Limb Lengthening Forum
Limb Lengthening Surgery => Limb Lengthening Discussions => Topic started by: TheLichKing on March 15, 2017, 07:54:33 PM
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Hello,
If you had the choice between these two considering your budget, which one will you prefer going to? Both are top notch doctors at very reasonable price.
The only drawback is the countries they are located in i.e., South Africa and India, the hospitals, and their lack of diaries? Plus Parihar has minimal experience doing precise on a patient, only one we know is Penguin.
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A representative of the Precise manufacturer is present during surgery for quality assurance whether you go to Dr B or Dr P. Both locations have comfortable options for stay.
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If you are n a budget those are the best internal options
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If you are n a budget those are the best internal options
Yes but which one would you chose going to?
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Both are far away from home but Dr Birkholtz has more experience in internals and he lives nearer. Where do you live?
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damn this is a tough one
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Both are far away from home but Dr Birkholtz has more experience in internals and he lives nearer. Where do you live?
Canada but my hometown is near India, which means visiting India won't be as much alienating. I don't mind Birkholtz since the location where he's at is actually beautiful, but the thought of going to Africa makes me uncomfortable for some reason. I'm just seeking what people here would go with as part of my research.
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in my opinion, dr birkholtz would be the obvious choice for the main reason that he simply seems to have a lot more experience with precice than dr parihar. I'm kinda paranoid in that I personally wouldn't be comfortable being any doctor's patient the first couple times doing a certain method, but that's up to you
Penguin is his first and only precice patient so far and I think it's still a bit too early to judge the outcome. It's a little concerning since he has not consolidated yet over 6 months post op, even though he is a pretty young guy. hopefully it's just a case of bad genetics and just really slow consolidation which could happen to anybody. I'm hoping I'm completely wrong about my concern and wishing the best for you penguin to have a great outcome at the end of your LL!
Dr parihar does seem to have plenty of experience in other methods though and if the question were about about external tibias, I think it would be a lot closer and harder of a decision between the two doctors.
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in my opinion, dr birkholtz would be the obvious choice for the main reason that he simply seems to have a lot more experience with precice than dr parihar. I'm kinda paranoid in that I personally wouldn't be comfortable being any doctor's patient the first couple times doing a certain method, but that's up to you
Penguin is his first and only precice patient so far and I think it's still a bit too early to judge the outcome. It's a little concerning since he has not consolidated yet over 6 months post op, even though he is a pretty young guy. hopefully it's just a case of bad genetics and just really slow consolidation which could happen to anybody. I'm hoping I'm completely wrong about my concern and wishing the best for you penguin to have a great outcome at the end of your LL!
Dr parihar does seem to have plenty of experience in other methods though and if the question were about about external tibias, I think it would be a lot closer and harder of a decision between the two doctors.
That's true but I'm not sure how often Birkholtz does precise II on patients, I mean he does way way more cases for people who are in need for LL opposed to CLL (cosmetic). I'm not even sure when's the last time he did precise II on someone.
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That's true but I'm not sure how often Birkholtz does precise II on patients, I mean he does way way more cases for people who are in need for LL opposed to CLL (cosmetic). I'm not even sure when's the last time he did precise II on someone.
yes that's a good point and something anyone considering him should research further and find out beforehand if you were going to commit to surgery with him. I would also find out about the results of the LL patients he done with precise and if he had a major complications / how he solved them etc. I shouldve prefaced my opinion was just based on my initial impression and little research (just what I've read about the 2 doctors on the forum so far). but it should go without saying you have to research any doctor you want to go with further and not rely on the opinion of random people on the internet like me!
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Admittedly, I've not consulted with Dr. Parihar, and I have heard a lot of positive things from this forum about him and his practice. I have consulted with Dr. Birkholtz, and he would be my choice. I asked him how many CLL cases he has done with the Precise, and his response was "about 20. We feel good about the procedure, and we know the nail."
