1. Other doctors say that often times Achilles tendo lengthening is necessary. They charge you extra money. How is that handled with you? And is the frame removal included in your price?
Thank you for your email. Answering to your questions:
We do not do Achilles lengthening as it almost always results in some degree of permanent loss of strength of the calf muscles which patients feel as weakness during their walking or their standing on their toes. In our opinion it is not a "fair trade" to trade function for lengthening. If equinus deformity (ballarina foot) is encountered, we treat it with a temporary extension of the frame to the foot during the lengthening phase. This method very reliably stretches the tendon and restores the position of the foot. It is a rather minor procedure, which is done as a day case, but it requires anaesthesia and extra frame parts so there is an associated additional cost of 1000 for one leg and 1500 for bilateral done simultaneously. The need for this procedure will be assessed before your main lengthening surgery. The frame removal is not included in the price as many patients choose to have them removed in their country rather than traveling back to us. The cost for frame removal with us is 950 Euro
2. Is the 4-5months recovery with TSF an average because with HEF for example I was told that they take off your frames 7-11months later.
The timing for frame removal depends on the lengthening goal, patient's age and healing rate.The numbers mentioned is an average (plus/minus 6 weeks).
3. Do I need some kind of VISA for staying multiple months (4-5months) in Greece as a German citizen?
For 5 cm of lengthening, we need you to stay in Greece for a minimum of 2.5 months. Greece is a member state of the EU so as a German citizen you do not need any special Visa or residency status and you can stay for as much time as you wish.
We remain at your disposal for any further information and assistance.
Τhe answer about atl make me believe that Giotikas is a respectable doctor who knows what he is talking about.
He is completely right about what he says and I really wonder how doctors like Catagni and Pili still perform atl which destroys feet capabilities.
I would have a close look to that doctor. He seems very promising and it is time to trust new doctors with better prices but still on first world countries (like Greece) because, except from USA where Paley and Rozbruch are really the top doctors in the world, there aren't any doctors who personally I'd trust completely for internal femurs, especially for their prices.
So it is time to give a chance to new, promising doctors like him who seem to really know what they are talking about.
We'll see.
Yes, I feel also safer with Greece and plan to make an appointment soon.
I forgot to post this e-mail exchange which fits in here
I asked them about the recovery time and about proportions:
1. With bilateral TSFs for 5cm lengthening in tibias the estimated time for frame removal is 4 to 5 months. You will be able to walk with the frames and with full weight bearing since immediately after your surgery.
2. With bilateral Precise-2 nail for 5cm lengthening in femurs the estimated time for walking without crutches is 4 months. Until then you will need to use wheelchair and walker or crutches. The same applies to tibias with precise nail, but tibias may take a bit more until walking without crutches (4 to 5 months)
3. I don't expect that your proportions will look strange after lengthening the tibias and before doing the femurs. In any case, we use Athena Method -a method developed and presented by Dr Dimitrios Giotikas- to accurately inform our patients about their proportions before and after the lengthening. So,you will know exactly, how each cm of lengthening in tibia and femur is going to affect your body proportions.
Hi friends ! 
I enclose the answer given to me by the doctor's service concerning the operation of both limbs (femur and tibia) on both legs (54k).
They answered me very quickly (one day), I find it really nice of them. Some of my questions are probably trivial for some of you but in case some ask them I prefer the posted.
1 - First, I would like to know what physical condition is required to be eligible for this type of operation? I am not overweight, but I do not know if I have the muscular mass required for such surgery.
"The muscle condition is not a prerequisite for cosmetic limb lengthening (CLL). Contraindications for CLL are: Morbid obesity, Smoking, Immuno-suppression, Chronic infection, Diabetes, Psychiatric disorders with poor compliance, Anaesthetic related contraindications. "
-> I find it pretty cool, unlike the method of doctor Guichet, we do not need to be an athlete to get surgery!
2 - Can you confirm that the final price for this type of intervention (cross lateral) is well 54.000 euros TTC?
" Prices shown are TTC."
3 - I would like to understand that it is preferential to have surgery done externally or internally the tibia? Which of his methods allows for faster recovery and no future pain? On the other hand, I'm not sure I understood what "PRECICE 1" and "PRECICE2" mean?
