Fully internal · magnetic nail

Precice 2 Internal Limb Lengthening in Turkey

Op. Dr. Serdar Karaman, Orthopedics & Traumatology
Live Taller Now, Istanbul · Last updated July 2026

In short: Precice 2 is a fully internal, motorized titanium nail lengthened by holding an external remote-control magnet against the leg, no external frame, no pin sites, minimal scarring. It is the most comfortable and discreet way to gain 6-8 cm, at $30,000-$45,000 all-inclusive in Turkey. The trade-off is limited weight-bearing (~20-30 kg) during distraction.

What is Precice 2?

Precice 2 (from NuVasive, the successor to earlier Precice systems) is a fully implantable, motorized intramedullary lengthening nail. Unlike the LON method or classic external fixators, nothing protrudes through the skin. The entire lengthening mechanism sits inside the bone, and the surgery leaves only a few small keyhole incisions near the hip or knee.

Inside the titanium nail is a small magnetic rotor connected to a precision gearbox. When the External Remote Controller (ERC), a handheld magnetic device, is placed on the skin directly over the implant and switched on, its rotating magnetic field spins the internal rotor, which telescopes the nail apart in sub-millimeter increments. Over a session of a few minutes, repeated two to three times a day, this delivers the standard 1 mm of lengthening per day that distraction osteogenesis requires. The new bone forms in the gap exactly as it does with any other technique, the difference is purely in how the pulling force is delivered.

How the magnetic nail lengthens your leg

Patients are often surprised that the lengthening itself is painless. You feel the muscle stretch of the leg getting longer, the same tightness every technique produces, but you do not feel the nail turning. A typical day looks like this: you place the ERC over each thigh (or shin) for the prescribed few minutes, the device confirms the movement, and you continue your day. There are no bulky frames to clean around, no pins passing through skin and muscle, and no daily pin-site care.

Because everything is internal, hygiene and cosmetics are dramatically better than frame-based methods, and the infection risk associated with pin sites is essentially removed. This is the single biggest reason patients choose Precice 2 despite its higher cost, particularly those who need to keep working through recovery or who simply cannot accept visible external hardware.

The honest trade-off: weight-bearing

Precice 2's comfort comes with one real discipline you must accept: the titanium nail's internal mechanism tolerates only partial weight-bearing, roughly 20-30 kg, until the new bone begins to consolidate. In practice that means using a walker for short distances and a wheelchair for longer ones during the distraction phase, and following your surgeon's loading limits precisely. Overloading the nail before the bone is ready is the main way the mechanism can be damaged, so this is not a rule to bend.

This is exactly where the LON method differs: LON's internal nail is supported by a temporary external frame, which lets you bear weight earlier, at the cost of wearing that frame for 2-3 months. So the decision often comes down to a simple question: would you rather have no frame but move more cautiously (Precice 2), or accept a temporary frame in exchange for earlier walking and a lower price (LON)?

Precice 2 vs Stryde vs Precice MAX

The Precice family has evolved, and the names cause confusion, so here is the current picture:

• Precice 2, titanium, partial weight-bearing, the proven and widely used internal nail today.
• Precice Stryde, stainless-steel, designed for full weight-bearing, but recalled and discontinued in 2021 after corrosion and bone-reaction concerns at the junctions. No longer implanted.
• Precice MAX, the newer-generation nail with refinements in strength and control. Availability depends on market and regulatory approval; where offered, it is used similarly to Precice 2.

If a clinic offers you a "full weight-bearing internal nail," ask specifically which device and which generation, and be cautious of any offer to implant Stryde. We will tell you exactly which system is appropriate and available for your case.

Precice 2 in the femur vs the tibia

Precice 2 is used in both bones. The femur is the more common choice for cosmetic height: it allows more gain (6-8 cm), tolerates lengthening comfortably, and consolidates faster. The tibia is chosen when a patient's proportions favour longer shins, or as part of a staged femur-plus-tibia plan for larger total gains. Tibial lengthening tends to feel tighter because the soft-tissue envelope is less forgiving, and consolidation can be slower. Your surgeon decides based on your goals, proportions, and, importantly, whether your bone canal diameter comfortably accommodates the nail, which is checked on X-ray before any quote is issued.

Recovery with Precice 2

The overall timeline mirrors other techniques, with the key difference being stricter weight-bearing during distraction. Expect the distraction phase to run about 10 days per centimeter, followed by consolidation at roughly one month per centimeter. Because there are no pin sites and the ERC travels with you, some suitable patients may be cleared by the surgeon to complete part of their distraction at home with scheduled remote X-ray reviews, a genuine advantage of the internal system, though it is decided case by case and never promised in advance. Removal of the nail is recommended around 18-24 months after surgery, once the bone has fully remodeled; it is a short, one-night procedure.

