Quote from: ForcedPuberty on December 19, 2014, 12:29:19 PMthere are many reasons why this 1 leg(femur + tibia) at a time time is such a bad idea.
I agree with you that doing 1 leg (femur+tibia) in a single surgery is probably a bad idea because you'll really overstretch it. It's too much for one leg to have two segments being lengthened at the same time and your recovery will last forever.
But I think there are many advantages in doing a two stage lengthening, provided you do only femurs or only tibias, stay below the recommended limits (<6cm femurs; <5cm tibias), and follow your doctor's instructions very carefully.
Advantages:
- only one segment is "broken", so you have less overall pain and your recovery is faster because your body is "concentrated" on healing that segment
- you can move around in crutches and still do most things you used to do before surgery, which is better for your recovery and your psychology
- if you study at a university, you can do 1 femur when classes are over in June/July, and then do the other femur during the Christmas/New Year break 5 or 6 months later
- if you work, just take 2 weeks off and do 1 femur (down time after surgery is about 1 week), then take another break some months later and do the other one (without leaving your job)
I'm planning to do 1 femur then the other femur a few months later, and I won't go beyond the recommended limits so there shouldn't be a problem.
I just wanted to warn people with crazy plans of doing unreasonable amounts of lengthening beyond the recommended limits.
Dr Alex Monegal (Barcelona, Spain) Clinica Diagonal
Quote from: Dingo on December 19, 2014, 02:26:40 PMI agree with you that doing 1 leg (femur+tibia) in a single surgery is probably a bad idea because you'll really overstretch it. It's too much for one leg to have two segments being lengthened at the same time and your recovery will last forever.
But I think there are many advantages in doing a two stage lengthening, provided you do only femurs or only tibias, stay below the recommended limits (<6cm femurs; <5cm tibias), and follow your doctor's instructions very carefully.
Advantages:
- only one segment is "broken", so you have less overall pain and your recovery is faster because your body is "concentrated" on healing that segment
- you can move around in crutches and still do most things you used to do before surgery, which is better for your recovery and your psychology
- if you study at a university, you can do 1 femur when classes are over in June/July, and then do the other femur during the Christmas/New Year break 5 or 6 months later
- if you work, just take 2 weeks off and do 1 femur (down time after surgery is about 1 week), then take another break some months later and do the other one (without leaving your job)
I'm planning to do 1 femur then the other femur a few months later, and I won't go beyond the recommended limits so there shouldn't be a problem.
I just wanted to warn people with crazy plans of doing unreasonable amounts of lengthening beyond the recommended limits.
1)When you do both tibias or both femurs,you are imparting the same amount of stress on your body as one femur and one tibia. Its two broken segments either way.
Doing one segment at a time isnt what I would do. I would do 2 segments at a time , if its bilateral or this approach.
I am not a fan of only doing femurs or tibs and then quitting. If I do the LL it will be all 4 segments in 2 surgeries.
2)This doctor advised us the 'safe' limit is 6cm for femurs and 6.0 for tibias on page 1 . I dont think anyone on this thread has planned on doing much more than this. Maybe 1 cm more. I didnt read anyone wanting anything crazy like 10cm segments.
If he caps us at 6 and 6 , I am ok with it. The only thing that I agree with is your assertion that a catastrophe can strike and you have to stop the other leg before it catches up to the first leg.
And in that unfortunate case , like I stated above, you would need to let that segment heal for a while then rebreak it to lengthen again.
I understand that you do not like this approach. I appreciate your thoughts on it. 
Quote from: TomD on December 19, 2014, 04:17:56 PM1)When you do both tibias or both femurs,you are imparting the same amount of stress on your body as one femur and one tibia. Its two broken segments either way.
I was talking about the difference between the one stage procedure and the two stage procedure:
1 femur + other femur later = 1 tibia + other tibia later = 1 "broken" segment at a time = less stress and trauma and shorter recovery
2 femurs at the same time = 2 tibias at the same time = 2 "broken" segments at the same time = more stress and trauma and longer recovery due to loss of muscle strength
1 femur + 1 tibia at the same time (same leg) = crazy and recovery takes much longer (that's why some doctors perform the infamous and also crazy cross lengthening: right femur + left tibia, then left femur + right tibia)
Quote from: TomD on December 19, 2014, 04:17:56 PMI didnt read anyone wanting anything crazy like 10cm segments.
You can bet there are people on this forum (who may just read and not write anything), who think that getting a total of 20cm would be desirable and achievable without consequences. Never underestimate desire.
Quote from: TomD on December 19, 2014, 04:17:56 PM2)This doctor advised us the 'safe' limit is 6cm for femurs and 6.0 for tibias on page 1 .
If you're set on doing all 4 segments, you should lengthen your tibias less than your femurs to maintain the bio-mechanical ratio of your legs, which is usually around T/F=0.8, but the doctor will give you the exact measurements of your bones and advise you on that.
I was considering your approach of doing both femurs at the same time before I read what Dr. Monegal wrote and started thinking about it. Considering all the variables in my life right now, I think his approach is the best one for me, because I can't really stay away for several months in some foreign country doing this.
Hi all in the forum.
There are several things people is asking me to clarify.
About pricing i am not in charge of the finantial of the Clinic expenses but when you do perform 2 bones (femur and tibia) It is not 2 times 18000 because you save or/anaesthetics/hospital stay expenses of one procedure.
