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[skeptic]

I consulted with 2 different orthopedic doctors about an issue I have and also brought up the idea of limb lengthening. They were both quite against the idea of doing LL and said it's a disputed idea in the orthopedic community. They both said the long term effects of lengthening are not known. It's not just against cosmetic LL that they had his opinion but also about LL in general. However they did seem to agree that for people with discrepancy it's worth the unknown risks of LL because the risk of scoliosis is worse.

Both these doctors are quite good and well respected where I live.

I just wanted to raise an alarm so that people see the other side of the story. This forum mostly interacts with LL doctors who have a fixed positive perspective about LL. Just like if you go to chiropractic forum you will hear nothing but positives about chiropractice the same applies here. If you ask other experts about chiropractic care many would say the research is not sound.

At the end of the day the field is quite questionable. None of us have the medical expertise to understand the science behind LL and question it. We are completely at the mercy of LL doctors and what they say. Please pay attention to what other experts say.

[RealLostSoul]

Of course normal orthopedics are against this. They care about the physical health and it‘s a fact that you endanger that if you break both legs and stretch them for 3 months. They do not understand the psychological aspect and think height dysphoria can be talked away and/or being heavily drugged with anti psychotics and SSRI for the rest of your life is a good solution. Another user on another thread made a post about how permanent stress probably has really worse long term effects too.
Of course different long term effects are probably not studied that much but honestly the ilizarov method has been around for quite a while and Paley eg does it since 1988 and he said he hasn‘t seen any of his patients suffering from any late onset problems after a healthy recovery. And even if you get tendon problems when you are old or whatever, I‘d still take that in the return of being less miserable throughout 3/4 of my life.

The difference to chiropractic is that this is pseudoscience bullocks, LL is not.

[skeptic]

Of course normal orthopedics are against this. They care about the physical health and it‘s a fact that you endanger that if you break both legs and stretch them for 3 months. They do not understand the psychological aspect and think height dysphoria can be talked away and/or being heavily drugged with anti psychotics and SSRI for the rest of your life is a good solution. Another user on another thread made a post about how permanent stress probably has really worse long term effects too.
Of course different long term effects are probably not studied that much but honestly the ilizarov method has been around for quite a while and Paley eg does it since 1988 and he said he hasn‘t seen any of his patients suffering from any late onset problems after a healthy recovery. And even if you get tendon problems when you are old or whatever, I‘d still take that in the return of being less miserable throughout 3/4 of my life.

The difference to chiropractic is that this is pseudoscience bullocks, LL is not.

Paley is an LL doctor. If he has really published peer reviewed material then the safety profile of the procedure would have been accepted worldwide. All I'm saying is to take opinion from other experts. Even doctors who do knee replacements are skeptical about using LL to realign bones. It's not like the legs of LL patients will dramatically drop off overnight. There might complications which might be even hard to associate with LL later on in life. Most Paley patients wouldn't do follow-ups decades after the initial procedure.

The psychological thing is real. But LL seems to be a little bit pseudoscientific among the rest of the medical community. Similar to chiropractics but I agree that's far more pseudoscientific.

The orthos I consulted said even if the complications of LL didn't happen (infection, embolism, etc) the procedure's safety profile is largely unknown.

I just wanted to point out that the ortho community is a little bit at odds with each other on this on a purely objective perspective keeping aside psychological situation of the patient.

[Serilium]

yeah one should keep an open mind and listen to all sides and all experts within the field as well as outside

however i think most people who do it are ultimately weighing a benefit/risk scale in terms of living a life of constant neurotic thoughts with their height and most do understand how serious this is. some go in knowing this is risky and potentially not good for their health and might even cause long term issues but is okay making that trade off- height neurosis is seriously damaging to human's mental health for some ppl
tldr: some are skeptical, but still proceed because that tradeoff is worth it to THEM

that said, every procedure has its risks and it is indeed true that we do not know the long term issues yet for cosmetics and knee arthritis and hip arthritis yet, that will come in the coming decades as we catchup with the first patients of cll


i bet however that same orthopedic surgeon will recommend amputation + prosthetics for severe Congenital Femoral Deficiency for a poor kid, while Paley can save that kid and go back to normal function full legs. Each person should really specialize in their own field, limb lengthening is really niche and a knee surgeon really knows very little about LL.

