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[DragonTurtle]

Hey guys,

Trying to make the best decision for me but I am stuck between these two doctors. Can you guys help me decide?

A few things:
1. Price difference is not an issue.
2. Location is not an issue.
3. The most important thing is safety and reduction of complication risk.
4. I want to go back to as close as 100% as possible, eventually including bodybuilding.
5. I want to lengthen about ~7 and ~7.7 cm (I have a small discrepancy too).
6. Recovery time is important too.

I like the idea of being able to weight-bear on the Guichet nail, but I am <150 lbs, so I guess can do that on the Precice anyway? And, is it true that Guichet's patients generally have faster recovery? I also keep seeing the figure that Paley has done 17,000+ surgeries, while Guichet has only done 300? That doesn't seem right?

Note: I've already had my consultation with Dr. Paley.

[ouroboros]

I used to think these two docs were the top choices too.....not anymore.

I'm not a fan of Paley's "take it or leave it" attitude, and his delegation of aftercare to his trainees.

I'm also not a fan of Guichet's "no pain no gain" attitude, and his traumatizing demands right after surgery when your body is still going through severe shock.

LL is not a perfect science, we are all just guinea pigs at the end of the day. 

All these docs contradict each other sometimes solely because they want to be right soooo bad.

Now, if these two were the only choices available, I lean slightly towards Paley because he seems more of a doctor and less of a scientist.

[Deads]

I used to think these two docs were the top choices too.....not anymore.

I'm not a fan of Paley's "take it or leave it" attitude, and his delegation of aftercare to his trainees.

I'm also not a fan of Guichet's "no pain no gain" attitude, and his traumatizing demands right after surgery when your body is still going through severe shock.

LL is not a perfect science, we are all just guinea pigs at the end of the day. 

All these docs contradict each other sometimes solely because they want to be right soooo bad.

Now, if these two were the only choices available, I lean slightly towards Paley because he seems more of a doctor and less of a scientist.

Not to jack this thread, but quickly, I'm interested to know who you're a fan of?

[ouroboros]

Not to jack this thread, but quickly, I'm interested to know who you're a fan of?

The honest truth..... it keeps changing.... evolving.

The more I read diaries, the more I read posts, the more I research online.... I begin to see patterns (like connecting the dots), and today I may be a fan of Dr. "??", but until the day I get the operation it could easily change.

Most of us in these forums behave like "armchair quarterbacks", thinking that we have as much knowledge as an orthopedic surgeon.  The reality is that we all have preferences based on what we believe to be right, but at the end of the day we are merely "spectators" in this insane asylum. 

[Deads]

The honest truth..... it keeps changing.... evolving.

The more I read diaries, the more I read posts, the more I research online.... I begin to see patterns (like connecting the dots), and today I may be a fan of Dr. "??", but until the day I get the operation it could easily change.

Most of us in these forums behave like "armchair quarterbacks", thinking that we have as much knowledge as an orthopedic surgeon.  The reality is that we all have preferences based on what we believe to be right, but at the end of the day we are merely "spectators" in this insane asylum. 

So who are you a fan of TODAY.

[DragonTurtle]

Of course, this is the truth of any cosmetic procedure in a competitive market. And this is only amplified by the novelty of CLL.

But I've narrowed down my choices to Guichet and Paley and it does seem like a very difficult decision. Here's another question, ignoring Guichet's pre-op training, is he actually faster at recovery?

[aspirant185]

He claims people achieve 4.4 cm in 1 month and 7 cm in two months. That seems pretty fast for me. For example, I will be lengthening with Mitkovic and it takes 2 months to lengthen not 7 cm but 4 cm.
In my opinion, if you are American stay with Paley, if you are European, stay with Guichet. If you are neither, welll go wherever you can get quicker your visa. It is important to be in the same continent where ur Dr. is in case complications arise.

[TIBIKE200]

I saw a post somewhere that claimed that guichet is a farce. It really lowered by confidence in going with him.