So when performing simultaneous femur and tibia total cost per limb is 31-32000€ approximately.
People from abroad can go home and they can be followed up in their countries. I always ask patients to send me an x-ray to check consolidation progress and they usually come at the end of the procedure for a clinical check.
Barcelona is a wide international city and most people speak English. At clínica diagonal we do receive lots of international patients and do believe that facilities are modern (Clinic Was built 2 years ago) and all patients are astonished when they visit it.
I don t like one of your comments saying people here is depressed and you might get an infection or whatever...i don t think he or she is serious saying China is a best option. He or she might have never been to china, chinese facilities or in touch with Medical and nursing staff over there. But as I always advice to you guys is not a matter of being conservative, but this is serious stuff and it s better to stay in the safe side.
Some of you wanted to contact me and you are welcome to send me an email to my personal address. For those interested to see the Clinic you can have a look at www.clinicadiagonal.com
In this sense, Fitbone manufacturers do select all their COE (centers of excellence) so all Clinics where Fitbone technique is performed needs their approval.
Once again Thanks to all of you. This forum is very helpful not only for you guys, but Also for LL specialists to understand your concerns and thoughts.
Let me wish you all Merry Christmas and Happy new year
When it comes to internal lengthening, does any one know what's "easier" (pain, comfort, contracture) to do - femurs or tibias? I mean, I'd like to do only one segment for about 6cm and would like to know the pros and cons. Thank you.
Quote from: Dingo on December 19, 2014, 07:40:06 PM
1 femur + 1 tibia at the same time (same leg) = crazy and recovery takes much longer (that's why some doctors perform the infamous and also crazy cross lengthening: right femur + left tibia, then left femur + right tibia)
You can bet there are people on this forum (who may just read and not write anything), who think that getting a total of 20cm would be desirable and achievable without consequences. Never underestimate desire.
If you're set on doing all 4 segments, you should lengthen your tibias less than your femurs to maintain the bio-mechanical ratio of your legs, which is usually around T/F=0.8, but the doctor will give you the exact measurements of your bones and advise you on that.
I was considering your approach of doing both femurs at the same time before I read what Dr. Monegal wrote and started thinking about it. Considering all the variables in my life right now, I think his approach is the best one for me, because I can't really stay away for several months in some foreign country doing this.
1) Posters keep putting up this stuff about it being 'crazy' to do but never get around to showing the abstract or quotes from medical professionals whom suggest it is outrageous or recovery time is greater. I have done my own research to answer this question and have found nothing outside knee pain in children with deformities whom do not have well developed muscles and ligaments.
2) Peoples desires are none of my business. It not for any of us to determine what they are. We all have our opinions on how much we will lengthen but in the end its up to the doctor and patient to decide what is reasonable.
3) I am fairly certain we know how to listen to a doctor and heed his advice, but thankyou anyways.
4) The safest way of all would be the 1 segment at a time if you want to do 4 separate operations which I do not. If you do, then great. I hope it goes well for you.
5 Lengthening the tibs or femurs only then quitting throws your ratios out of whack. Unless your femur / tib relationship is way out to begin with and lengthening the lower or higher bones would correct it. I doubt that is the case with those of us seeking cosmetic surgery.
And again for the 3rd time, I appreciate the point about the fact once you do one leg, you have to hope you can also do the other leg to the same proportions. I wish the doctor would address that issue. Perhaps stats on how many folks are unable to do the second leg as long as the first.
Good luck with your surgeries. Let us know how it goes.
This link shows several video clips of Clinica Diagonal:
http://www.clinicadiagonal.com/ca/tour-virtual
If I were to go with Dr Monegal then I'd do all four bones(2 femurs+ 2 tibias) in two operations, no way am I going to do 4 separate surgeries.
Thats probably as mad, if not, more than doing 1 femur+ 1 tibia in a single surgery.
2 surgeries for all four bones and tank having one whole leg broken each time is my plan. Not only is doing 4 separate surgeries more time consuming but its also going to be more expensive and a lot of flights back and forth. I wouldnt do this if I were planning to do either only the tibia or femur unless I lived in Barcelona.
64,000 Euros for all 4 segments, hmmm, that is still expensive but a lot cheaper than other well known doctors. Decisions, decisions
Im still not sure about internal tibias and the risk of permanent knee pain though...
Ohh and the hospital looks so clean and brand new from those vids
Quote from: ShortyMcShort on December 20, 2014, 01:39:53 PMIf I were to go with Dr Monegal then I'd do all four bones(2 femurs+ 2 tibias) in two operations, no way am I going to do 4 separate surgeries.
Thats probably as mad, if not, more than doing 1 femur+ 1 tibia in a single surgery.
2 surgeries for all four bones and tank having one whole leg broken each time is my plan. Not only is doing 4 separate surgeries more time consuming but its also going to be more expensive and a lot of flights back and forth. I wouldnt do this if I were planning to do either only the tibia or femur unless I lived in Barcelona.
64,000 Euros for all 4 segments, hmmm, that is still expensive but a lot cheaper than other well known doctors. Decisions, decisions
Hey shorty. Yeah he does bilaterals so he can do 2 femurs for 32euro which = $39124 US which is pretty sweet if you ask me.
I am either doing one leg all internals then the other or bilateral femurs then cheap out on monorail in India for the tibs.
You must be logged in to post a reply.