Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Wannabegiant]

Hi guys, i have a lot of questions regarding my journey to get taller, which will take place in the near future. im 23 years old and i want to get it done as soon as possible so i can enjoy it during as much of my youth as i can.

I was a member on the old forum but got banned without warning for unknown reasons, i didnt bother emailing any of the admins to ask why.

My goal is to become 5'10 inches tall (178 cms) and im currently about 5'9 (varies between 174-175 cms during the day) so i really only need about one inch increase but i intend to do 4 cms to be precise (i heard you can lose a little of the gained height after frame removal). People might say that it is unnecessary and that i can use lifts instead, but the problem is that in the country im living in (Sweden) a good ammount of the guys use lifts, so me using it too doesnt make up for anything really by itself.

The reason i want this small increase is because so many guys in this country seem to be around 5'10, and i just dont want to stick out in a crowd as the shortest guy, which happens quite a lot even if it is by a little. Also id say in Stockholm the capital probably around 2/10 girls are taller than me, mostly by very little, but im pretty sure this is skewed by them using small lifts on their shoes.

I already have the money i need, and i picked Dr. Mirzoyan in Armenia particulary because the price is very low and dependant on how many cms you increase. Also they offer the double incision method which I intend to use (I want to get back to my home as soon as possible and then recover there).

Breakdown on the method i will be using:

4 cms in Tibias.
Externals
Double incision for 2 mm per day lengthening
ilizarov frames or monorails depending on what answers i get here, i dont really know yet what is the optimal for me.

Height is the only thing i feel bad about myself, im so happy about everything else, and there is nothing else i really could see myself spending this money on that would serve me better.

Alright so to the questions i have:

1. What are the actual negatives of using the double incision method? i heard lengtening to fast will unable the muscles and nerves to stretch fast enough to cope with it, and result in longer recovery time. Although since you have two cuts shouldnt that split up how much the tendons are stretched? since it is happening in two places instead of one? also since im only doing 4 cms maybe i will be fine anyway? Also on their website the price doesnt seem to be different from the normal method.

2. Should i use monorails or ilizarov frames? i dont really care to much about scares, i have kind of dark skin so it wont be that visible and there are ways to get rid of them. Pain is not much of an issue either. All i care about is probaility of success in terms of lengthening and recovering (I want to recover 100%, but im fine if it takes a year for that to happen). I also dont want any height loss after removal of the stabilizers but if it cannot be prevented i want as little of it as possible (i heard a litte about pin bending)

3. I want to do this surgery early 2014, so if i wanted to get it done around februari or mars, should I try to contact Mirzoyan now or when? i heard doing it about a month in advance would work but im not sure.

Im sure i will have some followup questions depending on what i learn from this, thank you in advance!

[KiloKAHN]

1. What are the actual negatives of using the double incision method? i heard lengtening to fast will unable the muscles and nerves to stretch fast enough to cope with it, and result in longer recovery time. Although since you have two cuts shouldnt that split up how much the tendons are stretched? since it is happening in two places instead of one? also since im only doing 4 cms maybe i will be fine anyway? Also on their website the price doesnt seem to be different from the normal method.

If you're doing a small amount of lengthening as it is then I don't think the double cut method is worth it due to the higher risk of complications. Complications from the double-cut method would include higher incidence of pre-consolidation. Another problem I could see happening is a higher chance of bone misalignment since you'll have this big piece of your tibia just sort of floating in the middle and only held by a few pins.

[Sweden]

Min första reaktion: Gör INTE det!!

Jag har träffat patienter som varit hos Mirzoyan och det finns inte EN som kan rekommendera honom.
Han har sabbat många patienters ben. Det är så mycket mer än att "bara" förlänga 4cm och framförallt om du använder dig av dubbelbryt. Det är aldrig en bra idé.

Dina nerver och leder klarar inte 1mm/dag och ska du skruva ännu fortare kommer det ta år att komma tillbaka.
Jag gjorde 7cm i Indien den 8 januari 2013 och jag kan FORTFARANDE inte springa, det går bara inte. Fötterna vill inte passera 90 grader om jag drar upp dem och vissa dagar är jag så stel att jag blir liggandes nästan en hel vecka.

Ska du enbart använda dig av extern Ilizarov kommer ställningen sitta på i 9 månader.
Har du otur så knäcks benet efter Mirzoyan tar av ställningen för han har ingen koll på när ditt ben är tillräckligt läkt. Det råkade Craig49 ut för. Honom träffade jag i Indien.
Han hade fortfarande korta hälsenor efter 5 år, därför skulle han operera dem hos Dr Sarin.

