Dear Friends,
As I am the doctor in question, I feel compelled to reply. Yes, Africa. South Africa is very different from your perceptions and I would challenge you to explore the country as a tourist before making general assumptions. The health system I work in and the unit I run is world renowned and I regularly (8 times per year) host surgeons from across the globe. During these weeks I teach the surgeons limb lengthening and reconstruction techniques. This includes surgeons from the US, UK, Sweden, UAE etc etc. Not really darkest Africa at all.
With regards to the lengthening itself, I stand by my comment that as a worst case scenario you could end up with an amputation and I would challenge you to discuss this with your chosen surgeon. This is how serious a decision cosmetic lengthening can be. Reasons for serious complications can vary, but may include injuring blood vessels, nonunions, infection etc. These complications happen anywhere, not only in Africa!
Although we perform lengthenings for malunions, congenital conditions and bone defects on almost every theatre list we do, and have vast experience in these techniques, we really do not perform cosmetic lengthenings anymore, and I would advise you to look elsewhere, but CHOOSE YOUR SURGEON CAREFULLY. Price should be the least of your concerns. Look for a doctor who communicates well and is happy to discuss potential complications with you...this is not a walk in the park.
Anyway, good luck in your search. Make sure that the extra inches will make you happy before you embark on your journey.
Best regards,
Franz Birkholtz
Dr Franz Birkholtz (Pretoria, South Africa)
Quote from: Franz on November 20, 2013, 08:32:14 PMDear Friends,
As I am the doctor in question, I feel compelled to reply. Yes, Africa. South Africa is very different from your perceptions and I would challenge you to explore the country as a tourist before making general assumptions. The health system I work in and the unit I run is world renowned and I regularly (8 times per year) host surgeons from across the globe. During these weeks I teach the surgeons limb lengthening and reconstruction techniques. This includes surgeons from the US, UK, Sweden, UAE etc etc. Not really darkest Africa at all.
With regards to the lengthening itself, I stand by my comment that as a worst case scenario you could end up with an amputation and I would challenge you to discuss this with your chosen surgeon. This is how serious a decision cosmetic lengthening can be. Reasons for serious complications can vary, but may include injuring blood vessels, nonunions, infection etc. These complications happen anywhere, not only in Africa!
Although we perform lengthenings for malunions, congenital conditions and bone defects on almost every theatre list we do, and have vast experience in these techniques, we really do not perform cosmetic lengthenings anymore, and I would advise you to look elsewhere, but CHOOSE YOUR SURGEON CAREFULLY. Price should be the least of your concerns. Look for a doctor who communicates well and is happy to discuss potential complications with you...this is not a walk in the park.
Anyway, good luck in your search. Make sure that the extra inches will make you happy before you embark on your journey.
Best regards,
Franz Birkholtz
Doctor Franz,
Your reply is extremely appreciated! Please continue to post on this forums as I would love to hear more about your experiences, successes and failures as a surgeon in CLL.
Also, allow me to apologize on the behalf of the other posters in this thread. They are incredibly uncultured and know nothing about Africa besides what the media in their home countries tell them. I would be honored to get surgery done with you since you sound very knowledgeable and wise in this craft (it is an extremely dangerous procedure to do, which no doctor should sugarcoat).
Are you still doing CLL? Do you have any interest in using PRECICE? What about accommodations in your hospital?
Thank you!!
I don't agree with most of you guys. South Africa is a developed country. I do think it would be a better option than India.
Quote from: Franz on November 20, 2013, 08:32:14 PMDear Friends,
As I am the doctor in question, I feel compelled to reply. Yes, Africa. South Africa is very different from your perceptions and I would challenge you to explore the country as a tourist before making general assumptions. The health system I work in and the unit I run is world renowned and I regularly (8 times per year) host surgeons from across the globe. During these weeks I teach the surgeons limb lengthening and reconstruction techniques. This includes surgeons from the US, UK, Sweden, UAE etc etc. Not really darkest Africa at all.
With regards to the lengthening itself, I stand by my comment that as a worst case scenario you could end up with an amputation and I would challenge you to discuss this with your chosen surgeon. This is how serious a decision cosmetic lengthening can be. Reasons for serious complications can vary, but may include injuring blood vessels, nonunions, infection etc. These complications happen anywhere, not only in Africa!