A large majority of the folks that go through CLL, regardless of Dr., will not post a diary, or post anything at all, so it doesn't surprise me. I'm still very uncertain of whether I will post a diary of my procedure. Dr. Paley has the most experience with the Precise nail (I think his count is in the hundreds), yet there are not hundreds of Paley diaries here, only a handful. The needle between Drs. Parihar and Birkholtz swings to Dr. Birkholtz for me due to his busy non-CLL practice (which I also saw with my consultation with Dr. Paley), his frank demeanor, his reputation, and the quality of the hospital.
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Penguin is his first and only precice patient so far and I think it's still a bit too early to judge the outcome. It's a little concerning since he has not consolidated yet over 6 months post op, even though he is a pretty young guy. hopefully it's just a case of bad genetics and just really slow consolidation which could happen to anybody. I'm hoping I'm completely wrong about my concern and wishing the best for you penguin to have a great outcome at the end of your LL!
I don't know if it's bad genetics, but during lengthening I was told not to weight bear to avoid preconsolidation, the side effect of that being slow consolidation later on. Also I was lazy for a month or so after lengthening was done, partly because my left achilles area started aching and became sore as hell randomly(yes, achilles area during a femoral lengthening experience, go figure) and basically did nothing for 30+ days. My callus is steadily improving so I'm not concerned unless callus can disappear/reduce/dissolve after a certain period of time despite consistent weight bearing, which I haven't heard of. But yes, if I had to guess I will probably walk unaided around 8 months post-op. Personally it doesn't phase me and I believe anyone that does LL should be prepared for a longer time frame. Don't look at the people walking 4-5 months post op and make plans.
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Dr. Parihar has a very good reputation and frank demeanor as well.
The number of Precice cases is a plus on Dr. Birkholtz though. But his first Precice patient was from this forum and he recovered fine. iirc he was walking pretty close to normal in 6 months.
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Not a knock against Dr Birkholtz at all, but I would go to Dr Parihar again if I had a desire to do femurs. India has a bad rep for CLL, not without good reason, but I really believe he's cut from a different cloth than all the other Ilizarov surgeons over there. He had better bedside manner than my own doctors here in the US and he never responded to my concerns with "don't worry". He wasn't afraid to tell me either if he was disappointed that I was not sticking to my PT as well as I should.
With the Precice manufacturer sending a rep to be present during the surgery, I think the number of times Dr P has used the Precice itself is really a non-issue here. When he says inserting a nail into the femur is the same process whether it is the Precice or not, I believe him. He's inserted nails into the femur plenty of times so it's not like nail insertion in itself is new to him. Plus, he's the one who went around India teaching other doctors how to use the hexapod external fixator when it was introduced, so I don't doubt that he can use new technology. He's not an "experimental" surgeon and won't do things that have unnecessary risk, like cross-lengthening or quadrilateral lengthening, neither will he do forearm CLL, so if he were uncomfortable using an extending nail like the Precice he would surely say so. It's not like he's getting extra money if you use it with him.
Other points for him, imo:
25+ years experience
Trained by Dr Paley
Primarily a reconstructive surgeon who treats patients with injuries or birth defects (meaning he knows how to treat/prevent a ton of complications that come with lengthening)
Conservative treatment recommendations
Good bedside manner but tells it like it is
Picky about who he will accept as a CLL patient
Friendly nursing staff
If you're international he will have someone there to act as your caretaker for the first week in the hospital
Has a guy who makes custom orthotics that you can order just about anything from
PT is no extra cost if you do it in the hospital and if they travel to your hotel it's really inexpensive
Easy to get a hold of him or Dr Ahuja once you're a patient
The tea they make in the morning at his hospital is so amazingly tasty
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I don't know if it's bad genetics, but during lengthening I was told not to weight bear to avoid preconsolidation, the side effect of that being slow consolidation later on. Also I was lazy for a month or so after lengthening was done, partly because my left achilles area started aching and became sore as hell randomly(yes, achilles area during a femoral lengthening experience, go figure) and basically did nothing for 30+ days. My callus is steadily improving so I'm not concerned unless callus can disappear/reduce/dissolve after a certain period of time despite consistent weight bearing, which I haven't heard of. But yes, if I had to guess I will probably walk unaided around 8 months post-op. Personally it doesn't phase me and I believe anyone that does LL should be prepared for a longer time frame. Don't look at the people walking 4-5 months post op and make plans.
