Hey guys,
I have finally decided that I want to go through with this procedure at the end of this year.
The question is, who should I go to and what method should I use?
Honestly, I am thinking of Dr Birkholtz, Dr Catagni, and Dr Pili. Im a little more nervous about Guichet.
My biggest concern as many of you know are issues such as amputation, death, non union, and permanently walking with a limp.
However, recently other concerns that Dr Catagni and Dr Pili brought about were the fact that they say that femur lengthening is not good aesthetically. They say you should only do Tibias . But then again, if I do tibias with Internals, I run the risk of permanent knee pain. But if I do externals, I would have to not work for almost a year in order to recover.
I am only looking to lengthen 52 mm which is exactly 2 inches.
But now more than ever I am confused.
In an ideal world, I would want to be out for 4 months come back to the states and work since I work in an office environment. But at the same time, I want aesthetics to look good and I want to have most of my athletic ability back as well.
Here is what I have as far as different methods
Internal femurs Pros:
Will be able to recover the fastest
Cons:
Possible fat embolism
Aesthetically speaking, it will look bad having long femurs but short tibias
External Tibias Pros:
Least risky procedure as far as long term consequences go
Aesthetically pleasing
Cons:
Long recovery time
Wont be able to work in frames
Pin site infection posibility
LON/LATN Pros:
Longer time than Precise but shorter time than externals
Can go back to work after frame removals.
Aesthetically pleasing tibias.
Cons:
Risk of permanent knee pain
So I guess I need your guys advice on how to proceed.
I have finally decided to go through with LL at the end of this year. Need help.
Aesthetically, it depends on the initial ratio between the two. normal ratio is 56/44 (or even 58/42 if I remember correctly) all the way to 52/48. Now, post op problem with tibial LL (especially big lengthening) might be that you won't be able to wear shoes which are not flat due to an already high knee post tibia LL.
My guess is that docs like Catagni say this because he is truly a master of tibia LL (considered almost a god among CLL and those who do LL for non cosmetic purposes) while docs like rozbruch and Paley say exactly the opposite for the same reason.
In the end, having a starting height of 5'8, 2 inches in either part will not cause any real visible disporoportion..
Quote from: yyes on March 07, 2017, 08:13:26 PMHey guys,
I have finally decided that I want to go through with this procedure at the end of this year.
The question is, who should I go to and what method should I use?
Honestly, I am thinking of Dr Birkholtz, Dr Catagni, and Dr Pili. Im a little more nervous about Guichet.
Dr Franz Birkholtz.
My biggest concern as many of you know are issues such as amputation, death, non union, and permanently walking with a limp.
Amputation? Highly unlikely. Death? Highly Unlikely. Non-union? Unlikely but dependent on circumstances. Limp? Likely at the beginning, if soft tissue is damaged, equinus contracture occurs, misalignment. If done to a good standard, unlikely to be permanent.
However, recently other concerns that Dr Catagni and Dr Pili brought about were the fact that they say that femur lengthening is not good aesthetically. They say you should only do Tibias . But then again, if I do tibias with Internals, I run the risk of permanent knee pain. But if I do externals, I would have to not work for almost a year in order to recover.
This makes no sense. If someone has long tibias and lengthens them it will look worse than if they had lengthened their femur - proportions are important but the general rule is longer femurs look more natural in my opinion, I have seen some horrendous tibial lengthening on the 'other' forum. Neither look bad 'aesthetically' if not done excessively with proportions as a guide.
I am only looking to lengthen 52 mm which is exactly 2 inches.
Femurs will recover better.
But now more than ever I am confused.
In an ideal world, I would want to be out for 4 months come back to the states and work since I work in an office environment. But at the same time, I want aesthetics to look good and I want to have most of my athletic ability back as well.
Athletic loss is part of the deal, generally, femurs are easier to recover from.
Here is what I have as far as different methods
Internal femurs Pros:
Will be able to recover the fastest
Cons:
Possible fat embolism
Aesthetically speaking, it will look bad having long femurs but short tibias
External Tibias Pros:
Least risky procedure as far as long term consequences go
Aesthetically pleasing
Cons:
Long recovery time
Wont be able to work in frames
Pin site infection posibility
LON/LATN Pros:
Longer time than Precise but shorter time than externals
Can go back to work after frame removals.
Aesthetically pleasing tibias.
Cons:
Risk of permanent knee pain
This is a personal decision and based on a multitude of factors. Which are you leaning towards?
So I guess I need your guys advice on how to proceed.
