Dr Dimitrios Giotikas (Athens, Greece)

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Note: please refer to our disclaimer about The Doctors Directory
http://www.limblengtheningforum.com/index.php?topic=55.0

Everything below was simply copied off of their site unless noted.


Dr Dimitrios Giotikas, MD, PhD
​Consultant Surgeon in Trauma & Orthopaedics
​Athens BJR Clinical Director
Hon. Senior Clinical Lecturer of the faculty of Medical Science at Anglia Ruskin University, Cambridge, UK.

Full profile including training, qualifications, work history, publications, and memberships


Cost & Pricing of Cosmetic Limb Lengthening

• Femoral lengthening with Precise-2 nails: 36950 Euro
• Tibia lengthening with TSF (Smith & Nephew) circular frames: 22600 Euro
• Tibia lengthening with Precise-2 nails: 38950 Euro
• Four segment cross-leg lengthening (femurs and tibias in two stages within 6 months) lengthening: 54000 Euro​

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What is included in the above prices:

• Pre-operative and post-operative blood tests
• Pre-operative and post-operative x-rays,
• full board hospital stay for 4 nights in two bed bedroom,
• Pre- and post-operative medications
• Anaesthetist's fees,
• Surgeon's fee,
• Surgical assistant's fee,
• Implants,   
• Soft tissue procedures (tendon or IT band releases) which will be performed at the same setting with the main operation
• in hospital physiotherapy until discharge.
• Crutches and wheelchair
• Post-operative (after discharge) physiotherapy, (5 sessions/week for the first two weeks, 3 sessions/week for the following 8 weeks. total 10 weeks,  34 sessions)

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What is NOT included

• Accommodations in Athens.
• Travel to and from Athens.
• Transportations in Athens.
• Food and other supplies during your stay in Athens.
• Entertainment and/or Internet costs.
• Home health aides (nurses, homemakers, etc.).

Consultation
You can book a free 15 minute consultation online. (Note: not sure how successive consults are handled.)

Contact Info
Athens Bone & Joint Reconstruction Centre
Athens Towers 20th floor, 2-4 Messogion Av, 11527, Athens, Greece
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Tel: +30 210 74 54 367
Mon-Fri:  09.00-18.00  (Time zone: UTC+02.00)
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email: [email protected]

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I sent an email a couple months ago with some questions. Emphasis in responses are his.




I have questions regarding four-segment cross-leg lengthening mentioned here:
https://www.athensbjr.com/cost-and-pricing-of-cosmetic-limb-lengthening.html

1. Which methods are used for these procedures? Is it a mix of internal/external methods or are all segments the same (all external, all internal)?

I do four-segment-cross leg lengthening with Precise-2 nail in the femur and Taylor Spatial Frame (TSF) external fixator with clickers on the opposite leg. The main advantage of this approach is that patients are able to have a limb to stand and walk on with full weight bearing at all times during the lengthening and consolidation phases. This greatly helps with physiotherapy, muscle preservation and allows patients to continue with their usual daily activities with the least disturbance ( Looking after themselves, seeing friends, going out, even return to work, etc).  If a patient is interested in four-segment lengthening with Precise nails only, I do both femurs (or tibias) first and both tibias (or femurs) at a later stage, (i.e not cross-leg). I do not do femoral lengthening with external fixators for cosmetic reasons.

2. The page says "two stages within 6 months," does that mean lengthening and consolidation is completed before starting on the next segments? Or can it be sooner? Trying to estimate the required time commitment.

For 6-7 cm lengthening on femur, the time to allow full weight bearing is approximately 6 months. This is the time when the second stage is done. With regards to time commitment, my aim is to have the patient completely finished, full-weight bearing and with the TSF frames removed within a year or 15 months (for 11 or 13 cm of lengthening respectively). The required time of stay in Athens at each stage is  2,5-3 months. With shorter lengthening the timings are shorter.

3. What is the recommended amount of lengthening per segment if I am 165cm?

The recommended amount per segment depends on your desired height goal, the current lengths of femur and tibia and and the length-ratio between femur and tibia. I usually suggest up to 6 cm in femur and 5 cm in tibia, but I can go for up to 7 cm and 6 cm respectively, after having appropriately counselled the patient.

4. How many limb procedures has Dr. Giotikas performed, both cosmetic and non-cosmetic patients?

I specialized in limb reconstruction at Cambridge University Hospital NHS foundation Trust in the United Kingdom since 2012 and I continue to work there in a permanent post. We are a team of three specialists there sharing a workload of approximately 100 limb reconstruction cases/year. These cases are  pathological, infected or post-traumatic limb length discrepancy, bone defects and deformities and, to a lesser degree, constitutional short height related to bone dysplasias.  We use TSF fixators, Precise nails and LRS systems for lengthening over nails or plates, depending on the case.

My involvement in these complex cases, especially on patients with serious injuries or infections (where the difficulty and complications increase because of the compromised soft tissue condition) has equipped me with significant experience on the surgical technique and on the overall management of these patients ( non-traumatic corticotomy of bone, frame configuration for increased stability,  assessment of progression of regenerate, adjustment of lengthening rate, weight bearing progression, prevention of complications, counselling and coaching of the patients).  Athens BJR is based on the transfer of the above  experience to the field of cosmetic limb lengthening.

