I'm 5'8, and just a disclaimer before I get the backlash of "limb lengthening isn't worth it for you!", realize I've contemplated this procedure for an extremely long-time (since 18 and I'm 24 now). I've decided that it just doesn't feel worth it for me to stall getting this done as I've been doing so my entire 18+ life up to this point, and now I'm in a perfect place financially and age wise to get this done.
I'm looking to do two-stage lengthening and maintain proportions somewhat.
1) What's the best split in this case?
2.5 inches femur and 2 inches tibia?
2.25 inches femur and 2.25 inches tibia? Any other splits to consider?
2) What order should I get the segments done if I want to do them both in a year?
3) Which nails should I use for each segment? External tibia seems to be worrisome for me due to the delay lengthening time. Any thoughts?
Advice for 4.5 inches total across two segments?
1. Usually what is recommended is 6 cm on femurs and 4 cm on the tibias. Espicially if you do both segments at once (NOT RECOMMENDED) But since your starting height is quite tall, you properly could do 7 on the femurs and 5 on the tibias safely. You will discuss this after x-rays usually with your future surgeon. According to Cyborg4life who has done more than 10+ years of experience, researching, talking with patients etc... 6-7 cm on the femurs and 3.5 - 4.5 cm on the tibias is safe and not overlengthening, but if very flexible and have tall starting height, you might be able to do more without overlengthening.
2. I would do femurs first then wait a year, cuz if you rush it, the complication rate is higher and you can usually gain less height. You should wait at least 6 months and ideally 1 year with doing the other segment. Many people who plan to do both segments end up only doing the femurs cuz 3 inches /7.5 cm is more than enough for them. Maybe the same thing will happen to you since 5'11 / 180 cm is not a bad height at all. Femurs also have a lower complication rate, heals faster, and most importantly you can gain more height safely with femurs.
3. Precice 2 is in my opinion what you should use. According to most western surgeons any external fixation is like old tech, and doesn't make sense if you have enough money for internal precice 2, since it's better overall in pretty much every category. Less complication rate, less risk of infection, more comfortable, wide spread usage in the entire world, reverse feature that can save you if you get a non union etc...
Source for this: http://www.limblengtheningforum.com/index.php?topic=72690.msg223167#msg223167 / and cyborg4life youtube channel espicially his live videos and surgeon interviews.
4. If you constantly think about your height every single day, then this is a sign you should do it in my opinion. 
^ 8 cm femur is pretty safe lol, it's just hard. There is a reason Nuvasive, an American public company, put 8cm limit on Precise systems. They wont risk people over lengthening and getting sued for it. 8 cm (for most people) has been shown to be safe enough for them to call that the limit. Obviously, it varies by people, but for the majority 8cm is doable. 7-8cm is just where it gets tight and you'll have a hard 10-15 days lengthening then.
Synoste nail which is a nail in devolopement can lengthen max up to 7 cm. And many surgeons recommend staying between 6-7 cm for the best recovery:
http://www.limblengtheningforum.com/index.php?topic=75056.0
Thanks for the well thought out reply!
As far whether it's worth it, it's extremely annoying when people say "at X height it's worth it, Y height it's not". People need to realize that it's solely worth it based on the satisfaction of the individual, purely subjective. If it's life-changing for someone going from 6'0 to 6'3, then it's not my place to say it's not worth it for this. It's a personal decision based on someone's newfound satisfaction of their post-surgery results.
Yeah you still recover fine with 8cm, it just takes longer lol. Paley allows 8cm, im sure if it's not safe or recommended, the BEST CLL surgeon in the world wouldnt allow it.
People have went 12 cm before, those are kinda crazy, but it shows that your body can adapt. 8 cm is just fine lol, dont listen to that viking. Guy acts like 1 cm will make a difference and you go from totally fine to dying because of a 1 cm difference. 8 cm is the STANDARD for max safe femur for a reason.
it is individual:)
Do one surgery and call it’s quits.
Find out what your tibia to femur ratio is currently and assess.
Get this 4-5” goal out of your head. You’re 5’8 not 5’4.
It’s easy to read diaries and think you can do it no hassles, it’s a bit painful (nothing where you wanna rope your self pain) but it’s mentally painful. This is something that I don’t think that is talked enough about.
5 inches is perfectly reasonable at 5ft 8. Would make him 6ft 1, basically the perfect height. Not everyone wants to settle for being average and mediocre, some of us want the best.
OP - I'm going for something similar although I'm an inch shorter than you to start with. I opted for femur first, on the basis that if you do end up deciding you can't face surgery a 2nd time, you can always wear lifts to get to 6ft whereas if you lengthened tibia, lifts would make the tibs look way too long.
I'll decide after the first surgery, but realistically don't see any reason to settle for 5'11 and not 6.05. Yes, the surgery is extremely painful, costly, time-consuming, but the height increase is a quality-of-life improvement that extends for the rest of my life.
People go through traumatic gambits in life to make the rest of their lives easier all the time. Example, college degree at an intense school, medschool, lawful school, intense early careers etc.
Why is limb lengthening any different? 1-3 years of your life, significantly higher quality-of-life for the rest of your life. It seems like an obvious fair trade to me.
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