During my first nights in the hospital for tibia lengthening I had a bunch of pain in my thighs, especially the right one. Funny how that works.
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Thanks KiloKahn for your informative reply as well as Penguin and SAD. One question, is Birhkoltz trained by paley or has any affiliation with him? I also see he is dedicated to several cosmetic and plastic surgeries other than limb lengthening, he has it here on his site: http://ffbirkholtz.co.za/
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are they the same people :o
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with regards to the topic, one thing tempting towards Dr. Franz is that he offers a full package of sorts and his patients have access to a residence, a PT centre, gym, concierge services, etc.
I might be wrong, but some of these things you might have to figure out yourself otherwise.
In the end, what matters most is the technical expertise and care and I think both these doctors are extremely good in both these criteria.
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Kilo, do you know why Cross lengthening is risky?
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During my first nights in the hospital for tibia lengthening I had a bunch of pain in my thighs, especially the right one. Funny how that works.
I think it's the short segment having a Napoleon complex tantrum.
Also, the secret to their tea... a lot of sugar. That's about it. :-\
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I am still wondering about this site of Dr. Birkholtz http://ffbirkholtz.co.za/ I thought he was only devoted to limb lengthening.
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Different Dr. Birkholtz, I believe
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Different Dr. Birkholtz, I believe
Same one
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Different Dr. Birkholtz, I believe
Same, website has description of having completed his graduate degree from Pretoria University, you can see in the "about us" section. Can't be 2 doctors with exactly the same first and last name and having graduated from the same institution lol.
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That site is a bit worrying. How many doctors that are experts in limb reconstruction also do breast and penis enhancement?
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Same, website has description of having completed his graduate degree from Pretoria University, you can see in the "about us" section. Can't be 2 doctors with exactly the same first and last name and having graduated from the same institution lol.
Dr. Birkholtz (Orthopedic surgeon) should be able to clear this up. However, I continue to believe they're 2 different doctors. I do admit to this being a really strange coincidence, however, the qualification and graduation dates don't match. Their professional organizations (Association of Plastic and Reconstructive Surgeons of South Africa and Health Professions Council of South Africa, respectively) should be able to verify this as well.
In addition to that, I guess someone can just call the hospital where Dr. Birkholtz (Orthopedic Surgeon) works and ask :)
https://goo.gl/TL2Scs
First one (plastic surgeon):
I am a South African trained plastic and reconstructive surgeon, and a full member of the Association of Plastic and Reconstructive Surgeons of South Africa.
I completed my pregraduate studies at the University of Pretoria in 1992. I then worked for three years in Namibia, where I gained valuable surgical experience. It was during this time that I had the honour of working with Prof Alistair Lamont. He introduced me to the fascinating discipline of plastic and reconstructive surgery.
I started my plastic surgery training at the University of Pretoria in 1996 and completed my specialization in 2001. During this five year period, I had extensive exposure to and developed a keen interest in micro vascular reconstruction as well as cosmetic surgery.
I have been in full time private practice at the Kloof Medi Clinic in Pretoria since 2003. I am still involved at the Pretoria Academic Hospital on a session basis and have been a guest lecturer at the University of Zurich for the past two years.
The discipline of plastic and reconstructive surgery has its roots in the time of the great world wars. During this period surgeons had to develop and come up with ingenious methods of reconstructing all the disfigured soldiers. This is a far cry from the modern concept of plastic surgery being portrayed by Hollywood.