Du kommer bli ordentligt deprimerad i Armenien vilket ökar risken för komplikationer. Där är kasst internet, inget att driva tiden med, vidrig mat och personalen är idioter.
Väljer du dessutom monorail ökar risken markant för komplikationer.

Tänk dig riktigt noga för innan du gör detta. Du kommer få livslånga besvär i form av värk och begränsad rörlighet. Det är väldigt få som vågar erkänna det att de lider flera år av denna operation men så är den bittra sanningen.

Armenien är INTE att rekommendera. Varför sätta sin hälsa på spel på det viset när det finns andra mer erkänt bättre läkare?

För 4cm skulle jag rekommendera Dr Salameh. Hans egna metod verkar väldigt framgångsrik och du slipper märgspiken som förstör dina knän permanent.

Lycka till!

[Wannabegiant]

Alright i guess that is true that the double cut method might be bad considering that a piece of my tibia will be floating freely almost. if i do normal lengthening for 4 cms it still wont be that much longer, maybe lengthening for about 40 days.

Sweden: Thank you for your reply, we could speak in swedish but i would like to hear other peoples opinions on your comment, this way, only I can understand you, so can we continue writing in english?

I find it puzzling that 1 mm a day would be to much, i assumed that was standard procedure, and only became a problem if you lengthen a big ammount (which is when you get ballerina foot). I also remember a diary from a guy who did the double incision at Dr Mirzoyan. Cant remember his name and apparantly his diary was moved to a section only members can read on old forum , but he claimed he didnt have much pain while lengtening 2 mm a day, and he went for 6 cms! still i have no idea about his recovery so you might be right.

Main reason i want to do it in Armenia is price, i already calculated that it will be about 70 thousand swedish krones. even less depending on if i choose the hotel room or the Hospital room. I can afford that by myself. I dont want to put a nail inside my leg because i heard about the risk of knee problems as well as the fact that i need to operate again to get it out of my leg. Also those rods are super expensive!

I cant imagine that all of Mirzoyans patients had the same experience as Craig did. Craig did demand a very complicated procedure if i remember correctly, still its not okey but i dont think it will be as risky when only lengthening 4 cms on tibias.

About being depressed in Armenia, im not worried about that, just the very fact that i will be working towards my final real self image problem i have will make me happy. I dont expect any hospital to be pleasant as long as i get the aid i need.

Are you sure that the ilizarov stays on for that long? so after 9 months and removing them i need crutches? for only 4 cms? that other diary i mentioned, the guy from america who went to armenia and did double incision, he removed his external fixator way earlier than that, cant remember how long he had to wait though. is there any external method where you can at least walk with crutches after about 3 months? I mean if i only lengthen 4 cms my muscles shouldnt atrophy that much i think?


What complications are specific for using monorails?

And finally dr Salameh is not within my price option, he charges like 25.000 euros? especially since im doing 4 cms only, not worth that kind of price when there are cheaper options imo and in either case i would have to wait a very long time to get that money. I dont want to wait.

[Medium Drink Of Water]

The double-cut method isn't so you can lengthen 2mm per day, it's so you can lengthen 0.5mm per day x2.  It's for people with bad bone growth who are at risk for non-union and are not at risk for premature consolidation.  Even at 1mm your muscles and tendons aren't going to be lengthening at the same rate as your bone.  The whole muscle/tendon is being stretched all at once, not just small parts of it, so you can't stretch them any faster no matter how many cuts you do.

Most loss from pin bending comes from weight bearing and the lengthening process.  Don't worry about losing height after the frame removal.  If your final x-ray shows 2.5cm then you lengthened between 2.4 and 2.6cm pretty much guaranteed.  Nobody magically shrinks 1.5cm after frame removal.

Ilizarov is better for corrections in case your bone starts to get crooked during lengthening, but is less comfortable.  You'll be hating life while you have an Ilizarov frame on, that's for sure.  You can walk with fixators on, but it's going to take many months for your bones to consolidate, and the frames can't be removed until then.  Now you know why people go with LON/LATN, because you can take those frames off after lengthening and have an (almost) normal life while you wait for consolidation.

[Wannabegiant]

The double-cut method isn't so you can lengthen 2mm per day, it's so you can lengthen 0.5mm per day x2.  It's for people with bad bone growth who are at risk for non-union and are not at risk for premature consolidation.  Even at 1mm your muscles and tendons aren't going to be lengthening at the same rate as your bone.  The whole muscle/tendon is being stretched all at once, not just small parts of it, so you can't stretch them any faster no matter how many cuts you do.

