According to Dr. Alexander Sergeevich Barinov, the chief surgeon at the center, they began offering the leg lengthening surgery in 1992 and, after it was featured in an English-language news article a few years later, foreigners began to inquire about it. He said the hospital has successfully operated on about two dozen foreigners over the past 15 years.
Some orthopedic experts, however, warn about the risks.
"I worry people are putting themselves at risk for only cosmetic reasons," said Dr. Alex Jahangir, an assistant professor of orthopedic surgery at Vanderbilt University Medical Center, who has used the technique for corrective purposes and is involved in the Pentagon study.
Those risks, he said, include stretching the blood vessels and nerves around the bone more than they can endure, which could result in long-term complications.
"It involves the breaking of a perfectly good bone, possible risk of infection, and six to twelve months of very meticulous care," Jahangir said. "If someone just wants to gain two or three inches, I don't think the risks are worth it."
Barinov, however, insists the procedure is safe.
"It is as dangerous as any other operation," he said, adding that the center has not had any patients suffer long-term problems as a result.
"If some problem does arise, we are able to handle it," he said.
Barinov says he only recommends the procedure for those who are physically and psychologically prepared.
"I usually have a long conversation with the potential patient and try to put him off the operation," he said. "It is a very serious operation and your approach cannot be frivolous."
He also recommends that patients stay active during their recovery as a way to manage the pain.
"If someone is lazy then this won't work. You have to be active," he said. "Of course we do give painkillers, in the form of injections, but of course there is a limit to how much painkillers they can have."
Asked about the quality of care at the Russian hospital, Jahangir said he had never been there but said that the Russian doctors are generally well regarded internationally.
"There is a lot of respect for their technique. They pioneered it and they continue to revolutionize it. Some of their doctors are probably better trained than a lot of Americans," he said.
John says he heard about the surgery on the internet and opted to do it in Russia because it was invented there and because, at a cost of $15,000 - $16,000 including hospitalization, it is several times cheaper than doing it in the United States. The American clinics, he said, usually send the patient home to recover.
But John admits there are some downsides, including sacrificing comfort. He complained about slow service from some of the nurses and bland food, but said that overall he was satisfied with the care he is receiving. He suggested people who want to do the same thing splurge for a private nurse, which would make the stay more comfortable, something he had not done.
His more immediate challenge, apart from the pain, is to maintain his cover story with family and friends to explain why he is gone for several months. He is not worried that they'll be suspicious when he comes back taller because he used to wear shoes with a heel to compensate for his height.
Now, just over a week after he began the long process, he doesn't think it will drastically alter his life.
"We'll see. It won't change. The only thing I can say, it will probably be better. I'll be taller. It'll be nice," he said.