Quote from: 682 on March 07, 2017, 08:28:07 PM
Honestly before I spoke to Catagni and Pili I was leaning towards internal fémurs.
They do internal fémurs as well so they said they would respect my wishes.
I've been impressed with Birkholtz. He always responds and seems genuine. But at the same time I hear Catagni I's amazing so who wouldn't want to get precise done with him?
Price wise for internals Catagni and Birkholtz are roughly the same.
Quote from: TIBIKE200 on March 07, 2017, 08:21:00 PMAesthetically, it depends on the initial ratio between the two. normal ratio is 56/44 (or even 58/42 if I remember correctly) all the way to 52/48. Now, post op problem with tibial LL (especially big lengthening) might be that you won't be able to wear shoes which are not flat due to an already high knee post tibia LL.
My guess is that docs like Catagni say this because he is truly a master of tibia LL (considered almost a god among CLL and those who do LL for non cosmetic purposes) while docs like rozbruch and Paley say exactly the opposite for the same reason.
In the end, having a starting height of 5'8, 2 inches in either part will not cause any real visible disporoportion..
OK good to know. Lately though just to be fair,
I've been hearing a lot of people with issues as far as post op complications. The Guichet patient that hasn't grown any bone. That's freaking scary. I don't know why that happened to her. Is it because she lengthened to much? Or is it because she didn't walk on it?
Will bone ever grow again or has the body stopped trying? So many questions.
I work for the state and the state offers great insurance. If the state can cover hospital expenses I might just go with Rozbruch
You should ask those questions a specialist in LL. You should go to google, and search "ASAMI NORTH AMERICA". Go to the list of docs of your state in the US and contact one of them to know everything. Go even to a consultation (pay for it I mean) just to get as much info as you can from a doc who does this kind of stuff for people who suffer medical conditions so he wouldn't be biased towards promoting it
Quote from: TIBIKE200 on March 07, 2017, 09:41:59 PMYou should ask those questions a specialist in LL. You should go to google, and search "ASAMI NORTH AMERICA". Go to the list of docs of your state in the US and contact one of them to know everything. Go even to a consultation (pay for it I mean) just to get as much info as you can from a doc who does this kind of stuff for people who suffer medical conditions so he wouldn't be biased towards promoting it
That's the key. I'd much rather go to a doctor whose practice is 90% deformity correction and 10% cosmetic LL, than a doc who's mostly cosmetic. The cosmetic docs need you more than you need them and are inclined to say what is necessary to get you to do it. The other physicians who do mostly corrective surgery don't need you and in fact, you have to convince them why they should take on your case.
Yves why Monegal isn't in your options?
Also, I don't think that Catagni does internal femur, I think that only his student, Pili, does.
But his prices for precise 2 are about 55.000 euro which is too much imo compared to about 38.000 euro of Monegal (with fitbone) or to about 42.000 euro of Birkholz (and precise 2 too).
Guichet will never be a choice for me due to his ridiculous price, his old nail, his weird and not caring character and (the most important) his many bad outcomes.
Quote from: Body Builder on March 07, 2017, 11:59:57 PMYves why Monegal isn't in your options?
Also, I don't think that Catagni does internal femur, I think that only his student, Pili, does.
But his prices for precise 2 are about 55.000 euro which is too much imo compared to about 38.000 euro of Monegal (with fitbone) or to about 42.000 euro of Birkholz (and precise 2 too).
Guichet will never be a choice for me due to his ridiculous price, his old nail, his weird and not caring character and (the most important) his many bad outcomes.
Monegal was one of my options but there's a user on this forum that made me worry about going to monegal.
Also I agree with 6feetsoon. Birkholtz deals with trauma on a regular basis and has only done 10 patients using precise. But most of his cases come from accidents. That gives me some peace of mind.
Monegal has one bad case with one woman and another one that we don't know exactly what happened (cooper) but Guichet has bad cases too with the most recent being Unicorn who has a diary here.
Also, all the patients of Monegal except fro m Cooper write good things about his personality while for Guichet, even patients with good outcomes doesn't write good things about his character.
I don't know if Monegal is a so good doctor as his patients say but I think that you should go for a consultation with him before your final decision.
Birkholz seems to be a professional doctor with sensible prices but s. Africa is too far for me.
Anyway, my opinion is to go to at least 3-4 doctors before you take your final decision.
I'm very curious about Pili however. He has a very good price for externals compared to other respectable doctors but his price for internals is expensive. I hope his price for precise 2 was about 10.000 euros less and I'd consider him as a very good choice.
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