Dr. Paley doesn't do more than 13 cm (5.1 inches), but I firmly wish to achieve 15.25 cm (6 inches). Most doctors in the sticky seem to have a similar range. Which doctors are open to the kind of increase I'm looking for?
Dr. Mahboubian normal standard will let you push tibia to 6.5cm instead of 5cm like paley
Dr. Donghoon Lee has different lenghening programs, one of them goes up to 16cm
You can get 16cm with Paley
Quote from: RealLostSoul on May 07, 2021, 12:01:28 PMYou can get 16cm with Paley
True, quadrilateral twice
(4cm+4cm)x2 same as Lee
He Tao Xia. Several others too as long as you do external.
Quote from: Future Skycraper on May 07, 2021, 01:17:49 PMTrue, quadrilateral twice
(4cm+4cm)x2 same as Lee
This is with two operations per segment? Wouldn't that have worse side effects than one large operation?
Quote from: nightstar on May 07, 2021, 04:34:43 PMThis is with two operations per segment? Wouldn't that have worse side effects than one large operation?
Quadri is usually fking the body quite a lot but since you only do 4+4 it's safe in terms of lengthening amount (you have 3 surgeries, excluding rod removal)
Quote from: RealLostSoul on May 07, 2021, 04:49:13 PMQuadri is usually fking the body quite a lot but since you only do 4+4 it's safe in terms of lengthening amount (you have 3 surgeries, excluding rod removal)
Yes, 4+4 is okay. There are different ways to do quad, 3 weeks apart (they say it's simultaneous) or 1y-2y apart. I know you can du simultaneous 4+4 3 weeks apart, so you break the femur than 3 weeks later you break tibia and lentgh both 4cm, than 1y later you rebreak both (3 weeks apart) and get 16 total, and yes, you need to remove the rod. So it would be about 5 surgeries. But with the same nail, cause stryde can lentgh up to 8cm maximum (device limit).
I know it sounds confusing, and my english is not the best with CLL topic. So let me show you this:
- Dr Paley: https://limblengthening.org/lengthening-strategies/
- Dr. Donghoon Lee:
"1. Femur lengthening – max. 8cm (3.15in.); lengthening period of 8cm is about 12 weeks
2. Tibia lengthening – max. 6cm (2.36in.); lengthening period of 6cm is about 12 weeks
3. Femur lengthening of 4cm then 6 months after another 4cm lengthening (lengthening period of 4cm (1.57in.) is about 6 weeks)
4. Tibia lengthening of 4cm then 6 months after another 4cm lengthening (lengthening period of 4cm (1.57in.) is about 8 weeks)
5. Femur or Tibia lengthening one leg at a time and lengthening the other leg (max. lengthening length and lengthening period is same as #1 and #2)
6. Simultaneous tibia and femur lengthening (max 8cm (3.15in.) in total; lengthening period of tibia and femur each lengthening up to 4cm is about 12 weeks in total)
7. Tibia lengthening up to 6cm then 1 year after femur lengthening up to 8cm (max 14cm (5.51in.); up to 6cm tibia lengthening and up to 8cm femur lengthening each takes about 12 weeks)
8. Simultaneous tibia and femur lengthening then at least 1 year after additional simultaneous tibia and femur lengthening (max 16cm (6.29in.); lengthening period of tibia and femur each lengthening up to 4cm is about 12 weeks)
*Because of the limitation in lengthening of soft tissue such as muscles and nerves, the maximum lengthening length is restricted to not go overboard. Therefore, excessive lengthening is not recommended for the safe recovery.
*Generally, the first two plans are mostly done. Either lengthening bilateral femur or bilateral tibia.
*If you are looking for the fast recovery, plan #3 and #4 are recommended.
*Another plan for the fast recovery is #5. Undergoing leg lengthening surgery one leg at a time and return back to everyday life using crutches.
