver the hoped-for improvement in confidence.

Muscles and tendons are also forced to lengthen beyond their natural capacity, which can lead to stiffness. Nerves are especially vulnerable. Unlike bone, they cannot regenerate across long distances. Healthy nerves can stretch by perhaps 6–8% of their resting length – but beyond this, the fibres begin to suffer injury and become impaired.

Patients often experience tingling, numbness or burning pain during lengthening. In severe cases, nerve damage may be permanent. Joints, immobilised for months, are at risk of stiffening or developing arthritis because of changes to how force and weight are distributed.

The rise of cosmetic limb-lengthening illustrates a broader trend in aesthetic surgery – where increasingly invasive procedures are offered to people without medical need. In theory, almost anyone could gain a few centimetres of height. But in practice, it means months of broken bones, fragile new tissue, exhausting physiotherapy and the constant risk of complications.

For those with medical need, the benefits can be life-changing. But for those seeking only to add a little height, the question remains whether enduring months of pain and uncertainty is really worth it.

Opinion

Alison Healy: Renewed push to honour Finnish sailor who fought in the Easter Rising

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It may be 109 years since the Easter Rising, but the State would like to award one more 1916 medal. It’s for a man from Finland who apparently had no connection with Irish republicans until he turned up at the GPO in April 1916.

At least four different versions of his name turned up in various accounts of the Rising and his nationality veered from Russian to Polish to Norwegian, depending on who was interviewed. But thanks to research by Dr Andrew Newby, historian at the University of Galway, we now know that his name was Antti Juho Mäkipaltio.

He was a sailor who found himself in Dublin with his Swedish colleague that fateful spring. The Swedish man’s name has been lost in the mists of time, but perhaps that will also be revealed one day.

Captain Liam Tannam of the Irish Volunteers gave an account of the Nordic men’s arrival in his witness statement held by the Bureau of Military History. On Easter Monday afternoon in the GPO, he was called to the window and saw “two obviously foreign looking men”. The Swede said they wanted to help the Irish rebels and explained that Mäkipaltio had no English.

The bemused Tannam asked why a Finn and a Swede would want to fight the British in Ireland. “Finland, a small country, Russia eat her up… Sweden, another small country, Russia eat her up too. Russia with the British, therefore, we against,” his statement recalled.

When asked about their experience with weapons, the Swede said he had used a rifle before but Mäkipaltio only had experience shooting fowl. He had not exaggerated about his friend’s lack of skills. Mäkipaltio was handed a shotgun and at one point, he let his gun hit the floor. It discharged and released a shower of plaster on the men’s heads.

Irish Volunteer Charles Donnelly’s statement said that when James Connolly heard about it, he declared: “The man who fires a shot like that will himself be shot.”

To avoid any more casualties, Joseph Plunkett asked them to fill fruit tins with explosives. When the surrender came, both men were captured but the Swedish man was quickly released.

Mäkipaltio, on the other hand, found himself in Kilmainham Gaol. Although he had no English, Tannam claimed he was saying the rosary in Irish before he left. He was sent to Knutsford Prison in Cheshire with his fellow rebels on May 2nd before being finally freed several weeks later.

Dr Newby’s research found that although Finnish media reported on various 1916 anniversaries, there was no mention of Mäkipaltio until recently. When the Finnish president Tarja Halonen visited Ireland in 2007, she referred to claims that a Finn had taken part in the Rising but said she didn’t know if it was a myth.

When Dr Newby began working on his book Éire na Rúise (The Ireland of Russia), about Finland and Ireland, he knew he had to establish the identity of the Finnish rebel. Jimmy Wren’s book, The GPO Garrison Easter Week 1916, was most useful as it said he had gone to the US after the Rising. Dr Newby discovered a newspaper report of a talk given by Mäkipaltio in New York in 1917.

He talked about the hunger in prison and of seeing rebels being beaten in the prison yard. He told the audience he had walked to Northern Ireland after being returned to Dublin. He sailed to the US from there, arriving in Philadelphia on June 24th, 1916.

His experience in the GPO must have stood him in good stead as he became a sergeant in the US army. After the first World War, he lived in Ohio and Illinois before settling in Michigan and working as a tool and die maker. He died in 1951.

The GPO is not ‘sacred ground’. It’s so much more than thatOpens in new window ]

Dr Newby tracked down Mäkipaltio’s step granddaughter who said his descendants knew about the Irish adventure. Family lore suggested that rather than deliberately travelling to take up arms against British forces, the duo had missed their boat’s departure from Dublin and took the opportunity for adventure.

When the Rising centenary was commemorated in 2016, Dr Newby said there was a suggestion that Mäkipaltio would be posthumously awarded a 1916 medal. I asked the Department of Defence if that had ever happened and a spokesman confirmed that a decision had been made to award the medal.

However, officials had been unable to reach his relatives. “The Department would be happy to hear from the family and ensure that the 1916 medal can be presented to his next-of-kin,” he said.

Efforts are now being made by Dr Newby to renew his contact with the family. Perhaps, by the time the 110th anniversary rolls around, Antti Juho Mäkipaltio will finally be recognised for his small role in the Easter Rising.

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The Guardian view on Nato airspace incursions: Russia is testing European and US will. It won’t stop here | Editorial

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The sheer volume of headlines tells its own tale. Russian drones over Poland and Romania. Russian fighter jets in Estonian airspace. Russian aircraft buzzing a German naval frigate in the Baltic Sea. Unidentified drones over Copenhagen and Oslo airports. Most recently, in the early hours of Thursday, further drones appearing at other Danish airports.