"Both external and internal fixation give satisfactory results in tibia. The choice in each case is based on patient's preference, cost considerations and appropriate counselling by Dr Giotikas about the pros and cons of each method. Precise 1 was the first version of the nail which is not routinely used anymore. Precise 2 is the subsequent improved version of the nail."
->I think I discuss this part in more detail with the doctor during a consultation. Indeed, I would like to know better the advantages of this or that method.
4 - I could see that many had complications with other doctors for the operation of a single limb (tibia or femur). Your service proposes to operate both successively, is that not more risky?
"Four segment lengthening (either cross-leg or not) is the only solution for people who want to go beyond 8 cm and consent to accept the related risk after having received appropriate counselling by Dr Dimitrios Giotikas. It is obviously statistically riskier than having lengthening of femur or tibia only."
->It was an obvious and logical answer to the question but other service of LL would not have had this frankness I think.
5 - How long does it take to finally get surgery and consolidate the 4 members to operate? While removing the fixers éxternes of the TSF?
"he actual timings depend on the lengthening goal to be achieved. We generally plan to have the patients back to their lives without frames within 12 months from first surgery."
6 - Finally how long does it take to get a date of intervention after the consultation at athénes?
"Two months, but sometimes can be sooner."
I then add questions that I will send you answers at parties!
1 - In case of possible physical complications following the operation. Should we take charge of any additional operations / treatments that this would induce?
2 - The payment of the entire process must be done before the transaction or it can be staggered?
3 - From what I could understand. You operate initially 2 segments (namely the tibia and the femur) of one leg then the other one after consolidation. (I may have misunderstood) Would not it be better to operate for example the two femur together then the two shins?
4 - All preoperative examinations are made during the initial consultation at athénes?
If you have other ideas of questions that I do not ask yet I'm interested! I intend to book an online service of 15 minutes to try a first approach.
Quote from: AlphaX on May 15, 2018, 10:08:59 PMHi friends !
I enclose the answer given to me by the doctor's service concerning the operation of both limbs (femur and tibia) on both legs (54k).
They answered me very quickly (one day), I find it really nice of them. Some of my questions are probably trivial for some of you but in case some ask them I prefer the posted.
1 - First, I would like to know what physical condition is required to be eligible for this type of operation? I am not overweight, but I do not know if I have the muscular mass required for such surgery.
"The muscle condition is not a prerequisite for cosmetic limb lengthening (CLL). Contraindications for CLL are: Morbid obesity, Smoking, Immuno-suppression, Chronic infection, Diabetes, Psychiatric disorders with poor compliance, Anaesthetic related contraindications. "
-> I find it pretty cool, unlike the method of doctor Guichet, we do not need to be an athlete to get surgery!
2 - Can you confirm that the final price for this type of intervention (cross lateral) is well 54.000 euros TTC?
" Prices shown are TTC."
3 - I would like to understand that it is preferential to have surgery done externally or internally the tibia? Which of his methods allows for faster recovery and no future pain? On the other hand, I'm not sure I understood what "PRECICE 1" and "PRECICE2" mean?
"Both external and internal fixation give satisfactory results in tibia. The choice in each case is based on patient's preference, cost considerations and appropriate counselling by Dr Giotikas about the pros and cons of each method. Precise 1 was the first version of the nail which is not routinely used anymore. Precise 2 is the subsequent improved version of the nail."
->I think I discuss this part in more detail with the doctor during a consultation. Indeed, I would like to know better the advantages of this or that method.
4 - I could see that many had complications with other doctors for the operation of a single limb (tibia or femur). Your service proposes to operate both successively, is that not more risky?
"Four segment lengthening (either cross-leg or not) is the only solution for people who want to go beyond 8 cm and consent to accept the related risk after having received appropriate counselling by Dr Dimitrios Giotikas. It is obviously statistically riskier than having lengthening of femur or tibia only."
->It was an obvious and logical answer to the question but other service of LL would not have had this frankness I think.
5 - How long does it take to finally get surgery and consolidate the 4 members to operate? While removing the fixers éxternes of the TSF?
"he actual timings depend on the lengthening goal to be achieved. We generally plan to have the patients back to their lives without frames within 12 months from first surgery."
6 - Finally how long does it take to get a date of intervention after the consultation at athénes?