Most loss from pin bending comes from weight bearing and the lengthening process.  Don't worry about losing height after the frame removal.  If your final x-ray shows 2.5cm then you lengthened between 2.4 and 2.6cm pretty much guaranteed.  Nobody magically shrinks 1.5cm after frame removal.

Ilizarov is better for corrections in case your bone starts to get crooked during lengthening, but is less comfortable.  You'll be hating life while you have an Ilizarov frame on, that's for sure.  You can walk with fixators on, but it's going to take many months for your bones to consolidate, and the frames can't be removed until then.  Now you know why people go with LON/LATN, because you can take those frames off after lengthening and have an (almost) normal life while you wait for consolidation.

Okey I see, i thought lengthening 1 mm per day was standard with the normal cut, even if the muscles cant stretch along with it. But do you agree with previous statements that double incision is more risky even if you lengthen at a reasonable speed? I assume 1 mm per day is possible with normal cut even if it is straining, and 2x 0.5 mm a day with double incision is easier but takes longer to recover?


So i guess you also advice against double incision?

okey but even losing 0.5 mm after frame removal would be a big deal and i want to avoid that, Do i need to lengthen extra to compensate for the mm loss? and then the question is how pricing is dealt with in such a situation, ie if i pay for 4 cms, and have to lengthen 4,5 cms to be 4 cms taller when the frames are removed, i should still only have to pay for 4 cms i would hope.


About having the frames on, im prepared for that, But from what i heard the bone is consolidated enough to stand on after like 2 months? and then its only the weakened muscles and tendons that need to be stretched (and muscle atrophy) that requires you to use crutches after frame removal? or do you really need to wear the frames for 9 months? that seems to conflict with what i have been told before.

Thanks again.

[KiloKAHN]

In general, adults using purely external methods will have to wear frames for 1.5 - 2 months for every centimeter lengthened. For 4cm expect to wear the frames between 6 to 8 months. That's just a general time frame that many orthopedic surgeons give.

[Wannabegiant]

In general, adults using purely external methods will have to wear frames for 1.5 - 2 months for every centimeter lengthened. For 4cm expect to wear the frames between 6 to 8 months. That's just a general time frame that many orthopedic surgeons give.

Okey gotcha, but then after the frames are removed do I need crutches still? and if so for about how long after frame removal? Cause looking at the FAQ here in this forum, it says:

For an increase of 5cm  the whole process  should take about 6 months from operation, to being able to walk again. For 7cm you would add a month. Again, each patient is different . Those who regenerate quickly and have a high pain threshold can get through it quicker.

from this FAQ:
http://www.limblengtheningforum.com/index.php?topic=82.0

So is that timeframe only for those who use Internal methods? although im not sure what that faq means by walking, apparantly you can walk with the frames on so does it mean you can only walk with frames after 6 months? doesnt sound right.

I guess if i have to wear frames for a long time i would be using the monorails since the can be hidden under clothes unlike the ilizarov, as long as i can walk with them after the lenthening process.

[Medium Drink Of Water]

Lengthening 1mm per day is the standard with the normal cut, and I believe with the double-cut as well.  The more cuts, the riskier the surgery is, so try just to have one cut.  Since you're lengthening each gap at half speed with the double cut, you're in danger of premature consolidation and having to have the bone re-broken.

How much you "lengthen" is irrelevant.  The dials on fixators are always inaccurate, and probably not only due to pin bending, although that is a major factor.  Your doctor will measure the size of your gaps in x-rays to figure out how much you've lengthened.

You've got it backwards about the muscles and bones.  You can walk with fixators on, and if you do enough exercise your muscle atrophy won't be too bad.  A guy in Beijing (KF in my Patient Experience) was walking around without crutches the day after his frames were removed.  What's delaying fixator removal is the gap in the bone.  A very rough estimate is 3 months per inch with external-only before the bone is consolidated enough to support weight bearing.

The bone will consolidate faster with the double cut since those 2 gaps will fill in at about the same rate as each other.  However, in most situations it's best to just do one cut at the thickest part of the tibia.  That gap will fill in with the thickest and strongest new bone possible.  Plus there's less risk of misalignment, and fewer pins in the leg.