[DragonTurtle]

He claims people achieve 4.4 cm in 1 month and 7 cm in two months. That seems pretty fast for me. For example, I will be lengthening with Mitkovic and it takes 2 months to lengthen not 7 cm but 4 cm.
In my opinion, if you are American stay with Paley, if you are European, stay with Guichet. If you are neither, welll go wherever you can get quicker your visa. It is important to be in the same continent where ur Dr. is in case complications arise.

Hmm interesting. On his website it actually says 1 mm/day or 1 inch/26 days. So that would be about 2.5 months for 7.5 cm, same as Paley. Interestingly, it also says 3-4 months consolidation (which seems more realistic than Paley's estimate of 2 months consolidation for 8 cm lengthening).

Is it true Dr. Paley has treated patients with complications because of Dr. Guichet?

[goodlucktomylegs]

Hmm interesting. On his website it actually says 1 mm/day or 1 inch/26 days. So that would be about 2.5 months for 7.5 cm, same as Paley. Interestingly, it also says 3-4 months consolidation (which seems more realistic than Paley's estimate of 2 months consolidation for 8 cm lengthening).

Is it true Dr. Paley has treated patients with complications because of Dr. Guichet?

How did you know?

[DragonTurtle]

I don't know, but someone on this forum (or might have been old forum ) posted that Paley said he had during a consultation..

[Alu]

That might have been Sarin but I digress

[LLuser1]

Not from Guichet. From Sarin, Betz, Monegal and some Russian doctors.

[DragonTurtle]

I'll try to find it but I definitely read a post on this - someone said this is what Paley said during the consultation. (Not sure who to trust though)

[LLuser1]

Not sure about this but sure about the other doctors.

[aspirant185]

Regardless, every doctor has unsuccessfull surgeries. This is how medicine works, take it or leave it. I had very imporant surgery in the past in my eyes and I went to arguably the best doctor in the world, one who practices in Beverly Hills and is ridiculously expensive. He did LASIK on many Hollywood celebrities and have outstanding reputation. However, on his YELP profile one can still find people complaining that their vision worsened post surgery or that they have other minor problems. This did not prevent me from going with him and it is arguably the best decision so far in my life.

[LLuser1]

Yes, the best decision in your life... What if you had been the unfortunate patient? In some cases you have to take this risk but this is elective surgery, my friend. You want to be taller and suddenly you are crippled and can't enjoy live anymore. LL is a gamble but you can minimize your risks if you go to Paley or Guichet (or Birkholtz if you don't have money). If you go to a bad surgeon your risks are higher.

[DragonTurtle]

Yes, the best decision in your life... What if you had been the unfortunate patient? In some cases you have to take this risk but this is elective surgery, my friend. You want to be taller and suddenly you are crippled and can't enjoy live anymore. LL is a gamble but you can minimize your risks if you go to Paley or Guichet (or Birkholtz if you don't have money). If you go to a bad surgeon your risks are higher.

LLuser, who would you pick if money/location was not a problem?

[aspirant185]

Yes, the best decision in your life... What if you had been the unfortunate patient? In some cases you have to take this risk but this is elective surgery, my friend. You want to be taller and suddenly you are crippled and can't enjoy live anymore. LL is a gamble but you can minimize your risks if you go to Paley or Guichet (or Birkholtz if you don't have money). If you go to a bad surgeon your risks are higher.

I agree that if you go to Paley, Guichet , Monegal , Betz , the ones considered the best, you will minize the risks. However, the OP is not asking whether he should go to one of these but to which one among these he should go. My point is that they are all excellent professionals , nevertheless there will be bad/unfortunate cases with any of them. And at some point, when you can choose among the best, you have already minimized risks as much as possible, and looking for more adds little value. Its up to God, or luck if you wish

[LLuser1]

I would pick Paley. Guichet would be my second option.
Please don't put everybody in the same bag. Paley and Guichet are the best. Betz is experienced but not really good because of a bunch of bad cases and dishonest behaviour (salesman). Monegal isn't good technically because he is unexperienced and he is dishonest too. They aren't good options. Patients have told me.

[aspirant185]

I would pick Paley. Guichet would be my second option.
Please don't put everybody in the same bag. Paley and Guichet are the best. Betz is experienced but not really good because of a bunch of bad cases and dishonest behaviour (salesman). Monegal isn't good technically because he is unexperienced and he is dishonest too. They aren't good options. Patients have told me.