*Plan #6 is to lengthen tibia and femur simultaneously. Although the maximum lengthening length is similar to the maximum length of femur lengthening but as lengthening about 4cm on each segment (tibia and femur) gives less burden to the body and you can attain an ideal nice body proportion. Furthermore, you can return back to everyday life faster than lengthening one segment of your leg to the maximum lengthening length.
*Plan #7 and #8 are for the people who wants to gain the maximum length
*Plan #7 is which you undergo either plan #1 or #2 initially then one year after undergoing lengthening surgery on the remaining segment.
*Plan #8 is which you undergo plan #6 twice within at least one year apart from the initial surgery. Lengthening for the second time, change in intramedullary lengthening nail is unnecessary as lengthening can be done by re-osteotomy while the intramedullary nails are remained.
*Most importantly, please be aware that above plans with the maximum lengthening length and the lengthening period are based on the average data. It varies by each person as everyone’s condition and rehabilitation is all different."
From my reasearches: Doing 4+4 is better than doing just 8 at one segment, beacause of proportions and complications. And since you want the maximum ammount, you can reach 16 only doing simulteneous quadrilateral twice. You don't pay that much for the second quadrilateral with palley, because the most expensive thing is the device. So one quad would be around 200K dollars, and if you do it twice he only charges 80K more, beacause the device is the same. Just don't forget that stryde has been recalled, so we don't know what to expect, but i highly recommend doing this with stryde, cause it will takes 2 whole years of surgery, so stryde is better, in view of the fact that stryde has a weight bearing tolerrence.
Leghening 8+8 at once is suicide. The only other option would be lenghening femur up to 8 and tibia up to 5-6 (or tibia first, depends at the doctor, Dr. Lee says that tibia takes more time to rehab, so he prefers doing it before, but Dr. Plaey prefer femur first, I think), 1 years apart, but only a total of 13-14, not 15-16.
Said that, it's not a rule, you should email your doctor and ask about all the possible ways and each coplications, risks and costs. Every case is a case. Hope that helped you.
(The information about Dr. Lee came by his email that his secretary sent me, with prices and etc.)
Quote from: Future Skycraper on May 07, 2021, 05:48:28 PM
Yes, 4+4 is okay. There are different ways to do quad, 3 weeks apart (they say it's simultaneous) or 1y-2y apart. I know you can du simultaneous 4+4 3 weeks apart, so you break the femur than 3 weeks later you break tibia and lentgh both 4cm, than 1y later you rebreak both (3 weeks apart) and get 16 total, and yes, you need to remove the rod. So it would be about 5 surgeries. But with the same nail, cause stryde can lentgh up to 8cm maximum (device limit).
I know it sounds confusing, and my english is not the best with CLL topic. So let me show you this:
- Dr Paley: https://limblengthening.org/lengthening-strategies/
- Dr. Donghoon Lee:
"1. Femur lengthening – max. 8cm (3.15in.); lengthening period of 8cm is about 12 weeks
2. Tibia lengthening – max. 6cm (2.36in.); lengthening period of 6cm is about 12 weeks
3. Femur lengthening of 4cm then 6 months after another 4cm lengthening (lengthening period of 4cm (1.57in.) is about 6 weeks)
4. Tibia lengthening of 4cm then 6 months after another 4cm lengthening (lengthening period of 4cm (1.57in.) is about 8 weeks)
5. Femur or Tibia lengthening one leg at a time and lengthening the other leg (max. lengthening length and lengthening period is same as #1 and #2)
6. Simultaneous tibia and femur lengthening (max 8cm (3.15in.) in total; lengthening period of tibia and femur each lengthening up to 4cm is about 12 weeks in total)
7. Tibia lengthening up to 6cm then 1 year after femur lengthening up to 8cm (max 14cm (5.51in.); up to 6cm tibia lengthening and up to 8cm femur lengthening each takes about 12 weeks)
8. Simultaneous tibia and femur lengthening then at least 1 year after additional simultaneous tibia and femur lengthening (max 16cm (6.29in.); lengthening period of tibia and femur each lengthening up to 4cm is about 12 weeks)
*Because of the limitation in lengthening of soft tissue such as muscles and nerves, the maximum lengthening length is restricted to not go overboard. Therefore, excessive lengthening is not recommended for the safe recovery.