[Wannabegiant]

Lengthening 1mm per day is the standard with the normal cut, and I believe with the double-cut as well.  The more cuts, the riskier the surgery is, so try just to have one cut.  Since you're lengthening each gap at half speed with the double cut, you're in danger of premature consolidation and having to have the bone re-broken.

How much you "lengthen" is irrelevant.  The dials on fixators are always inaccurate, and probably not only due to pin bending, although that is a major factor.  Your doctor will measure the size of your gaps in x-rays to figure out how much you've lengthened.

You've got it backwards about the muscles and bones.  You can walk with fixators on, and if you do enough exercise your muscle atrophy won't be too bad.  A guy in Beijing (KF in my Patient Experience) was walking around without crutches the day after his frames were removed.  What's delaying fixator removal is the gap in the bone.  A very rough estimate is 3 months per inch with external-only before the bone is consolidated enough to support weight bearing.

The bone will consolidate faster with the double cut since those 2 gaps will fill in at about the same rate as each other.  However, in most situations it's best to just do one cut at the thickest part of the tibia.  That gap will fill in with the thickest and strongest new bone possible.  Plus there's less risk of misalignment, and fewer pins in the leg.

awesome, thanks again for the great info, now finally it sounds like i have a good idea about what im getting myself into exactly, and if what you are saying is accurate it definitely sounds doable for me, since i have like 9 months to spare from beginning of 2014.

The reason i was surprised about the double cut lengthening at the same speed as the normal cut, except in two places, is because according to the FAQ at the website of the armenian LL center: 

http://www.leglengthening.am/index.php?option=com_content&view=article&id=16&Itemid=27&lang=en

it says that the double incision speeds up the lengthening process by 40% and that you can lengthen 2 mm a day, although i will probably avoid that since it seems like that could potentially damage my nerves and tendons since they cannot stretch nearly as fast. also the increased risk of bone misalignment since it will be cut in two parts sounds dangerous.

At the same time, if the faster consolidation phase means i can remove the frames earlier, then thats another positive with double incision method, in addition to allowing me to return home earlier. So im not really sure now which way im gonna do it.

Also since you can walk with fixators, i guess using monorail is better than ilizarov, since im not worried about temporary pain and the scars. I can hide the monorails easier. And then after walking with them for about 5 months and then removing them i can expect to walk without crutches, that would be absolutely perfect :p, am i getting this correctly?

[Medium Drink Of Water]

Yeah I wouldn't do 2mm per day even if it's possible theoretically.  I've never heard of anyone lengthening that fast.  1mm is quite painful and some people want to slow down when they're doing that much.  That kind of worries me about that clinic, that they'd be saying 2mm when all the world's experts say half that. 

You might have it correct, but be prepared for delays and complications.

[Wannabegiant]

Yeah I wouldn't do 2mm per day even if it's possible theoretically.  I've never heard of anyone lengthening that fast.  1mm is quite painful and some people want to slow down when they're doing that much.  That kind of worries me about that clinic, that they'd be saying 2mm when all the world's experts say half that. 

You might have it correct, but be prepared for delays and complications.

Yeah agreed, not sure but will probably do the regular incision, unless some new info comes up. Im pretty sure there was a diary of a guy on old forum  that did the double incision, and he didnt experience any complications during lengthening phase at least. But i have no idea if that method had complications for him later.

Do you have any insight towards monorails? since i can cover them with clothes and walk with them, i see no reason to pick ilizarov over them. temporary pain is no problem and slightly bigger scars can still be removed eventually. Not a big deal for me.

Unless there is some big negative towards monorails that isnt listed in the FAQ here i will use them. Pin bending will be accounted for regardless of frame i guess.

[Medium Drink Of Water]

I don't have anything against monorails.  My first choice was to get LL in Serbia with Dr. Mitkovic's monorail fixator.

[Wannabegiant]

I don't have anything against monorails.  My first choice was to get LL in Serbia with Dr. Mitkovic's monorail fixator.

Alright! then ive settled most things here:

4 cm external tibias
In Armenia with Dr. Mirzoyan.
Monorails
most likely regular single incision.

Now i guess this depends on the doctor, but if i want to go there and start lengthening in late februari/early mars, should i try to contact him about now? or when is the appropriate time?

[Medium Drink Of Water]

Now is a good time to contact him.

[Wannabegiant]

Now is a good time to contact him.

Awesome! thanks again all of you guys

[endeavor]

I'll hop in here, as I have a question that is very relevant to this discussion.

Dr. Mirzoyan states that total time in the external fixator is 20-25 days/cm. This is very different from the 1.5-2.0 months/cm. or 3 months/in. estimates given here. How is this discrepancy explained?

