The pros and cons of using limb-lengthening surgeries to enhance the human body

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surgeons huddling together during surgery

Body Enhancing Surgery

The surgeon comes into the operating room and begins the procedure. This surgery is supposed to enhance the young person’s life. First comes the buzzing and grinding of the medical equipment. Next there’s the implantation of the medical device. Lastly, the surgeon stitches the wounds right back up, and it’s recovery time. The patient is still the same person, but an enhanced version. “The surgery went well,” the surgeon tells the parents. “He’ll be able to function in the world like everyone else.” His parents look at each other, thinking the same thought: “Was it all worth it?”

With today’s advances in technology, there are many possibilities to create what some might call “the perfect human being.” This is known as human enhancement. The word “enhancement” is usually associated with “bio medical interventions that are used to improve human form or functioning beyond what is necessary to restore or sustain health.” (Juengst & Moseley, 2015). In other words, technology is being created to help people function normally or better and remain healthy if they weren’t able to before.

What’s important though is the need to look at the different situations where people might choose human enhancement. In some cases, the enhancement is done to conform to social pressures to be like or to be better than everyone else. In other situations, parents choose to enhance some physical trait of a child since they are the ones who have the ability to give consent for enhancement procedures. This goes back all the way to when parents can pick specific traits for their kids to have and not to have before pregnancy (Juengst & Moseley, 2015). Then there are other situations where the person receiving the enhancement is doing it to help them live a better or easier life; this choice is usually in response to injuries or disabilities.

According to Amal Graafstra, the desire for enhancement or augmentation has been around “‘since humans picked up sticks and rocks and started using tools…'” (Swain, 2014). Since the beginning of time, humans have been wanting to change or adjust themselves in order to survive. According to Neil Harbisson, who attached an antenna to his head in order to hear colors, declared that we are more human if we continue to modify ourselves (Swain, 2014). Humans are essentially always evolving. There are several forms of enhancements, such as these mechanical enhancements: cochlear implants, bionic eyes, or prosthetic limbs.

To understand more about why some people opt to have medical enhancements, let’s talk about the pros and the cons of a specific enhancement. One technology started being widely used in the late nineteenth and early twentieth century, but variations were in use way before. These devices are called external fixators, which are used to gain extra height through the surgical procedure called limb lengthening. Originally, this device was used to stabilize the bone if it suffered a complicated fracture (University Stellenbosch, 2008). Now, one of the main purposes of this device is to increase the height of someone of short stature, such as Little People – someone who is less than 4 ft. 10 in. tall. It can also be used to correct the height of those with limb length discrepancies – having one leg or arm shorter than the other. Recently it is also being used for purely cosmetic purposes or for people who are not Little People, but want to gain a few extra inches in height.

External fixators are known to have been used as early as 2,400 years ago. The philosopher, Hippocrates, created a splint made from Egyptian metal rings to prevent a fracture in the tibia from worsening (International Limb Lengthening and Reconstruction Society, 2012). The latest external fixator that most orthopedic surgeons use today was developed by Dr. Gavriil A. Ilizarov in 1951 in Kurgan, Russia (Rozbruch). Each fixator has several metal pins that are drilled into the side, front and back of the leg and through the bone. The fixator stabilizes the bone, allowing the fracture to heal. What makes this fixator different from the previous ones is that it is designed like a metal cage that holds the leg through multiple pins drilled into all sides of leg and bone.

However, it was Ilizarov who discovered how the fixator could give someone more height. It occurred when Dr. Ilizarov treated a soldier from World War II for a fracture that didn’t heal properly. Once the doctor placed the external fixator on the leg, he instructed the soldier to turn a screw that was on the fixator so the gap in the bone would compress and heal. Accidentally, the soldier turned the screw the wrong way and ended up separating the bone and increasing the gap from the fracture. But after several weeks, he noted that new bone was forming in between the two ends of the separated bone, and thus, he realized that it was possible to lengthen the bones in both legs and arms (Rozbruch). Ilizarov even operated on Olympic high jumper, Valery Brumel (Rozbruch & Ilizarov, pg 5-6). In 1965, Brumel broke one of his tibias in a motorcycle accident, but it stopped healing properly when other surgeries he had to fix it resulted in complications. As a result, he ended up with a discrepancy in the length of his legs. In 1968, Dr. Ilizarov used the cage device to help the fracture heal as well as make up the height he lost from the accident and failed surgeries. One year after the corrective surgeries, he was able to compete again.

