What does Dr Assayag say about muscle regeneration in this video?

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At the 1:24:45 mark a question is asked about what happens to muscles after 10% of lengthening

The audio is quite bad so I can't quite hear the answer. He does say the IT band heals up. But the muscles "don't necessarily regenerate per se and only stretch". After that he goes on to say something about "electromyograph", "electrical stimulation", "contractile units" which I could not hear properly. I think the gist is that even though there are negative changes to the muscles, there are no changes clinically.

Can anyone else give it a listen and tell me? I want to know what those negative changes exactly are and whether they might cause long term problems.

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bump. anyone?

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Quote from: Serilium on April 10, 2021, 08:12:10 AMWell, the truth is, if uh the IT band when we’re doing a femoral lengthening it does regrow, so it heals and then slowly, slowly stretches. However, the muscles just stretch. They do not necessarily regenerate per se. We know that, if you analyze with an electromyogram, the muscles… the electromyogram being the nerve conduction… the activity within the nerves that go into the muscle, there are signs after lengthening of denervation. That can be decreased by using e-stim, and it recruits sarcomere used which are the contractile units. Now clinically, it does not cause any functional impairment. Now a lot of people ask me can I remain a high level athlete…..


https://pubmed.ncbi.nlm.nih.gov/2298769/

You are a hero Serilium!

So he stops with the muscles at "they just stretch" and do not "regenerate per se".

And then he goes to explain how nerves also become worse in a way and that it's possible to reduce that by using "e-stim" but I don't know why it's not used in practice then.

It's puzzling how this question is not asked more often by us PATIENTS. Most people ask questions like how much length, how much does it cost, how soon can I work again, what are the complications, but the unique thing about this surgery is the stretching. Patients need to be more curious about that.

It also puzzles me to this day how they don't make people sign all this on the informed consent form. If you see the informed consent form, it's made to make you think that things might go wrong and cause complications but the truth is, it has been studied that there will be some degeneration which a patient needs to be aware of. In some sense, patients need to be made aware that this is an experiment at some level.

But kudos to Dr. Assayag for being completely honest. He seems like a very genuine doctor.

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I'm afraid a lot of this stuff like impact on organs and is it more effort to pump blood upstream or not, might simply not be studied. I can't even find conclusive research on how the lengthened soft tissues are different or similar to healthy soft tissue. Impact of other organs is probably a less important study.

But I largely agree with redwedding that as far as other organs are concerned, growing taller is similar to growing bigger through working out and eating a lot. At the end of the day the organs have to work harder to maintain more cells in the body.

If you are concerned about your health or have to decide on your lengthening goals, you can talk to one of several good doctors who do paid video consultations. Some I know are Dr Giotikas, Dr Parihar, Dr Donghoon, Dr Assayag, Dr Debiparshad. I think these surgeons know the theoretical stuff. But it's best you inform them that the intention of your consultation is to partially ease your mind and that you are not a prospective patient of theirs.

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Quote from: Body Builder on April 10, 2021, 10:24:17 PMAlso, I think that muscles regenerates and new cells are created from LL and the muscles are not just stretched. But I am not sure. I think that is is very hard though for skin, nerves, muscles etc to stretch that much .

Did you do the surgery without confirming this with your surgeon?

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Quote from: TheDream on April 11, 2021, 01:44:09 AMIt is definitely an interesting topic.

I remember watching a YouTube video of Dr. Paley about a year ago (which also had bad sound for some reason) where he discussed some of these lengthening details. Specifically he talked about what he thinks the future of LL will bring. Here he mentioned a new technology that would lengthen more slowly but continuously. At the moment (correct me if I am wrong) the lengthening occurs like 3 times a day to typically 0.81 mm total. The problem with this is that the soft tissue experiences a short burst of very high pressure when the lengthening is increased in one step like this.

Paley mentioned machine learning being used from large datasets that would automatically find the optimal lengthening steps over time. When we grow naturally as children and teenagers the body does not make one large lengthening step of ~0.3 mm in one second, but it is more gradual.