[Medium Drink Of Water]

I'll hop in here, as I have a question that is very relevant to this discussion.

Dr. Mirzoyan states that total time in the external fixator is 20-25 days/cm. This is very different from the 1.5-2.0 months/cm. or 3 months/in. estimates given here. How is this discrepancy explained?

It's because he lets you lengthen way too fast if you want to.

[endeavor]

It's because he lets you lengthen way too fast if you want to.

Oh I see. He states that this is for 1 mm/day. Is this an unreasonable duration estimate, or is it unreasonable to try to do 1 mm/day on the tibias? That's what I'm a bit confused about.

[Medium Drink Of Water]

Then he's talking about LON/LATN not external-only.

[Wannabegiant]

I'll hop in here, as I have a question that is very relevant to this discussion.

Dr. Mirzoyan states that total time in the external fixator is 20-25 days/cm. This is very different from the 1.5-2.0 months/cm. or 3 months/in. estimates given here. How is this discrepancy explained?

Thats awesome, so did you contact him through his personal email or at this site?

http://www.leglengthening.am/index.php?option=com_contact&view=contact&id=1&Itemid=26&lang=en

How long did it take him to respond?

I just sent an email through the above site, im not sure what is the best way to make first contact, but I guess I will recieve information about that in their response. If it takes to long without response I probably have to call them on.

One important thing Im quite concerned about right now is that on their site it seems like ilizarov frames are the only external fixator being shown, is it possible that they do not offer monorails? I thought that was a standard option in most LL clinics. If i remember correctly Craig had a monorail but he was at several clinics so maybe he didnt get it from Mirzoyan.

[Medium Drink Of Water]

He probably only uses Ilizarov then.  Most doctors have their preferred device and don't offer many (if any) choices.

[Medium Drink Of Water]

Here's an external-only case example.  5cm in 5 months, and he took the frames off before the bones were fully consolidated.

http://www.leglengthening.am/index.php?option=com_content&view=article&id=36&Itemid=38&lang=en

[endeavor]

Thats awesome, so did you contact him through his personal email or at this site?

http://www.leglengthening.am/index.php?option=com_contact&view=contact&id=1&Itemid=26&lang=en

How long did it take him to respond?

I just sent an email through the above site, im not sure what is the best way to make first contact, but I guess I will recieve information about that in their response. If it takes to long without response I probably have to call them on.

One important thing Im quite concerned about right now is that on their site it seems like ilizarov frames are the only external fixator being shown, is it possible that they do not offer monorails? I thought that was a standard option in most LL clinics. If i remember correctly Craig had a monorail but he was at several clinics so maybe he didnt get it from Mirzoyan.

This information was on his webpage. I have contacted him, and he responded very quickly (about one day). But I do think there's some miscommunication, as MDOW says that 20-25 is not for the external fixator-only method. In both our cases, LON/LATN makes no sense, as it's too expensive and can cause our knees permanent damage. That's not worth a small height gain.

Here's the bind I'm in:

1) I want to lengthen 3 cm. I am willing to go as low as 2.5 or 2 cm., however.
2) I have three months to get the fixators OFF. I'm fine with crutches/casts/whatever. But they need to be off in three months.
3) Double-cut seems to raise too many dangerous aftereffects, especially at 2 mm/day.
4) LON/LATN can cause permanent knee pain.

With these constraints, I may not be able to do lengthening until later when I have more time. I can try to do 2 cm. completed in 3 months, but there really seems to be no other option.

Aren't you in a similar situation? Do you really have 6-8 months to do 4 cm? Dr. Mirzoyan told me 4 cm. is possible in about 3 months, but that might require a double-cut.

[endeavor]

Here's an external-only case example.  5cm in 5 months, and he took the frames off before the bones were fully consolidated.

http://www.leglengthening.am/index.php?option=com_content&view=article&id=36&Itemid=38&lang=en

I can see this rather clearly. This increases risk of re-fracture, yes? Is it possible to do this but stay in casts/on crutches for a few months afterward, or is this very risky?

[Wannabegiant]

He probably only uses Ilizarov then.  Most doctors have their preferred device and don't offer many (if any) choices.

Man that would suck..i hope he does offer monorails, the ilizarovs are so hard to hide under clothing. But still because of the price I have no choice but to pick this clinic. If I have to wear ilizarov frames, then I actually think i might have to do the double incision, so i can get the frames of sooner. I will only have two 2 cm gaps so not that bad, dont think there will be much room for misalignment.

