Posted on Oct 3, 2013, 9:08 pm
#1
Here;s the response from Dr Jamal Abu Nemer from Medical centre BONAMED .
1) How many patients have you operated for cosmetic Limb Lengthening so far and How many patients do you operate yearly?
We use technique of intraosseous osteosynthesis applying driving devices for femurs (hips) and tibias (shanks) that were developed by prof.Bliskunov (since 1980) and continuously improved. You can see information about our method in our web sites.
Bliskunov Nails
Dragan-Bliskunov Nails
Jamal Nails (JN)
Limb lengthening programs (pairwise lengthening) by internal method aimed for solution of patient’s social-adaptive problems (relative stunting) were implemented in 47 patients (by Jamal Abu Nemer M.D., Ph.D. in person). 22 legs elongation programs were made with the new generation of devices. Total number of patients operated using Bliskunov’s method for Cosmetic Leg Lengthening exceeds 550.
2) What is the estimated total cost, including post-op treatments, stay, medications, physiotherapy? Are unscheduled surgeries covered and How much does a consultation cost?
The consultation is free of charge. There may be some low costs associated with examination (X-ray, CT, etc)
The total cost of the lengthening program since May 2013 takes into account a stay of a patient in the Ukraine for three months. 90-100 days - this is the time period for conducting a surgery and lengthening of femurs or tibias to the optimum length. The optimum length refers to the lengthening when muscles, tendons, and nerves are adapted sufficiently well to the new state of tension. It is 7.0 cm for femurs and 4.5-5.0 cm for tibias.
The total cost of the lengthening program (TCLP) is 39 000,00 USD, the same as for femurs and for tibias ( since May 2013). (Lengthening more than the optimum length increases the time period of lengthening and restoration. In this case it is necessary to adjust additional costs of the program of lengthening.)
This cost includes the cost of surgeries and a stay of a patient in hospital for the necessary term (as a rule 2-3 days), and also the cost of a surgery and a stay in hospital for the removal of devices (in 1 - 1.5 years after the beginning of lengthening).
The cost of the lease of apartments during the stay for the period of the lengthening is not includes in TCLP. Assistant can help to lease suitable apartment. /Cost of comfortable apartments is around 1000 USD per month. Additional costs may be associated with a broker service for searching for an apartment - usually half the monthly cost, single payment/.
The costs for unscheduled surgery are covered.
3) What kind of physical therapy is assigned to the patient?
It has to be mentioned here that it is very essential for the patient to stay active in the lengthening period and during rehabilitation for successful restoration of these functions. Walking (at first with outer supports, then, without them) is the best way of rehabilitation. The fact is that, graduated weight bearings on the bone and muscle contractions are very effective in recovery and shorten the rehabilitation period.
The more the patient walks, the quicker and more efficient the functions of his musculoskeletal system will restore (return). Success of this process depends only on the patient and his readiness for daily hard work.
As it was mentioned above, the most important factor influencing the speed and quality of the regeneracy of the lower limbs musculoskeletal system functions is the patient’s activity (walking, exercises). When selecting workload, the patient should be guarded by the doctor’s recommendations (the doctor should make some adjustments of the rehab program after studying the check x-ray picture and evaluating the patient’s progress in recovery). The patient should also take into consideration his/her state of health (confidence in motions, fatigue, etc).
Physical exercises also matters a lot. This is a set of special exercises to be performed in a lying position on the bed (the doctor will show these exercises and select the program appropriate for the patient). Regular exercises on the stationary bike (exercycle) also contribute to progress in recovery.
It is recommended for the patient to take some massage during the rehabilitation (not fewer than 10 sessions monthly of intensive lower limbs massage (duration not less than 1 hour).The massage helps muscles regain flexibility and capacity for work more effectively. The patient can also use an electromassage device for .independent procedures.
Regular exercises in the swimming pool can add to regaining the stereotype of walking by the patient. In water, overall load on the body and on the feet decreases; the patient starts feeling more confidently. It is important that the temperature of water be comfortable for the body. It is necessary to monitor the temperature conditions for the stretched muscles. The patient should not become too cold. Before any exercises, the muscles should be prepared for being loaded – legs should be rubbed for more intensive blood circulation, and it is worth doing some surface massage.
Physiotherapy methods are very important too. The physiotherapy blood circulation stimulating effect in muscles and other deeper limb structures proved to be very popular. This physiotherapy can provide mild stimulating influence on the bone tissue regeneracy. There are a lot of varieties of devices for the musculoskeletal system regeneration including those for home use. It is recommended to use physiotherapy devices generating pulsed magnetic field of low frequencies (10-25 hertz).
4) What maximum amount of lengthening do you recommend per segment, regarding patient safety? What is the daily rate of lengthening?
Optimum value of the lengthening: 6,5-7,0 cms for femurs and 4,5 - 5,0 cms for tibias. Maximum "hard" program: 10-11 cms for femurs and 6-7 cms for tibias. There is a big resistance of Achilles tendon after 4,5-5,0 cm of tibias lengthening.