Ok, of course you are entitled to your opinion. This is why people join online communities. I would be more cautious though going so far and using so strong words, calling doctors you never met dishonest and unexperienced for many reasons, some of which are:

1) There are currently patients that are getting treated by these doctors. They read the forum. They have many worries now and one of them should not be the uncertainty whether they made the right choice with a doctor

2) There are many patients here who reported outstanding results and superior care/service by these doctors and their staff, so, at the very least, your words sharply contradict the opinion of people who experienced these doctors first hand. Instead, If I were you, I would invite these patients that supposedly told you, to come here, tell their full story, and contribute to the LL community.

3) Doctors read the forums. Again, these are all professionals with outstanding reputation who achieved a lot in life. Betz for instance developed his own device. It would be deeply offending for these people to come here and see that rumors that they are technically incompetent and lack care are being spread out.

To conclude, you know really well that the most highly regarded doctors have bad cases, and some of the so called budget doctors like the ones in India, Russia, China and Dr. Mitkovic produce outstanding results. It is up to the individual body, psychology etc, not only to the doctor's abilities, which in most cases do not differ.

[Madmax_01]

I always thought, that Guichets fast recovery programm is quite unique. Does Dr Paley also demand good preparation as Guichet and which one would you choose if recovery time is limited?

[Alu]

I always thought, that Guichets fast recovery programm is quite unique. Does Dr Paley also demand good preparation as Guichet and which one would you choose if recovery time is limited?

No he doesn't believe in that too much. That's not to say that preparing won't help, but for Paley it's less important

[YellowSpike]

What I personally really appreciate about Dr. Guichet is that he is VERY conservative. He is not a salesman, but more of a scientist who is very passionate about orthopedic surgery in general.

Whereas many other doctors (including from what I have heard, Dr. Paley, who I still think is an amazing doctor, but out of my price range for tibias - I would go to him for tibias if not for crazy price) will just take your money and tell you what you want to hear, Dr. Guichet is not at all like this. He tells it like it is, all the bad and ugly possibilities that might come with LL, whether you want to hear it or not. I want to do a low amount of lengthening on tibias now, for example, and he keeps telling me not to do tibias because, even for small lengthening amounts, my recovery would be slow.

I still have a lot of research in front of me, but I trust Dr. Guichet, and his opinion is definitely giving me reason for pause.

[LLuser1]

Doctors becoming salesmen are disgusting. They smile and say what patients want to hear (no complications at all, quick recovery...) but then you realize all this is false. Patients don' tell the truth about themselves and other patients because they are scared. Do some research and you will see I'm telling the truth about these patients.

Bad and ugly possibilities are mentioned by Paley too. Guichet is more clear about them though. Yellowspike is right.

[goldenegg]

But I've narrowed down my choices to Guichet and Paley and it does seem like a very difficult decision. Here's another question, ignoring Guichet's pre-op training, is he actually faster at recovery?

I wouldn't read too much into how many months they say it takes until you're recovered and walking again since the largest factor is your consolidation and neither doctor can control this.  Your consolidation rate determines how soon you can walk again and the sooner you can walk the sooner you'll recover.  I was worried about the same thing when deciding because I wanted to return to normal life as fast as possible and read into their estimates too literally.  There are examples of slow consolidation and recoveries in recent diaries for both doctors.

On the margin, recovery with dr. G may be slightly faster because of the weight bearing aspect and heavy focus on post op PT, but that may also be offset with the extra month of pre-op training.  But I believe any difference from those factors is no where near as significant to faster recovery as bone consolidation is.

[ouroboros]

I think that Guichet can be considered a salesman too.   He has his own branded albizzia just like betz.   The purpose behind this is to have full control of the price to avoid competitors from undercutting him.  We do this in my business too to protect our sales margins.  We tell our customers that our brand is the "cat's a$$", and they believe us.