*Generally, the first two plans are mostly done. Either lengthening bilateral femur or bilateral tibia.
*If you are looking for the fast recovery, plan #3 and #4 are recommended.
*Another plan for the fast recovery is #5. Undergoing leg lengthening surgery one leg at a time and return back to everyday life using crutches.
*Plan #6 is to lengthen tibia and femur simultaneously. Although the maximum lengthening length is similar to the maximum length of femur lengthening but as lengthening about 4cm on each segment (tibia and femur) gives less burden to the body and you can attain an ideal nice body proportion. Furthermore, you can return back to everyday life faster than lengthening one segment of your leg to the maximum lengthening length.
*Plan #7 and #8 are for the people who wants to gain the maximum length
*Plan #7 is which you undergo either plan #1 or #2 initially then one year after undergoing lengthening surgery on the remaining segment.
*Plan #8 is which you undergo plan #6 twice within at least one year apart from the initial surgery. Lengthening for the second time, change in intramedullary lengthening nail is unnecessary as lengthening can be done by re-osteotomy while the intramedullary nails are remained.
*Most importantly, please be aware that above plans with the maximum lengthening length and the lengthening period are based on the average data. It varies by each person as everyone’s condition and rehabilitation is all different."
From my reasearches: Doing 4+4 is better than doing just 8 at one segment, beacause of proportions and complications. And since you want the maximum ammount, you can reach 16 only doing simulteneous quadrilateral twice. You don't pay that much for the second quadrilateral with palley, because the most expensive thing is the device. So one quad would be around 200K dollars, and if you do it twice he only charges 80K more, beacause the device is the same. Just don't forget that stryde has been recalled, so we don't know what to expect, but i highly recommend doing this with stryde, cause it will takes 2 whole years of surgery, so stryde is better, in view of the fact that stryde has a weight bearing tolerrence.
Leghening 8+8 at once is suicide. The only other option would be lenghening femur up to 8 and tibia up to 5-6 (or tibia first, depends at the doctor, Dr. Lee says that tibia takes more time to rehab, so he prefers doing it before, but Dr. Plaey prefer femur first, I think), 1 years apart, but only a total of 13-14, not 15-16.
Said that, it's not a rule, you should email your doctor and ask about all the possible ways and each coplications, risks and costs. Every case is a case. Hope that helped you.
(The information about Dr. Lee came by his email that his secretary sent me, with prices and etc.)
You have to keep in mind though that despite the fact that you are lengthening the soft tissue a lot with simultaneous lengthening (nerves over a mm/day) you are as well doing 2 major surgeries in a short time which is very taxing both mentally as well as physically. Plus you are paying a lot more. Almost 300k of which you have to pay 200k in advance (with Paley). So the only two upsides to quadri options is you lengthen less at once and it‘s better for proportions.
Also, if you chose to do quadri now you are stuck with precise. Once you return for rebreaking you will have to do it with precice while ppl around you will be getting stryde.
So what are my recommendations: don‘t do quadri, especially now. If you want to go with nuvasive‘s internals start with femurs. Don‘t start with tibias ever, unless you choose externals. 8cm in femurs is a goal almost everyone should be able to achieve. Then after a year you can choose internal tibias when stryde is back with which you can try to gain around 6cm. So int total around 14cm which is quite a lot. And if you want to max out both nails I am sure you can ask your doctor to rebreak later (for example lets say you had to stop at 7cm femurs and 5cm tibia. It won‘t be too much of a problem to rebreaken some time later to get to 8 in both leading to 16cm. You will have the same amount of surgeries as with quadri but you don‘t endure the insane stretching of soft tissue and two surgeries (with a combined duration of almost 10 hours btw) within 2-3 weeks.
I am very sure though that most people who want this stop either after femur surgery or they are satisfied with 14cm and don‘t want to do this all over again for 2 more cm. But who knows, some are very dedicated.
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