Still be skeptical of Paley and other LL docs yes. But for other reasons than an outsider who happens to have an MD in bones and maybe can stick a trauma nail into a femur

ortho pedics is broad... like spine surgery, knee and hip surgery, limb surgery, etc, most specialize
(meanwhile u have debiparshad do spine and limb haha and mahboobian do knee and limb and everything and paley specialize in limb and maybe a little more but paley wouldn't know how to do complex spine surgery so he shouldnt talk about spines, only thing related is Orthopedic name that is all )

but in the end you are right. be skeptical and not everything is as cut as it seems. we dont know long term for specificially cll and arthritis

[skeptic]

yeah one should keep an open mind and listen to all sides and all experts within the field as well as outside

however i think most people who do it are ultimately weighing a benefit/risk scale in terms of living a life of constant neurotic thoughts with their height and most do understand how serious this is. some go in knowing this is risky and potentially not good for their health and might even cause long term issues but is okay making that trade off- height neurosis is seriously damaging to human's mental health for some ppl
tldr: some are skeptical, but still proceed because that tradeoff is worth it to THEM

that said, every procedure has its risks and it is indeed true that we do not know the long term issues yet for cosmetics and knee arthritis and hip arthritis yet, that will come in the coming decades as we catchup with the first patients of cll


i bet however that same orthopedic surgeon will recommend amputation + prosthetics for severe Congenital Femoral Deficiency for a poor kid, while Paley can save that kid and go back to normal function full legs. Each person should really specialize in their own field, limb lengthening is really niche and a knee surgeon really knows very little about LL.

Still be skeptical of Paley and other LL docs yes. But for other reasons than an outsider who happens to have an MD in bones and maybe can stick a trauma nail into a femur

ortho pedics is broad... like spine surgery, knee and hip surgery, limb surgery, etc, most specialize
(meanwhile u have debiparshad do spine and limb haha and mahboobian do knee and limb and everything and paley specialize in limb and maybe a little more but paley wouldn't know how to do complex spine surgery so he shouldnt talk about spines, only thing related is Orthopedic name that is all )

but in the end you are right. be skeptical and not everything is as cut as it seems. we dont know long term for specificially cll and arthritis

Good post.
By the way the doctors had concerns about the implications of lengthening legs than arthritis due to misalignment. I wanted to argue with Ilizarovs studies but the doctor was getting impatient with having to explain medical stuff to me. He was basically like "I can't teach you how the body works but I can tell you that stretching limbs will not be good and impacts of it are unproven."

[Serilium]

honestly you probably know more about limb lengthening than that doctor assuming you read illizarovs studies and lurk this forum and etc. we are  at the point in medicine where a middle age person in 40s has knee arthritis which is pretty early and most doctors will recommend knee replacement, but LL docs and similar long bone speciality limb deformity docs know that it's very likely there is a bowleg or knock knees, and by fixing that you get a much better outcome than a knee replacement, but of course the general consensus between other doctors is knee replacement- but deformity correction via breaking bones is probably better.

that doctor might even argue a person who has an LLD using soles for life is better than getting limb lengthening- haha that's just bullshiet and they are seriously just speaking outta their ass :0

medicine is still new af and ur doctor just sounds like he's spitting hearsay, which LL being bad could be the case- but is unsubstantiated. I have no doubt there is possibility of LL just being bad like he saids even if alignment issues is excluded, but it's just probably his "hunch" haha

i think a big part is the stigma of "oh you broke your bones!!! must be bad!!!" and something related to that. it's still a shocking surgery to be fair XD i bet in the year 1900 most surgical interventions in 2020 will appear to be absolutely barbaric and obviously harmful- but turns out it aint

[skeptic]

big part is not breaking bones but distraction. That is what made these doctors uncomfortable. Usually doctors in the medical community learn about each other specialties. Like everyone knows how angioplasty works. Everyone knows knee replacements are inevitable. But with LL they still see it as that forbidden procedure. Interestingly this is how Ilizarov was treated back in his day but things have gotten better over time. But it's still not to point of satisfaction of orthopedic docs.