[Wannabegiant]

This information was on his webpage. I have contacted him, and he responded very quickly (about one day). But I do think there's some miscommunication, as MDOW says that 20-25 is not for the external fixator-only method. In both our cases, LON/LATN makes no sense, as it's too expensive and can cause our knees permanent damage. That's not worth a small height gain.

Here's the bind I'm in:

1) I want to lengthen 3 cm. I am willing to go as low as 2.5 or 2 cm., however.
2) I have three months to get the fixators OFF. I'm fine with crutches/casts/whatever. But they need to be off in three months.
3) Double-cut seems to raise too many dangerous aftereffects, especially at 2 mm/day.
4) LON/LATN can cause permanent knee pain.

With these constraints, I may not be able to do lengthening until later when I have more time. I can try to do 2 cm. completed in  months, but there really seems to be no other option.

Aren't you in a similar situation? Do you really have 6-8 months to do 4 cm? Dr. Mirzoyan told me 4 cm. is possible in about 3 months, but that might require a double-cut.

Awesome thanks, well i guess i was stupid to use that other mailing option, could you post Mirzoyans email adress to me in a PM? Cause i couldnt find it in the Yerevan clinic home site.

And if he says 4 cm is possible in 3 months for frame removal then i will definitely do that, if you do double cut, the main risks seem to come from those who lengthen to fast, but the main benefit seem to be that it consolidates faster. So maybe it is worth doing the double cut and still  only lengthen at 1 mm a day, like the regular cut. The other potential risks tied to the fact that you have two incisions seem to be minor, i dont think the pins should have much trouble holding that loose part of the tibia in place, but who knows. during lenthening i will remain quite immobile anyway, and after that phase is over i think the outer "shell" of the tibia will be consolidated already holding the bone in place and as long as it doesnt break it should remain that way even with two gaps.

And i technically have the whole first half of 2014 to do this, I had my last term for my university program beginning this year, but i decided to postpone it to start in autumn instead. And i still live with my parents. Obviously i would want to get the frames of as soon as possible so i can actually meet my friends and stuff. i dont want to have to hide myself at home with the frames which is why the monorails would be perfect, they are easy to hide as long as i only meet people outside. its cold in sweden so thick clothes wont raise suspicion.

Btw I agree, we are in similar situations, except you seem to have more time constraints. Armenia is the only logical choice it seems, because of price. But did you ask him about risks about the double incision? Cause if they are minor i think they seem to be the only opttion for you if you really only have 3 months, you could lengthen slowly but still go for double cut maybe. At the same time regardless what the Dr says i guess we cant fully trust anybody including him.

[KiloKAHN]

Regarding the LON/LATN permanent knee pain discussion, I'm not quite sure going purely external would be that much better in the long run. The chance for bone misalignment is higher with external only. Also, didn't Stadiometer find a study that said you will get permanent muscle damage if you wear external frames for longer than 4 months or so? So the tradeoff would be possibility of permanent muscle damage vs possibility of permanent knee pain.

[Medium Drink Of Water]

http://www.leglengthening.am/index.php?option=com_content&view=article&id=37&Itemid=39&lang=en

Look at how low the 2nd cut is.  The new bone there is going to be so thin.  I like the thickness of the new bone that the single cut offers.

[Wannabegiant]

Regarding the LON/LATN permanent knee pain discussion, I'm not quite sure going purely external would be that much better in the long run. The chance for bone misalignment is higher with external only. Also, didn't Stadiometer find a study that said you will get permanent muscle damage if you wear external frames for longer than 4 months or so? So the tradeoff would be possibility of permanent muscle damage vs possibility of permanent knee pain.

But then you can apparantly get the external frames of within 3 months if you only lengthen 4 cms according to Dr Mirzoyan. But i guess this is with double incision but im not sure. Still that would remove the muscle damage risk. And the pins are not supposed to go through muscle tissue so im not sure why the muscle would get permanently damaged from the frames, i thought muscle aptrophy was the issue, but that can be recovered.

[Wannabegiant]

http://www.leglengthening.am/index.php?option=com_content&view=article&id=37&Itemid=39&lang=en

Look at how low the 2nd cut is.  The new bone there is going to be so thin.  I like the thickness of the new bone that the single cut offers.

What do you mean? the new bone that is consolidated will be the same or stronger than before the surgery right? the cut being low means that the bone is naturally thinner there so i dont what is the problem with that cut?