And there is a big resistance of hip's muscles after 6,0 - 7,0 cm of femurs lengthening .
We can continue the program (more then optimum values), but it will take more time (and money for patient). Each additional centimeter more (higher) than optimal values of elongation (7cm for hips, 5 cm for shanks) is an additional money to the total cost of the lengthening program.
This is about 2 500 - 3000 USD for every additional centimeter. The reason - the extension beyond the optimal value takes more efforts, time and make complexity to the lengthening program.
This cost can vary, but we need to see X-ray pictures of your bones in order to assess the complexity of the "big program."
The approximate rate of elongation of the day - it's one millimeter. To get this millimeter You have to realize 24 clicks (in new construction) ...Clicking sound quite hear well...
We try to create a comfortable environment for the patient during elongation. In the process of the lengthening we can sometimes go a bit more of a millimeter, sometimes giving rest for a few days. We (and You) assess the condition of the muscles, and choose the optimum way ...
5) What are your opinions regarding the weightbearing of the patients?
Of course, no doubt, devices can take /support/ the weight of the body ... this is an important option of construction,
since it creates conditions for the activity of the patient and a faster recovery ...
6) How often will you follow up with patients during lengthening?
You will see doctor each day during lengthening period.
7) How fast can patients return to normal life (walking without support)? What is the time required to lengthen 5 cm and 7.5-8 cm ?
The period of basic recovery after the lengthening (lasts for 6,5-7 months after the devices were disconnected)).
The period is characterized with gradual restoration of the stretched muscles functions and regaining the stereotype of walking. At this point, bone regenerative process reaches the level which makes it possible to expose the legs to some load (forces) without using any outer supports (such as crutches, walking stick). At the beginning of this period, the patient can drive a car.
Toward the end of the period, the patient can resume his/her work (study) if it does not involve putting excessive forces (load) on the patient’s legs.
The period of sufficient recovery (from 7 months up to 14-15 months) from the moment of disconnecting the devices). The period is characterized with further bone consolidation and restoration of muscle functions to the condition, which would allow to remove the devices from the bones and expose the legs to usual (not sports training) load (forces).
Medical centre BONAMED
Dr Jamal Abu Nemer and Dr Dmitry Alipov
E-mail: [email protected]
Phones: +380 44 244-77-61, +380 44 244-77-62
Website: www.correction.kiev.ua and www.lengthening.ukrpack.net
1) How many patients have you operated for cosmetic Limb Lengthening so far and How many patients do you operate yearly?
We use technique of intraosseous osteosynthesis applying driving devices for femurs (hips) and tibias (shanks) that were developed by prof.Bliskunov (since 1980) and continuously improved. You can see information about our method in our web sites.
Bliskunov Nails
Dragan-Bliskunov Nails
Jamal Nails (JN)
Limb lengthening programs (pairwise lengthening) by internal method aimed for solution of patient’s social-adaptive problems (relative stunting) were implemented in 47 patients (by Jamal Abu Nemer M.D., Ph.D. in person). 22 legs elongation programs were made with the new generation of devices. Total number of patients operated using Bliskunov’s method for Cosmetic Leg Lengthening exceeds 550.
2) What is the estimated total cost, including post-op treatments, stay, medications, physiotherapy? Are unscheduled surgeries covered and How much does a consultation cost?
The consultation is free of charge. There may be some low costs associated with examination (X-ray, CT, etc)
The total cost of the lengthening program since May 2013 takes into account a stay of a patient in the Ukraine for three months. 90-100 days - this is the time period for conducting a surgery and lengthening of femurs or tibias to the optimum length. The optimum length refers to the lengthening when muscles, tendons, and nerves are adapted sufficiently well to the new state of tension. It is 7.0 cm for femurs and 4.5-5.0 cm for tibias.
The total cost of the lengthening program (TCLP) is 39 000,00 USD, the same as for femurs and for tibias ( since May 2013). (Lengthening more than the optimum length increases the time period of lengthening and restoration. In this case it is necessary to adjust additional costs of the program of lengthening.)
This cost includes the cost of surgeries and a stay of a patient in hospital for the necessary term (as a rule 2-3 days), and also the cost of a surgery and a stay in hospital for the removal of devices (in 1 - 1.5 years after the beginning of lengthening).
The cost of the lease of apartments during the stay for the period of the lengthening is not includes in TCLP. Assistant can help to lease suitable apartment. /Cost of comfortable apartments is around 1000 USD per month. Additional costs may be associated with a broker service for searching for an apartment - usually half the monthly cost, single payment/.
The costs for unscheduled surgery are covered.
3) What kind of physical therapy is assigned to the patient?