[limbcllnea]

honestly you probably know more about limb lengthening than that doctor assuming you read illizarovs studies and lurk this forum and etc.
that doctor might even argue a person who has an LLD using soles for life is better than getting limb lengthening- haha that's just bullshiet and they are seriously just speaking outta their ass :0

medicine is still new af and ur doctor just sounds like he's spitting hearsay, which LL being bad could be the case- but is unsubstantiated. I have no doubt there is possibility of LL just being bad like he saids even if alignment issues is excluded, but it's just probably his "hunch" haha

i think a big part is the stigma of "oh you broke your bones!!! must be bad!!!" and something related to that. it's still a shocking surgery to be fair XD i bet in the year 1900 most surgical interventions in 2020 will appear to be absolutely barbaric and obviously harmful- but turns out it aint

Dunning-Kruger in full effect here 

[Bantem]

Not all doctors know about surgeries outside of their immediate fields. For me though since I think about my height every single day, then this surgery will be worth it if it finally means relieving all that stress.

[RealLostSoul]

Dr Paley is primarily a deformity reconstruction surgeon. And he does have quite some publications out there. I agree that the topic in general is very controversial but I believe as well that those orthopedics who don‘t care at all about permanent mental illness from height dysphoria and think turning people into drug addicted zombies is the better thing are the same that recommend cutting of childrens limbs if they are deformed than trying to fix them with callous distraction surgeries.

[skeptic]

Unfortunately neither LL doctors nor regular ortho doctors are willing to have a detailed conversation about the science behind all this. They will tell you you're a layman and so you won't understand. You are on your own at researching the science behind the surgery. And finally you have to choose to trust one side.

I have consulted Paley and he doesn't like patients questioning the validity of his answers. You either trust what he says or you leave basically.

We'd have to see if LL doctors do cosmetic LL on their own family members. That's one way of building trust.

[Going-For-Three]

Unfortunately neither LL doctors nor regular ortho doctors are willing to have a detailed conversation about the science behind all this. They will tell you you're a layman and so you won't understand. You are on your own at researching the science behind the surgery. And finally you have to choose to trust one side.

I have consulted Paley and he doesn't like patients questioning the validity of his answers. You either trust what he says or you leave basically.

We'd have to see if LL doctors do cosmetic LL on their own family members. That's one way of building trust.

I wouldn't be surprised if they don't even know the molecular biology behind their work. Orthopedic surgeons tend to be the 'bruisers' of the medicine field and aren't known for their scientific or medical knowledge.

[Polvorón]

This systematic review supports CLL:
https://online.boneandjoint.org.uk/doi/full/10.1302/2046-3758.97.BJR-2019-0379.R1

Bone & Joint ResearchVol. 9, No. 7 Systematic ReviewOpen AccessOpen Access license
Cosmetic stature lengthening
systematic review of outcomes and complications

Yousef Marwan, Dan Cohen, Mohammed Alotaibi, Abdullah Addar, Mitchell Bernstein, Reggie Hamdy
Published Online:3 Jul 2020https://doi.org/10.1302/2046-3758.97.BJR-2019-0379.R1

Conclusion
Cosmetic stature lengthening provides favourable height gain, patient satisfaction, and functional outcomes, with low rate of major complications. Clear indications, contraindications, and guidelines for cosmetic stature lengthening are needed.

Some doctors doesn't know the latest information, reading every article about orthopedic science is difficult, bear with them.

[Sambollio]

I wouldn't be surprised if they don't even know the molecular biology behind their work. Orthopedic surgeons tend to be the 'bruisers' of the medicine field and aren't known for their scientific or medical knowledge.

Wait this is blatantly not true, there definitely stereotypes about orthos as with every specialty, but it’s in the top 3 most competitive specialties to get into. So after your 4 years medical school you need to be a top student.

[Going-For-Three]

Wait this is blatantly not true, there definitely stereotypes about orthos as with every specialty, but it’s in the top 3 most competitive specialties to get into. So after your 4 years medical school you need to be a top student.

But once you're a practicing ortho, you don't really keep the same proximity to medicine as someone in IM/medicine. I didn't say they weren't smart, they are generally just more procedure-driven, like all surgeons.

[Unknown]

This procedure is no doubt insane. Which is why I am hesitating so much on doing it. And the lack of patients returning to document their healing years post op is unsettling. There could be some patients with cognitive dissonance who convince themselves that they are better off where in actuality they are still suffering with post op trauma which may never heal properly.

[Polvorón]

This procedure is no doubt insane. Which is why I am hesitating so much on doing it. And the lack of patients returning to document their healing years post op is unsettling. There could be some patients with cognitive dissonance who convince themselves that they are better off where in actuality they are still suffering with post op trauma which may never heal properly.

That doesn't happen, you can read this document (I have linked it before):
https://online.boneandjoint.org.uk/doi/full/10.1302/2046-3758.97.BJR-2019-0379.R1