Who is Precice 2 best for?

• Patients for whom visible hardware or pin scars is a firm no
• Those who can trade earlier walking for maximum comfort and discretion during distraction
• Remote workers who value the possibility of monitored distraction closer to home
• Anyone with adequate bone-canal diameter on X-ray to accept the nail

Precice 2 cost in Turkey

All-inclusive Precice 2 packages typically run $30,000-$45,000. The higher price versus LON reflects the cost of the motorized nail itself, not a difference in the care around it, accommodation, physiotherapy, imaging, transfers and coordination are included just the same. Compared with $100,000 or more for internal lengthening in the US or UK, Istanbul remains a fraction of the price. Always ask for the optional future nail-removal cost in writing alongside your quote; ours states it by default. See the full cost guide.

Your journey with Live Taller Now, step by step

Travelling abroad for Precice 2 lengthening works best when every stage is mapped before you board a plane. Our international-patient pathway is deliberately transparent:

1. Day 0

   Free remote assessment

   You send your X-rays and a short health history. The surgeon confirms whether you are a candidate, what is safely achievable, and which method suits your anatomy, then you receive a fixed, written, all-inclusive quote with nothing hidden.

2. Before travel

   Planning & scheduling

   We agree your dates, explain exactly what to bring, and prepare your pre-operative checklist. Your coordinator is reachable on WhatsApp throughout, in English.

3. Arrival week

   Surgery & hospital care

   Airport VIP pickup, pre-operative tests and clearance, then surgery. You recover in a private hospital room with pain management and your first physiotherapy before moving to serviced accommodation.

4. In Istanbul

   Supervised recovery

   Daily physiotherapy, scheduled X-rays and 24/7 support through the phase that matters most. Nothing about your recovery is left to chance or done unsupervised.

5. Back home

   Remote follow-up

   You fly home with a written aftercare protocol any local orthopedist can follow, and continue scheduled X-ray reviews with the surgeon who treated you.

What the daily ERC routine actually looks like

Living with Precice 2 during distraction is far less intrusive than a frame, but it is a routine you must follow precisely. Two to three times a day, at the intervals your surgeon sets, you position the External Remote Controller over the implant site and run it for the prescribed few minutes per session. The device guides you and confirms that the nail has moved the intended fraction of a millimeter. Around this, your day is shaped by the weight-bearing limit: a walker for short distances, a wheelchair for longer ones, and consistent physiotherapy to keep the muscles lengthening with the bone. Many patients settle into the rhythm quickly, and because there are no pins to clean and nothing protruding, showering, dressing and sleeping are all markedly easier than with external methods. The discipline that replaces pin care is simply respecting the loading limit, the one rule that protects the mechanism until the bone consolidates.

Why bone-canal diameter decides Precice 2 candidacy

Unlike a frame, an internal nail has to physically fit inside the medullary canal of your bone, and it must be wide enough to house the motor and gearing. This is why a Precice 2 recommendation always follows imaging: if your canal is too narrow, the appropriate honest answer may be the LON method or a different plan rather than forcing an implant that does not fit. Checking this in advance avoids surprises in the operating room and is part of why we insist on proper X-rays before issuing any quote.

Why patients choose Live Taller Now in Istanbul

Turkey has become the world's highest-volume destination for limb lengthening and deformity correction, and Istanbul sits at its centre. The advantage is not simply price, though all-inclusive packages here run a fraction of US and UK costs, it is the combination of an licensed private hospital, a surgeon who performs these operations as a core part of his practice, dedicated in-house physiotherapy, and coordinators who manage the entire journey in English. Just as importantly, we practise honest candidacy: if your X-rays or health profile make you a poor candidate, or your goal exceeds safe limits, you will be told so plainly, with the reasons. Every figure on this page, the gain limits, the 1 mm/day rate, the recovery windows, reflects real orthopedic practice rather than marketing, and every quote is fixed in writing before you commit. You can read more about your surgeon on the Our Doctor page.

Risks of Precice 2, and how they are minimized

Precice 2 removes the pin-site infection risk of frame methods, but it is still major surgery with its own considerations. The main device-specific issue is mechanical: overloading the nail before the bone consolidates can damage the lengthening mechanism, which is exactly why the weight-bearing limit is enforced so strictly. Beyond that, the general risks of any lengthening apply, muscle and joint tightness, temporary nerve irritation, delayed consolidation, blood clots and, rarely, deep infection. They are minimized through the same safeguards used across all our lengthening work: careful candidate selection, the 1 mm/day rate, weekly imaging, anticoagulation, daily physiotherapy, and a strict no-smoking requirement to protect bone healing. Because the hardware is internal and cannot be inspected directly, monitoring relies on regular X-rays, another reason scheduled follow-up is non-negotiable rather than optional.

Frequently asked questions