Second one (Orthopedic surgeon):
Dr Birkholtz qualified from the University of Pretoria as a medical doctor in 1997 and comes from a family of doctors. He started his post-graduate career in Orthopaedic Surgery in 2000. During his time as a registrar (resident), he created the Limb Reconstruction Unit at the Pretoria Academic Hospital (later Steve Biko Academic Hospital). During this time he developed his skills and understanding of the Ilizarov method and limb lengthening and reconstruction surgery in general. He also developed a keen interest in complex trauma. He qualified as an orthopaedic surgeon in 2006 and holds both the MMed (Orth) degree from the University of Pretoria and the FCOrth(SA) qualification from the College of Orthopaedic Surgeons of South Africa. He is fully registered with the Health Professions Council of South Africa. The private practice was started in 2006 and rapidly developed into a highly renowned practice both locally and internationally, especially catering for complex trauma and limb reconstruction cases. With the addition of Dr De Lange, the practice was turned into the Walk-A-Mile Centre and has continued to grow from strength to strength.
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Both have the same middle initial too
I'm now inclined to believe they are not the same person but related
Dr. Birkholtz (Orthopedic surgeon) should be able to clear this up. However, I continue to believe they're 2 different doctors. I do admit to this being a really strange coincidence, however, the qualification and graduation dates don't match. Their professional organizations (Association of Plastic and Reconstructive Surgeons of South Africa and Health Professions Council of South Africa, respectively) should be able to verify this as well.
In addition to that, I guess someone can just call the hospital where Dr. Birkholtz (Orthopedic Surgeon) works and ask :)
https://goo.gl/TL2Scs
First one (plastic surgeon):
I am a South African trained plastic and reconstructive surgeon, and a full member of the Association of Plastic and Reconstructive Surgeons of South Africa.
I completed my pregraduate studies at the University of Pretoria in 1992. I then worked for three years in Namibia, where I gained valuable surgical experience. It was during this time that I had the honour of working with Prof Alistair Lamont. He introduced me to the fascinating discipline of plastic and reconstructive surgery.
I started my plastic surgery training at the University of Pretoria in 1996 and completed my specialization in 2001. During this five year period, I had extensive exposure to and developed a keen interest in micro vascular reconstruction as well as cosmetic surgery.
I have been in full time private practice at the Kloof Medi Clinic in Pretoria since 2003. I am still involved at the Pretoria Academic Hospital on a session basis and have been a guest lecturer at the University of Zurich for the past two years.
The discipline of plastic and reconstructive surgery has its roots in the time of the great world wars. During this period surgeons had to develop and come up with ingenious methods of reconstructing all the disfigured soldiers. This is a far cry from the modern concept of plastic surgery being portrayed by Hollywood.
Second one (Orthopedic surgeon):
Dr Birkholtz qualified from the University of Pretoria as a medical doctor in 1997 and comes from a family of doctors. He started his post-graduate career in Orthopaedic Surgery in 2000. During his time as a registrar (resident), he created the Limb Reconstruction Unit at the Pretoria Academic Hospital (later Steve Biko Academic Hospital). During this time he developed his skills and understanding of the Ilizarov method and limb lengthening and reconstruction surgery in general. He also developed a keen interest in complex trauma. He qualified as an orthopaedic surgeon in 2006 and holds both the MMed (Orth) degree from the University of Pretoria and the FCOrth(SA) qualification from the College of Orthopaedic Surgeons of South Africa. He is fully registered with the Health Professions Council of South Africa. The private practice was started in 2006 and rapidly developed into a highly renowned practice both locally and internationally, especially catering for complex trauma and limb reconstruction cases. With the addition of Dr De Lange, the practice was turned into the Walk-A-Mile Centre and has continued to grow from strength to strength.
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Same one
Same, website has description of having completed his graduate degree from Pretoria University, you can see in the "about us" section. Can't be 2 doctors with exactly the same first and last name and having graduated from the same institution lol.
That site is a bit worrying. How many doctors that are experts in limb reconstruction also do breast and penis enhancement?
Hahahahahahahahahahahahaha! OMG! You have got to be kidding me?!
The lack of critical thinking among some members on this forum is frightening. No wonder certain doctors have a line around the block of potential patients just waiting to get butchered, despite the evidence of their horrific results on previous patients.