Also, the reason I lost respect for Guichet is because of all the drama with leetchlet.   It was a huge publicity and promotion attempt that went wrong in the worst possible way.   I wonder if leechlet was served with a serious gag order to remain silent and force to delete his youtube channel or face a major law suit.

Lastly, I think that he makes more money from the kickbacks from his personal training centers, being the reason why he insists that it be a prerequisite to his operation.  I wouldn't be surprised if there are more patients that go to him for consultation, sign up for the pre-op training, fail at meeting the so called level of fitness, or simply give up, and never go through with the operation.  This would be a nice steady source of income for not doing much and not having to operate.

I could be wrong about all this, but it seems that in this forum too many people are in a trance thinking that he must be right about everything that comes out of his mouth.  I think Guichet is just trying his hardest to have a "unique" type of LL business in favor of making huge profits from this niche market.

I still think Guichet is a good option because he does get results, just like all the top doctors, but he shouldn't have to resort to all these "guerrilla" marketing techniques to justify such a high price. 

[Deads]

I think that Guichet can be considered a salesman too.   He has his own branded albizzia just like betz.   The purpose behind this is to have full control of the price to avoid competitors from undercutting him.  We do this in my business too to protect our sales margins.  We tell our customers that our brand is the "cat's a$$", and they believe us.

Also, the reason I lost respect for Guichet is because of all the drama with leetchlet.   It was a huge publicity and promotion attempt that went wrong in the worst possible way.   I wonder if leechlet was served with a serious gag order to remain silent and force to delete his youtube channel or face a major law suit.

Lastly, I think that he makes more money from the kickbacks from his personal training centers, being the reason why he insists that it be a prerequisite to his operation.  I wouldn't be surprised if there are more patients that go to him for consultation, sign up for the pre-op training, fail at meeting the so called level of fitness, or simply give up, and never go through with the operation.  This would be a nice steady source of income for not doing much and not having to operate.

I could be wrong about all this, but it seems that in this forum too many people are in a trance thinking that he must be right about everything that comes out of his mouth.  I think Guichet is just trying his hardest to have a "unique" type of LL business in favor of making huge profits from this niche market.

I still think Guichet is a good option because he does get results, just like all the top doctors, but he shouldn't have to resort to all these "guerrilla" marketing techniques to justify such a high price.

I think he's just passionate about what he does.. Yeah, he'd make a ton of money, but he deserves it. He has systematically created a nail that has had huge success due to its capabilities (e.g. Full weight bearing) and has his patients in the best possible condition before they undergo surgery. He doesn't accept anyone that isn't ready to the proper standards and is forthright about his track record and the possible complications.. Someone that adds that much value has obviously taken the time to research the shortcomings of other lengthening methods (e.g. Long lenfthening periods, long periods with no weight bearing, extreme pain due to a lack of preparation.... All the aspects about lengthening that most takes its toll on the patient) and has overcome them.

The best salesman don't need to sell anything. The product and service sells itself and he knows this. So he is a money maker in the best possible way... By adding more value then anyone else in his field.

[Madmax_01]

What is considered as the "leechlet PR-stunt drama" ?

[ouroboros]

I think he's just passionate about what he does.. Yeah, he'd make a ton of money, but he deserves it. He has systematically created a nail that has had huge success due to its capabilities (e.g. Full weight bearing) and has his patients in the best possible condition before they undergo surgery. He doesn't accept anyone that isn't ready to the proper standards and is forthright about his track record and the possible complications.. Someone that adds that much value has obviously taken the time to research the shortcomings of other lengthening methods (e.g. Long lenfthening periods, long periods with no weight bearing, extreme pain due to a lack of preparation.... All the aspects about lengthening that most takes its toll on the patient) and has overcome them.

The best salesman don't need to sell anything. The product and service sells itself and he knows this. So he is a money maker in the best possible way... By adding more value then anyone else in his field.

I want to believe this too.  I'm rooting for someone to come up with an innovative solution to LL.   

There is just something about Guichet that doesn't seem right to me.

[ouroboros]

What is considered as the "leechlet PR-stunt drama" ?

You can read Leechlet's diary in both forums, but unfortunately most of the best information was on his youtube channel that no longer exists.