Although we perform lengthenings for malunions, congenital conditions and bone defects on almost every theatre list we do, and have vast experience in these techniques, we really do not perform cosmetic lengthenings anymore, and I would advise you to look elsewhere, but CHOOSE YOUR SURGEON CAREFULLY. Price should be the least of your concerns. Look for a doctor who communicates well and is happy to discuss potential complications with you...this is not a walk in the park.
Anyway, good luck in your search. Make sure that the extra inches will make you happy before you embark on your journey.
Best regards,
Franz Birkholtz
Hello Dr. Birkholtz,
Thank you for your reply. It would certainly be to everyone's benefit if more doctors really emphasized what to expect in a worst-case scenario with limb lengthening. I've spoken to a number of orthopedic surgeons in my various inquires and whenever one tells me that complications are minimal or that the worst to expect is a pin-site infection here and there, I automatically scratch the doctor off my list. I guess I just think that if they give you sunny expectations, then they might not address a potentially serious problem that could happen later down the line. I've never heard any accounts of people getting their legs amputated, but then again my only other resource for years had been that site old forum and it's known to sugarcoat and even hide serious complications that patients may receive. Now that that's a real possibility, it gives people a lot more to think about.
May I ask why cosmetic lengthening is something that you aren't fond of doing? Is it that you think it's too much risk for someone with perfectly healthy legs?
Dr. Birkholtz is an honest man and a good doctor as can be seen from his posting. Yes indeed, cosmetic LL is too dangerous to be recommended. It should be only done as a last resort when you are totally unhappy with your life, not just as a luxury.
Dear Kilokahn,
I think the debate around CLL goes wider. I suppose it has to do with cosmetic surgery in general. The reality is surgery is invasive and never perfectly safe. Up till recently we have not really had devices that were reliable, reproducible and predictable for femoral lengthening. Now with Precice we have that. In addition, the desired length is important. Anything beyond 4-5cm per segment becomes really problematic in terms of complication rates. Realistically the cost is almost prohibitive to go through a 4 segment lengthening, which means most patients end up with 5 cm either femoral or tibial. With this in mind, we have to ask whether the patient will really be happy with gaining 5 cm.
Having said all this, I realise very well that there are individuals who benefit greatly (physically and psychologically) from CLL, and it is this select group that I believe are the ideal patients.
As you can see this leaves us with a small group of patients who can a) afford it and b) be happy with it c) are healthy enough and d) are appropriate candidates (2 standard deviations shorter than the population average).
Once we've met all these criteria, there are few patients left.
From a doctor's perspective there are really 3 issues: patient safety, medicolegal risk and lastly a potential increased arthritis risk after CLL.
Hope this all makes sense?
Btw, Ballpark figure for CLL using bilateral Precice in our unit would be around 40 000 Euro. Tibial lengthening can be done with frames and would be a little less.
Rgds,
F
Thank you Doctor. Could you let me know the best way to reach your office? I have many more questions and am very interested in having CLL done with you.
You are welcome to phone the office at +27(0)126442641 and speak to Madelein. They will probably tell you we do not perform CLL's though. :-).
If you wish you can mail me your questions, then I'll endeavour to answer them as quickly as possible.
You can reach me at [email protected]
I thnk the pricing is a bit too much for LL in south Africa.
At these prices i would rather go to china where they have done a thousand times more LL surgeries and benefit from all that experience that they have over there.
I thought South african prices would be slightly higher than those in India but not what i see quoted here.
Dear Dr Franz, thanks for joining our forum and answering our questions.
After reading many of the posts here, I can see that people don't really know a lot about South Africa and it's nice to have someone enlightening us.
When you gave us the round figure of 40k euros for femoral lengthening with the Precice, what would that include exactly? Just the surgery and a few days at the hospital? Or would it include everything (accomodation at a safe location, food, medications, physio, etc)?
If it includes all that I've mentioned above, then the 40k euros are not really that steep. If not, then it's very expensive. (one can get internal femurs in South Korea with ISKD for 35k euros with everything included)
I'd also like to emphasive the need to guarantee patients' safety, since from what I've been told by an Afrikaner who emigrated to my country and from what one can read about in praag.org, Pretoria isn't exactly the same as a small town in Switzerland.
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