"Two months, but sometimes can be sooner."
I then add questions that I will send you answers at parties!
1 - In case of possible physical complications following the operation. Should we take charge of any additional operations / treatments that this would induce?
2 - The payment of the entire process must be done before the transaction or it can be staggered?
3 - From what I could understand. You operate initially 2 segments (namely the tibia and the femur) of one leg then the other one after consolidation. (I may have misunderstood) Would not it be better to operate for example the two femur together then the two shins?
4 - All preoperative examinations are made during the initial consultation at athénes?
If you have other ideas of questions that I do not ask yet I'm interested! I intend to book an online service of 15 minutes to try a first approach.
That's great man. I also plan to do the free online consultation.
Here's my list of questions I want to ask him next months, but if you want you can ask some of them before (at your online consultation), let me then know which one you chose:
1. How many patients did you have concerning limb lengthening. How many CLL patients did you have so far?
2. How many cross leg lengthenings have you done so far?
3. Is cross leg lengthening far more dangerous than doing tibias or femurs separate?
4. What are the most common risks with each method you offer? And which ones occured to your former patients?
5. What will I be able to do during lengthening and consolidation (walking, driving, sightseeing, sitting for a longer time?)
6. How close should the appartment I'll rent be to the clinic?
7. Will the Physio therapist visit me at my place of stay?
8. After the 10 weeks of PT you offer, how long and how often per week should I hire a PT?
9. Are there PT's in Athens you recommend after the surgery? (who aren't too expensive)
10. Is there something I can do before surgery to improve my recovery?
11. What kind of doctors are able to remove such frames if you choose to do it in your home country?
12. Do you have an emergency number in case something happens?
13. Did you notice if a certain amount of lengthening (cm) is more safe?
14. I have read that having longer tibias can be bad for your health, so should I start femurs first or will it make no difference if the lengthening of the other segments will be done about a year afterwards?
15. If someone does cross LL how long after the first surgery will the second will be done?
16. I am just 117 lbs. Does this make a difference concerning recovery and mobility?
17. Will it be worth waiting for Stryde for femurs ? Will it cost a lot more?
18. What can you do if for example with Cross LL the first surgery+lengthening+consolidation goes fine but the second time complications occur, wouldn't you have a discrepancy if you have to stop lengthening?
19. Can the so called "duck ass" or "ballerina foot" be avoided somehow?
20. If I go home for consolidation phase whom should I contact If something happens like infection? What kind of doctors in my home country would be able to treat that?
21. Does the frame removal cost 950€ in total or for each frame? (if you do cross ll )
excellent work guys.
I am at 165cm and want to do also 10cm on femurs(5/6) and tibia(5/4), just like you guys. My main question would be, in case everything goes well, how much time from operation till walking unaided/resuming normal activities?
Quote from: Honore on May 16, 2018, 12:26:15 AMI am at 165cm and want to do also 10cm on femurs(5/6) and tibia(5/4), just like you guys. My main question would be, in case everything goes well, how much time from operation till walking unaided/resuming normal activities?
That has been answered previously:
QuoteWith 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).
Here are the answers to my questions (always super responsive).
1 - In case of possible physical complications following the operation. Should we take charge of any additional operations / treatments that this would induce?
"Although we try to reduce the cost as low as possible in the treatment of an adverse event, there may be additional cost if unexpected interventions are required. We generally advise our patients to have an additional 4000 euros for such a case."
2 - The payment of the entire process must be done before the transaction or it can be staggered?
Payments are paid in full tbefore the surgery date.
3 - From what I could understand. You operate initially 2 segments (namely the tibia and the femur) of one leg then the other one after consolidation. (I may have misunderstood) Would not it be better to operate for example the two femur together then the two shins?
"The main advantage of the four segment cross-leg is that it allows full weight bearing on one side through out the whole procedure. Doing both tibias (or femurs) first and then the other parts can also be done."
4 - All preoperative examinations are made during the initial consultation at athénes?
"Yes, they are."
@Great321 Thank you so much !! I find your questions super perceptive and precise. I did not think about it but many of them are important.
I will ask these 5: 2-4-5-10-18 and tell you what I give as an answer.
Subsequently I think to agree to an online appointment for a first approach ..
Thank you all!
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