One of the first Little People to complete a total of three limb lengthening surgeries was Gillian Mueller. She was once 3 ft. 11 in. and as a result of he surgeries, she is now 5 ft. In an article about her, she exclaims to her mom, “Hi mom. I’m off for my first swim as a tall person.” (Hubbard, 1992). She later explains that even though she felt pressured by her parents to do the surgery and even though the pain was excruciating, she felt it was worth it. Similarly, in a video entitled, “Limb Lengthening Surgery Creates Controversy,” another 20 year old girl named Chandler Crews, who is also a Little Person, explains that she did the surgery for herself (McMullen, 2014). “It’s not that I hated who I was,” Chandler explains, “I just didn’t feel comfortable where I was in the world.” As a result, Chandler can now buy pants off the rack, walk longer distances without pain, drive a car, and even do simple tasks such as reaching door knobs or brushing her hair. Parents often explain that they are motivated to choose the surgery for their child to assist their child be more independent and not have to rely on others for help.

So why is this procedure and this device considered controversial? The reason it is so controversial today is that while in the past it has been used for healing and enhancing independence, people can also use it for cosmetic reasons. During adolescent years, peer pressure and the desire to fit in can lead a person to want to change his or her appearance. According to a father who reflects on his daughter’s dwarfism – another term for a Little Person – the teenage years are usually the time when a lot of Little People decide on the surgery because of the social pressures to fit in, and he doesn’t approve of this (Kennedy, 2007). Advocates for Little People often reject this procedure because they feel Little People should take pride in themselves and not change their bodies to be like everyone else. For instance, Rebecca Cokely, an advocate who is a Little Person has as her motto, “short by birth, staying that way by choice.” (Mullen, 2014). There are also the side effects and possible complications from the procedure. In one example, the patient, Reza Garakani, was left paralyzed. He regrets undergoing the surgery, which he feels his father pushed him into. “I was just an average dwarf,” he said. “I was able to run around. I would’ve much rather have been three feet than a few inches taller with all of these complications.”

In another scenario, people who are said to have low normal stature (LNS), who aren’t Little People but are at a shorter height than average may choose the surgery mainly for cosmetic reasons and to change their image. People with LNS who successfully have the surgery and gain those extra two or three inches, often leave the experience with a greater sense of self-esteem. Some surgeons call this “short person neurosis” (Positano, 2011).

Limb lengthening is not the only bio medical technology that is used to enhance humans. A recent documentary called “Fixed” was released about how technological advances are being used to create a more “perfect” human being. It discusses both sides of the argument: how these advances can help one function in life, and also how it is important to love one’s body, no matter how different it may be.

There’s no correct answer to the question, is human enhancement ethical? This question is still up for debate, and probably always will be. However, the choice to do human enhancement should be up to the person. Everyone is entitled to their rights, and if human enhancement is what will make the person happy, will better their life, and give them more confidence, then should anyone deny that person of their rights?

 

Primary Sources:

ABC News. “‘Dwarf’: Woman Endures Painful, Controversial Surgeries to Grow Taller.” Online video clip. YouTube. YouTube, 1 Dec. 2012. Web.

Hubbard, Kim. “Long on Courage.” People. People Magazine, 17 Feb. 1992. Web.

Kennedy, Dan. “Chapter 9: The Bone Machine.” A Father Reflects on His Daughter’s Dwarfism — and What It Means to Be Different. Boston: Northeastern University, 2007. Print. [PDF]

Mullen, Mark. “Limb-Lengthening Surgery Creates Controversy.” NBC 7 San Diego. NBC 7 San Diego, 30 June 2014. Web.

PART 1 INTRODUCTION – The Ilizarov Method: History and Scope.” Limb Lengthening and Reconstruction Surgery. Ed. S. Robert Rozbruch and Svetlana Ilizarov. Boca Raton: CRC Press, 2007. 1-18. Print.

 

Secondary Sources:

Eveleth, Rose. “‘I Was Blind… Now I Have Bionic Eyes‘” BBC. BBC, 23 Sept. 2014. Web.
External Fixators.” External Fixation. Department of Orthopaedic Surgery – University Stellenbosch, South Africa, 2008. Web.

Historic Background.” International Limb Lengthening and Reconstruction Society. International Limb Lengthening and Reconstruction Society (ILLRS), 2012. Web.

Juengst, Eric, and Daniel Moseley. “Human Enhancement.” Stanford University. Stanford Encyclopedia of Philosophy, 7 Apr. 2015. Web.

Limb Length Discrepancy.” OrthoInfo – AAOS. OrthoInfo, 1 July 2007. Web.

Positano, Rock. “Courting Controversy: Cosmetic Limb Lengthening Surgery.” The Huffington Post. TheHuffingtonPost.com, 28 Mar. 2008. Web.

Swain, Frank. “Cyborgs: The Truth about Human Augmentation.” BBC. BBC, 24 Sept. 2014. Web.

The Cochlear Implant Controversy.” CBSNews. CBS Interactive, 2 June 1998. Web.