It has to be mentioned here that it is very essential for the patient to stay active in the lengthening period and during rehabilitation for successful restoration of these functions. Walking (at first with outer supports, then, without them) is the best way of rehabilitation. The fact is that, graduated weight bearings on the bone and muscle contractions are very effective in recovery and shorten the rehabilitation period.
The more the patient walks, the quicker and more efficient the functions of his musculoskeletal system will restore (return). Success of this process depends only on the patient and his readiness for daily hard work.
As it was mentioned above, the most important factor influencing the speed and quality of the regeneracy of the lower limbs musculoskeletal system functions is the patient’s activity (walking, exercises). When selecting workload, the patient should be guarded by the doctor’s recommendations (the doctor should make some adjustments of the rehab program after studying the check x-ray picture and evaluating the patient’s progress in recovery). The patient should also take into consideration his/her state of health (confidence in motions, fatigue, etc).
Physical exercises also matters a lot. This is a set of special exercises to be performed in a lying position on the bed (the doctor will show these exercises and select the program appropriate for the patient). Regular exercises on the stationary bike (exercycle) also contribute to progress in recovery.
It is recommended for the patient to take some massage during the rehabilitation (not fewer than 10 sessions monthly of intensive lower limbs massage (duration not less than 1 hour).The massage helps muscles regain flexibility and capacity for work more effectively. The patient can also use an electromassage device for .independent procedures.
Regular exercises in the swimming pool can add to regaining the stereotype of walking by the patient. In water, overall load on the body and on the feet decreases; the patient starts feeling more confidently. It is important that the temperature of water be comfortable for the body. It is necessary to monitor the temperature conditions for the stretched muscles. The patient should not become too cold. Before any exercises, the muscles should be prepared for being loaded – legs should be rubbed for more intensive blood circulation, and it is worth doing some surface massage.
Physiotherapy methods are very important too. The physiotherapy blood circulation stimulating effect in muscles and other deeper limb structures proved to be very popular. This physiotherapy can provide mild stimulating influence on the bone tissue regeneracy. There are a lot of varieties of devices for the musculoskeletal system regeneration including those for home use. It is recommended to use physiotherapy devices generating pulsed magnetic field of low frequencies (10-25 hertz).
4) What maximum amount of lengthening do you recommend per segment, regarding patient safety? What is the daily rate of lengthening?
Optimum value of the lengthening: 6,5-7,0 cms for femurs and 4,5 - 5,0 cms for tibias. Maximum "hard" program: 10-11 cms for femurs and 6-7 cms for tibias. There is a big resistance of Achilles tendon after 4,5-5,0 cm of tibias lengthening.
And there is a big resistance of hip's muscles after 6,0 - 7,0 cm of femurs lengthening .
We can continue the program (more then optimum values), but it will take more time (and money for patient). Each additional centimeter more (higher) than optimal values of elongation (7cm for hips, 5 cm for shanks) is an additional money to the total cost of the lengthening program.
This is about 2 500 - 3000 USD for every additional centimeter. The reason - the extension beyond the optimal value takes more efforts, time and make complexity to the lengthening program.
This cost can vary, but we need to see X-ray pictures of your bones in order to assess the complexity of the "big program."
The approximate rate of elongation of the day - it's one millimeter. To get this millimeter You have to realize 24 clicks (in new construction) ...Clicking sound quite hear well...
We try to create a comfortable environment for the patient during elongation. In the process of the lengthening we can sometimes go a bit more of a millimeter, sometimes giving rest for a few days. We (and You) assess the condition of the muscles, and choose the optimum way ...
5) What are your opinions regarding the weightbearing of the patients?
Of course, no doubt, devices can take /support/ the weight of the body ... this is an important option of construction,
since it creates conditions for the activity of the patient and a faster recovery ...
6) How often will you follow up with patients during lengthening?
You will see doctor each day during lengthening period.
7) How fast can patients return to normal life (walking without support)? What is the time required to lengthen 5 cm and 7.5-8 cm ?
The period of basic recovery after the lengthening (lasts for 6,5-7 months after the devices were disconnected)).
The period is characterized with gradual restoration of the stretched muscles functions and regaining the stereotype of walking. At this point, bone regenerative process reaches the level which makes it possible to expose the legs to some load (forces) without using any outer supports (such as crutches, walking stick). At the beginning of this period, the patient can drive a car.
Toward the end of the period, the patient can resume his/her work (study) if it does not involve putting excessive forces (load) on the patient’s legs.
The period of sufficient recovery (from 7 months up to 14-15 months) from the moment of disconnecting the devices). The period is characterized with further bone consolidation and restoration of muscle functions to the condition, which would allow to remove the devices from the bones and expose the legs to usual (not sports training) load (forces).
Medical centre BONAMED
Dr Jamal Abu Nemer and Dr Dmitry Alipov
E-mail: [email protected]
Phones: +380 44 244-77-61, +380 44 244-77-62
Website: www.correction.kiev.ua and www.lengthening.ukrpack.net
