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[LLSouthAmerica]

Hi everyone! I am a 22 year old medical student from South America, and I will be traveling to Milan on January 25th for the pre-op training with Dr. Guichet. I am starting this thread to contact any LimbLengthener currently in Milan, and also to answer any question you may have regarding the procedure or the post-op management. Please excuse my English! Good luck for everyone who has decided to embark on this journey. Stay safe.

[Alu]

Cool congrats. Anything you'd be willing to share about yourself? How was it getting into contact with Guichet and figuring out LL?

[Robespierre]

First tell us about which bone will you length, how much,if the fixador is internal or external! Thank you for sharing these informations

[The Kaiser]

First tell us about which bone will you length, how much,if the fixador is internal or external! Thank you for sharing these informations

I am sure he's going for femur with Guichet

Whats your initial height?

How much does the surgery cost in US$?

How many cm you want to achieve?

[LLSouthAmerica]

Internal femurs. Starting height 166 cm. Goal: what my body can handle, realistically 7-8 cm. For the surgery you have to pay in 2 different bank accounts: 28000 euros (nail implants) 31000 GBP (surgery itself). You can do the math. Pre-op exams, medications, cardiac and dentist consultation are not included.

About getting in contact with Dr Guichet, it is very variable. The first time I wrote to him, I had to wait about 1 month for the response. (Dr Guichet said he had no secretary at the time). Then he always responded the following day. Now that almost all is planned (appointments in Milan, documents ,etc), the only thing I do not know is when the initial consultation will be. I wrote to him last week, but no answer yet. Does anyone know a way to reach Dr. Guichet other than his email?

[AnotherLevel]

How is your flexibility, can you palm the floor with your legs straight?

When do you plan to have your surgery?

Why did you choose Milan over London, especially as you speak English?

Good luck, I appreciate you taking the time to write to us.

[fivesix]

Maybe its because he's from South America and he's better with Spanish?

[LLSouthAmerica]

Maybe its because he's from South America and he's better with Spanish?

Actually, I'm pretty sure they speak Italian in Italy 

I can touch the floor with my legs straight (not the whole palm). My flexibility is average at best. After 30 days of pre-op training, I believe the surgery will take place late February or early March. London is overall a more expensive city, but the main reason is that I have a place to stay in Milan (distant relative) at least for a couple months. I speak a little Italian, at least enough to survive everyday life.

[helloworld]

Have you ever thought about LL Barcelona, Spain with Dr. Alejandro Monegal?
Total cost are here are around 36,000 euro total everything covered, which is almost half of what you pay.
And you get treated by one of the best surgeons in LL in the world (according to Wittenstein company),
and fitbone implant seems to be every bit as good if not better than Precise, Betz bone or Guichet nail.
Also, if you stay at recovery residence, you will be with other patients (including me) and can use the gym and pool right in the building and have 24 hours support from caretakers.

Only drawback: you will probably not improve your Italian that much.

[LLSouthAmerica]

Aren't there many reports and diaries about fitbone malfunctioning? While I would've preferred a "cheaper" lengthening, it is a surgery with many risks, some of them permanent. I am not interested in being a pro athlete, but functionality is my number 1 priority. That being said, Paley and Guichet are living legends in the lengthening business. They have developed the procedure throughout the years, especially Paley who is very active in the scientific community (https://www.ncbi.nlm.nih.gov/pubmed/27892743). There are plenty good doctors out there, but for this procedure, I want the best I can get.

You are lucky you get a gym and pool, and support from caretakers and fellow limb lengtheners! Post-op period is most important. Dr Guichet is also really stern about physical condition and training.

[Col92]

Hi,

Does Dr Guichet use the same internal device as Dr Paley, the Precise 2. Dr Paley is just so expensive as to make it unrealistic. Any suggestions from everyone on other well thought of doctors that use the Precise 2?

[Auron]

Hi,

Does Dr Guichet use the same internal device as Dr Paley, the Precise 2. Dr Paley is just so expensive as to make it unrealistic. Any suggestions from everyone on other well thought of doctors that use the Precise 2?

No, Dr. Guichet uses the albizia nail which he calls the gnail and drives a porsche. Wait....did I get it wrong?

[TIBIKE200]

You cant say that the fitbone is as good, better or worse than the precice or any other nail for that matter without showing scientific articles supporting your claims...

Precice and fitbone sure are a step ahead of the albizzia and external frames (when lengthening the femurs) simply because they are much more modern.. Which one of the two is better, I searched over the web but couldnt find any comparable research done on the two.. What I did find was that the precice is far more used around the world than the fitbone though.

[Mtall]

Actually, I'm pretty sure they speak Italian in Italy 

I can touch the floor with my legs straight (not the whole palm). My flexibility is average at best.

Exactly, so how much can you touch the floor, with your legs straight?

[LLSouthAmerica]

Dr Guichet uses an improved version of the Albizzia nail. Dr. Paley uses Precise 2, but he is not the only one. You can find many doctors who also have experience using Precise 2 and are much cheaper (although not as good as Dr. Paley I imagine). He is more expensive than Dr. Guichet. 