I am wondering whether this large sudden pressure increase damages the soft tissues (muscles, nerves, arteries etc) and causes the degeneration mentioned in your video and what other LL’ers have experienced.

I don't know if it's because 0.33mm at once is dangerous or 1mm a day is dangerous no matter how gradually performed.

We should go with what technology we have today. Anybody getting surgery should inquire about what the effects are on the body, particularly soft tissues.

Even Cyborg4life an expert in this topic, in the video laughs after the question with something like "of course it's not stretching it's distraction histogenesis" and then Dr Assayag honestly corrects him soon after. Respect to Dr Assayag.

It's surprising even many who take the plunge of this procedure still have lingering doubts on their minds. It's best to understand what the unknowns are become comfortable with them if you're doing this.

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Quote from: Ahd1978 on April 11, 2021, 09:19:40 AM
I have also asked victor from cyborg that I would like to get his new data but to please ask doctors about effects on organs with new height.

You can pay for his paid program and have better chances of an answer. He has done a lot for the community so far but I think he is now monetising it (nothing wrong with it) so you might have a better chance getting your concerns cleared. It costs $100 I think. He says he will also help you with post surgery recovery if you buy the program.

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Quote from: Ahd1978 on April 11, 2021, 02:18:53 PMYes I have decided to buy it and he helped me in making final decision to go with paley too as a doctor for LL.

Well I have recieved reply from him and he would be asking doctors same to clarify further.

I have also told him to request docs either to charge extra but ensure blood tests are mandatory during distraction for all patients and during discharge  to ensure all vitals come clear before sending one home.

Attaching his reply here towards my question

I don't, however, believe getting taller will affect your blood flow. The cool thing about the body's vascularization is that it can reroute and adapt to new situations to keep you alive regardless of the stimulus or situations. Whether that means creating new capillaries to engorge your new legs with blood or ensuring you properly oxygenate your upper body, I would say that perhaps it will take some time after distraction to feel more normal but I would like to keep on top of this to ensure you're okay.

Victor

Hope this helps

Good to hear this. His response seems awesome and I hope it's true and what the doctors said

If you get a chance, please also ask him about this thread (how muscles, vessels and nerves respond to lengthening considering what Dr Assayag said in the above video).

As for blood tests, yeah I think it's a good idea. But I guess most patients don't have problems and so maybe they have decided it's not necessary. But for someone like you who had fat embolism it would be more necessary I think.

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Razal was kind enough to ask Dr Assayag this question and Dr Assayag was kind enough to answer it.



- He says there is both regeneration and stretching.
- Nerves, he said theoretically deteriorate he said.
- But clinically patients seem to fine functionally.
- He did not specifically address blood vessels.
- But generally all soft tissues have regeneration and stretching. He did not say how much of each.

All in all, it seems like clinical observation is the primary way in which doctors think this procedure is safe to perform.

I guess anyone who plans to do this should dedicate their 100% to staying fit (eating and exercising right) so that even if there are theoretical deteriorations you will compensate for that by doing everything else right.

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Quote from: TheDream on April 26, 2021, 11:11:32 AMI feel like LL doctors are strangely optimistic and vague about soft tissue degeneration.
There are people on this forum who legitimately believe they can regain 90-100% athleticism after 8 cm lengthening...

The truth is you will be lucky to ever play sports again, even on the lowest level possible. The fact that doctors aren't very clear and explicit on this matter sets off a lot of alarm bells for me personally. You are stretching your muscle, nerve and arteries an insane amount about a very small origin point, at like 1-2 mm a day for 60-40 days in a row, with no way for the soft tissue to release the pressure at any point.

If you can go for a walk with your family and friends, go on a bike ride once in a while and walk up stairs after that; it is the max you can hope for post-lengthening. I am not saying it is not worth it to lengthen +5 cm, but you should be aware of the permanent trade off in athleticism.

At least in the short term most people recover much more than that. There are plenty of examples of people recovering more than that. It's just the long term impact that no one knows about and don't seem to be working on also.