It takes about 2 minutes to read through their bio, and 5 seconds of thinking to clearly see they are different people, who simply have the same name.
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Hahahahahahahahahahahahaha! OMG! You have got to be kidding me?!
The lack of critical thinking among some members on this forum is frightening. No wonder certain doctors have a line around the block of potential patients just waiting to get butchered, despite the evidence of their horrific results on previous patients.
It takes about 2 minutes to read through their bio, and 5 seconds of thinking to clearly see they are different people, who simply have the same name.
Actually, for Dr. Franz Birkholtz (orthopedician), I checked his background details on this website and it said "From his website" :
Background
"From his website: Dr Franz Birkholtz studied at the University of Pretoria and currently teaches courses in South Africa and abroad. He is practicing in Centurion with rooms in Lifestyle Management Park next to Unitas Hospital.
As of June, 2012 now does limb reconstruction operations bi-monthly at Vincent Pallotti Hospital in Cape Town. Contact the Cape Orthopaedic Trauma Group (Dr Bernstein) on 021 506 5555 to schedule an appointment."
My mistake, should had opened his website nevertheless, since his bio given here is incomplete or might have needed updating. Anyways, this is still really a strange rare coincidence lol.
And the irony of you claiming some people ready to be butchered by doctors who had previously bad cases is rather amusing in this case when I'm comparing some of the best doctors at a budget. I think choosing a doctor and entrusting your life upon him is quite different than having a mere misunderstanding given the rare coincidence and circumstances given above, no?
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Hahaha,
You guys crack me up! Penis and breast surgery? Really?
Myself and my cousin are both surgeons who qualified from the University of Pretoria at different times. We both live and work in Pretoria and have exactly the same names. We are named after our common grandfather. He is a plastic and reconstructive surgeon and I am an orthopaedic surgeon.
Hope this helps?
;)
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This forum always looks for some kind of conspiracy :)
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Oh, so you don't do penis surgery Dr Birkholtz? Thanks for clarifying.
Crosses off list. ;D
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Hahah, priceless. Anyways, Thank you Dr. Franz for clarifying. Looking forward to do precise II Femurs with you in the near future;)
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Forgot about this: Dr. Birkholtz offers a 7-day step-down program from the hospital in addition to the 4 days in hospital post surgery. Huge difference maker IMO and something Drs. Parihar and Lee should seriously consider as well. It is very tough to care for yourself post-surgery, in a foreign country this can seriously affect your outcome in a negative way.
I am glad to see these Drs. being considered more and more vs. less expensive/less experienced surgeons. Other than Drs. Paler and Rozbruch, who are at the top of the CLL field, Drs. Birkholtz, Lee and Parihar offer terrific alternatives for overseas patients or those that want to take advantage of cost reductions tied to not being a part of the US hospital system.
Another reason I am glad to see more prominent surgeons like Drs. Birkholtz and Parihar adopt an open mind regarding CLL: as I approach surgery myself, I was chatting with my primary care physician about the procedure. He is Asian and aside from his practice, a professor at a prominent medical school here in the US. He was surprised to see that Dr. Rozbruch is performing LL for cosmetic reasons, but believes it is only a matter of time before CLL becomes a more mainstream surgery everywhere. His quote: "This has been done in China for many years to thousands of people. Now doctors in Western countries are adopting the practice, and we have the research, money and technology to make it much better and safer."
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Oh, so you don't do penis surgery Dr Birkholtz? Thanks for clarifying.
Crosses off list. ;D
LOL I'm sure some folks would have liked to lengthen their penis at the same time as LL, cause you know "proportions"
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The thing with penile lengthening, however, is that you can't lengthen more than 20% of your original length, otherwise plastic deformation will occur. You can also get exertional compartment syndrome and will feel sore every time you achieve an erection, making it so you can only stay up for 30 seconds at a time. Also, for those who are especially small, they won't be able to fit a nail inside and can only lengthen with external fixation only and not LON, LATN, or internals.