5. Are there any photos of CLL patients?

No, I am sorry, there aren't.

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Makes sense everything the doc wrote, maybe is a good option, I like the idea of TSF frames.

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Link: https://www.athensbjr.com/dr-dimitrios-giotikas.html

Great find Android. His credentials look rock solid, strong emphasis on safety, very affordable for PRECICE & TSF, fees include everything except living expenses.

Conversion to U.S. Dollar: 6-January-2018

TSF Tibia: $27,000

PRECICE Femur: $44,500

PRECICE Tibia: $46,850

Four Segment Cross Lengthening: $65,000

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Quote from: Stadiometers on January 06, 2018, 03:52:01 PMLink: https://www.athensbjr.com/dr-dimitrios-giotikas.html

Great find Android. His credentials look rock solid, strong emphasis on safety, very affordable for PRECICE & TSF, fees include everything except living expenses.

Actually found him through these very forums in this thread. He does look quite good, he's on my shortlist.

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Is anyone considering this doctor? I think he seems like a great option.

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Quote from: Android on December 27, 2017, 12:59:00 AM1. Which methods are used for these procedures? Is it a mix of internal/external methods or are all segments the same (all external, all internal)?

I do four-segment-cross leg lengthening with Precise-2 nail in the femur and Taylor Spatial Frame (TSF) external fixator with clickers on the opposite leg. The main advantage of this approach is that patients are able to have a limb to stand and walk on with full weight bearing at all times during the lengthening and consolidation phases. This greatly helps with physiotherapy, muscle preservation and allows patients to continue with their usual daily activities with the least disturbance ( Looking after themselves, seeing friends, going out, even return to work, etc).  If a patient is interested in four-segment lengthening with Precise nails only, I do both femurs (or tibias) first and both tibias (or femurs) at a later stage, (i.e not cross-leg). I do not do femoral lengthening with external fixators for cosmetic reasons.

Interesting approach for cross-lateral. Is Giotikas the only doctor mixing internals and externals for cross-lateral?

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Quote from: myloginacct on April 26, 2018, 12:18:43 AMInteresting approach for cross-lateral. Is Giotikas the only doctor mixing internals and externals for cross-lateral?

I haven't seen it advertised as an option anywhere else. Though using TSF, it seems to be classic Ilizarov without LON/LATN (needs confirmation).

You could probably ask a clinic that offers both externals and internals if it's an option though, since Dr. Birkholtz has mentioned cross-lateral lengthening in the past (and he offers both fixator types). While Dr. Paley doesn't offer it anywhere for CLL patients, Dr. Mahboubian's site still mentions TSF.

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I posted the answers in my topic already http://www.limblengtheningforum.com/index.php?topic=5412.0
but as it also fits in here, here is my e-mail correspondence:

I sent my questions yesterday (On Mon, Apr 30, 2018 at 5:38 PM) and they responded today at 07:47 AM (that was sooner than I expected.)

1.   How long do you have to wait for an appointment (consultation and surgery)?
You can see available dates for online consultations and consultations at Mediterraneo Hospital in Athens by clicking here. Generally the waiting time is approximately 2 weeks. For surgeries, we plan at least two months in advance. The shortest available surgery date for you, would be on 5 or 6 July 2018 and then in September.

2.   Do you recommend staying in Greece for the whole lengthening process or is it still safe to travel back to Germany for consolidation?
We require that patients remain in Athens during the lengthening period only, but we allow them to return back home during the consolidation period. We provide a detailed schedule for physio, online consultations and x-rays for after their repatriation.

3.   I am interested in the cross-leg lengthening method. I have read from another doctor that by doing externals for tibia the risk of permanent knee pain (due to the nail insertion and removal) is lesser. Why do you recommend the Precise 2 for tibias?
Cross-leg lengthening is in our opinion the best strategy for patients aiming for more than 8 cm of lengthening. Anterior knee pain is a rare (less than 3%) risk of tibia nailing; even when it happens it tends to improve gradually. We offer the option of Precise-2 in tibia for patients who do not want external ring fixators.

4.   Does it make a difference concerning the duration of the healing process which method someone chooses?
No, it doesn't.

5.   I am 1,60m how long would it take for me to walk normally again if I aim about 10cm more?
For 10 cm of lengthening in two stages with cross-leg lengthening it will take approximately 9 to 10 months to walk without walking aides. During all this time you will be able to walk independently with crutches and full weight bearing on the leg that has the ring fixator frame.


6.   How many CLL patients have you had so far?
Dr Dimitrios Giotikas discusses all questions about his clinical experience, including the volume of cases, during a free introductory 15 min consultation via Skype or phone, which you can book now.

7.   I have read about MESKA (Mediterranean rehabilitation Centre), how long can you stay there and how much does it cost per month? Are there inexpensive places a patient can stay safely close to your clinic?
MESKA costs approximately 200Euro/day but includes full board meals, hydrotherapy, daily physiotherapy, transportations etc. There are indeed  inexpensive options for accommodation (hotel rooms and Airbnb apartments) near to our clinic.