In just over a fortnight, European states have reported a striking spate of incursions into their airspace. Russia has repeatedly denied responsibility and questions remain over individual events: so far, Denmark has said only that a “professional actor” was at work in the airport incidents and that it can’t rule out Russia. But overall, there is a pattern which fits clearly into Moscow’s longer record of provocations and often implausible deniability – and which amounts to a notable escalation.

Such operations may distract from Russia’s slow progress on the battlefield in Ukraine. More obviously, they look like a test of both military responses and political will. On the first count, there is work to be done, judging from the reaction to the 19 drones in Polish airspace. On the second, Russia is testing whether Europe will hold its nerve in supporting Ukraine – and perhaps others in future – when faced with nuisance or worse. Drones come cheap, yet forced Denmark to suspend flights from its largest airport for four hours, and Poland to spend millions scrambling jets.

Most obviously, these incursions are also testing US intentions. Donald Trump suggested this week that Ukraine could win back its lost territory and that Nato countries should shoot down Russian aircraft entering their airspace. Yet that looks less like a reorientation of US policy than, in the words of one Nato official, “his hot take of the hour”. It is surely no coincidence that these events followed the red-carpet welcome that Mr Trump awarded Vladimir Putin in Alaska. An emboldened Russia is confident that the US intends to further disengage from European security, rather than to bolster support.

Nato members met this week at Estonia’s request, but there are marked differences between their positions as well as shared alarm. Though shooting down a Russian plane would not be unprecedented – Turkey did it in 2015 – there is a division between those who believe it would deter Moscow and those who fear it would escalate the dangers.

These incursions should not treated as a narrowly military affair, but seen within Russia’s multi-domain strategy. The broader picture of security risks covers civilian infrastructure, too, and may involve non-state agents either enlisted or enabled by Moscow. Incidents may be less attention-grabbing yet potentially more significant.

The past year has seen repeated damage to undersea communications cables in the Baltic Sea, with suspicion of Moscow’s involvement. Norway’s spy chief said recently that Russian hackers had taken control of a dam this spring, releasing water for four hours before their interference was noticed. Ken McCallum, head of MI5, warned last October that Russia’s military intelligence agency, the GRU, was “on a sustained mission to generate mayhem on British and European streets: we’ve seen arson, sabotage and more”. He stressed that businesses, as well as the state, must address their vulnerabilities. The difficulties of establishing a unified response to the last fortnight’s events are a reminder that a comprehensive and coherent response to these broader issues will be essential, and even more challenging.

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The Guardian view on Ireland’s presidential election: a contest with consequences | Editorial

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The idea that the next head of state might be an elected one is as remote from British experience as a visit to the far side of the moon. But it is hardly an unthinkable proposition, and you do not have to travel as far as the moon to see such a process taking place in a smooth and dignified manner. In fact, you only have to travel to Ireland.

Next month, Ireland will elect a successor to President Michael D Higgins, who has served two seven-year terms as the occupant of Áras an Uachtaráin (in bygone days the Viceregal Lodge) in Dublin’s Phoenix Park. Mr Higgins has done the largely ceremonial job with charm, toughness and imagination. He has been good for Ireland, and good for British-Irish relations at a difficult time. In 2014, he made the first state visit to Britain by an Irish president. He is not a large man, but he leaves big shoes to fill.

When the presidential nomination process opened this month there was much talk of celebrity candidates, including Michael Flatley, Bob Geldof, Pádraig Harrington, Conor McGregor and the TV meteorologist Joanna Donnelly. But the rules, which require nominations from Dáil members or local authorities, give such candidates little chance of collecting enough support. Predictably, when nominations closed this week, it turned out that the final choice will be between three political nominees, as it has often been in the past. The danger is that the field is too narrow to facilitate the kind of future-focused conversation that any country, including Ireland, needs at such a time.

Ireland’s next president will therefore be the winner of a contest on 24 October between Jim Gavin, backed by the country’s largest party, Fianna Fáil, Heather Humphreys from its government coalition partner, Fine Gael, and the independent Dáil member Catherine Connolly, who is backed by Sinn Féin and by a group of smaller parties, including Labour and the Social Democrats. Early polling has put Ms Humphreys very narrowly in front, but there is almost a month still to go, and the campaign has barely started.

In the 20th century, when Fianna Fáil still dominated Irish politics, its candidate normally won. That ended in 1990, when Labour’s Mary Robinson became Ireland’s first female president, as well as the first not from Fianna Fáil. Ms Robinson modernised the role in her seven years as head of state, helping project a changed image of Ireland on the world stage. Her successor, Mary McAleese, the first president to have been born in Northern Ireland, carried this further for two terms, which included the Belfast/Good Friday agreement and the visit to Ireland by the late Queen. Mr Higgins has trod the same path that his two female predecessors cleared.

Ireland has much to thank them all for. They have all made major soft-power contributions to good relations between Britain and Ireland, too, particularly in the volatile times around the peace process and after Brexit. Yet those tensions are not yet over.

A radical shake-up in British politics, especially if it makes the Belfast agreement more difficult to operate because of any UK withdrawal from the European human rights convention, would revive them. Moves towards a unification referendum, though currently distant, would pose a large challenge of a different kind. Ireland’s new president will have to help guide the country into the 2030s. The path through those years is not looking easy. The outcome of this contest will matter.

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