Offered the Precise method last year, she said she was thrilled to shed the scaffolding, which left scarring and always seemed to be in the way. Even though her bones have hardened, she still returns to Sinai for occasional physical therapy.

Standard said just getting a few extra inches can change patients' lives in ways big and small.

"The thing I hear from boys is that they don't have to use a step stool in the bathroom," he said. "My goal is to help people be more functional."

That's why the Sinai doctors shy away from purely cosmetic lengthening, something they believe is done more regularly in Asia.

But some doctors worry others will not be so discerning.

It is likely to draw attention from new patients — and doctors — because it's much more user-friendly, said Dr. Sanjeev Sabarwal, president of the Limb Lengthening and Reconstruction Society and a pediatric orthopedic surgeon specializing in spinal and limb deformities.

"Caution is needed," said Sabarwal, also a professor at Rutgers-New Jersey Medical School. "This needs to be in the hands of people who know how to bail themselves out of complications, and even before that they need to recognize there is a problem that needs to be worked out. … For certain things, you can't go back in time."

Sabarwal doesn't want this to become "like a face lift," done assembly-line-style in clinics. But he called the system an advance and has "cautious optimism" that it will improve the lives of patients with deformities. He said he expects to use it himself on his older patients.

Concerns over limb lengthening extend beyond medical circles to some in the dwarfism community, who believe they should not be viewed negatively because of the way they were born.

The Little People of America takes no position on limb lengthening, but a spokeswoman for the support and advocacy group said its medical advisory board found there was only a cosmetic benefit, not a medical one, and there is little known about the long-term consequences.

"As an organization we've chosen to say it's an individual decision, and we really encourage individuals to do their own research," said Leah Smith, director of public relations for the group, which reports there are about 30,000 people in the United States with a form of dwarfism.

"We're not here to knock anyone's decision," Smith added. "Personally, I've never considered it. I've never questioned or wanted to be something else."

Crews understands the view, but said she sees her procedures as important to her health. Her back and leg pain is gone. She's more independent. She'll be able to go for long walks, improving her long-term well-being.

Like others of her generation, Crews turned to Facebook to tell her story. She launched a group called L.E.A.D., or Limb Extension Awareness for Dwarfism, that "invites all to openly discuss the concept of limb lengthening without disparagement and negativity."

The condition she was born with occurs in 1 in 15,000 to 40,000 newborns, according to the National Institutes of Health.

People can decide for themselves, she said. They also can understand the commitment it takes for the procedure.

There have been sacrifices: She's spent months away from home and endured 18-hour drives from Arkansas to Baltimore with her mother, Cathe Crews, as well as surgeries, wheelchair confinement and physical therapy.

She still walks a bit slowly. And she still needs to have her last rods removed and her many scars smoothed over.

But the experience convinced her she wants a career in medicine, helping children.

For now, Crews is happy just to "look my age" and for little things like being able to order at the counter of a coffee shop.

"I'm the same person," said Crews. "But taller."

meredith.cohn@baltsun.com