"Precice and fitbone sure are a step ahead of the albizzia": I am not quite sure. Guichet claims his nail is full weight bearing but whether that is true remains to be seen (I'll tell you in one month!). However, I know for a fact (searched in Pubmed), all the articles about Precise 2 specify that it is only partial weight bearing. The Precise 2 has the most amount of research done among the new nails I believe and is FDA approved (better than Fitbone).

What I like about the Gnail is that I am allowed to walk and therefore notice if there is something wrong along the way, and immediately stop if that is the case.

[TIBIKE200]

Dr Guichet uses an improved version of the Albizzia nail. Dr. Paley uses Precise 2, but he is not the only one. You can find many doctors who also have experience using Precise 2 and are much cheaper (although not as good as Dr. Paley I imagine). He is more expensive than Dr. Guichet. 

"Precice and fitbone sure are a step ahead of the albizzia": I am not quite sure. Guichet claims his nail is full weight bearing but whether that is true remains to be seen (I'll tell you in one month!). However, I know for a fact (searched in Pubmed), all the articles about Precise 2 specify that it is only partial weight bearing. The Precise 2 has the most amount of research done among the new nails I believe and is FDA approved (better than Fitbone).

What I like about the Gnail is that I am allowed to walk and therefore notice if there is something wrong along the way, and immediately stop if that is the case.

I dont care what guichet claims. Neither what Paley or any other doc claims... I only look into scientific articles and paper. Guichet uses the Albizzia (there is nothing wrong with this fact btw) which is an old intramodullary nail.. His weight is more weightbaring because it is made from cobalt chrome (I think that's the material) unlike the precice or fitbone. The fact that he calls it Gnail instead of "more robust version of the albizzia" doesnt change the fact that it is still an albizzia nail. It can't go backwards (which is crucial in case of soft tissue limitations such as muscle spasm or extreme loss of range of motion, and also in case of joint contractures and subluxation) and also uses a "traumatic" way to lengthen (the clicking mechanism).. There is a reason (in my opinion) why the albizzia is no longer being used in any modern hospital in well developped countries.

[LLSouthAmerica]

I dont care what guichet claims. Neither what Paley or any other doc claims... I only look into scientific articles and paper. Guichet uses the Albizzia (there is nothing wrong with this fact btw) which is an old intramodullary nail.. His weight is more weightbaring because it is made from cobalt chrome (I think that's the material) unlike the precice or fitbone. The fact that he calls it Gnail instead of "more robust version of the albizzia" doesnt change the fact that it is still an albizzia nail. It can't go backwards (which is crucial in case of soft tissue limitations such as muscle spasm or extreme loss of range of motion, and also in case of joint contractures and subluxation) and also uses a "traumatic" way to lengthen (the clicking mechanism).. There is a reason (in my opinion) why the albizzia is no longer being used in any modern hospital in well developped countries.

You should be wiser than to only look at scientific articles (many papers about LL I've read have methodological errors). There is not plenty of evidence about the Guichet Nail and since he is the only one who uses it, there may be a publication bias. I have read many cases of Precise patients who have a seemingly complication free lengthening ( no infections, minimal stiffness). However, when they start walking, they notice duck ass and ballerina feet. I agree with you that the "backwards" function of the Precise is a definite advantage. Nonetheless, since I will be in control of my lengthening and evaluate myself continuously from post op day 1 , I hope to notice before such soft tissue limitations take place and stop immediately if that is the case.

[helloworld]

Guichet is a living legend indeed and Guichet nail was one of the first.
But look at the picture on his website: http://www.leg-limb-stature-lengthening-taller-height-increase-cosmetic.eu/us/technology%20comparison%20with%20other%20internal%20lengthening%20nails.php
Baumgart was co-inventor. But he wanted to develop something better and therefore went to a German precision manufacturer to come develop the Fitbone, which by now has been around for like 10 years and has a very low failure rate:


About Monegal: he is less experienced than Guichet as he is in his early 40s. But I know he does more than 365 operations per year and has teams regularly come over to learn from him.
Do you really need 10,000 operations to be become the best?

In summary, I would say Dr. Guichet is like an iPhone 1, Dr. Monegal is like an iPhone 7 and additionally less expensive, which made the choice very easy for me.

[assa13ssin]

why do you think fitbone is superior to the Guichet nail? Is there full weight bearing with the fitbone? when can you walk without crutches during LL?

[helloworld]

About weight bearing as far as what I have read and heard there is not much difference between Precise, Betz, Guichet, Fitbone. The difference is how cautious they recommend you to be.

In terms of the superiority of Fitbone, I heared a long explanation, why Dr. Monegal, though being able to earn more with Precise, preferred Fitbone. However, best if you talk to the doctors themselves. Monegal and Guichet seem to be respond quite quickly.

[Auron]

why do you think fitbone is superior to the Guichet nail? Is there full weight bearing with the fitbone? when can you walk without crutches during LL?

Is there full weight bearing with the Guichet's albizzia nail? He does claim so but all I've read through the diaries is that people would rather use the wheelchair to move around bcuz they can't tolerate the pain while walking. Also, while every fitbone user breezes past the clicking phase, Guichet's patients sound like they're being tortured to death. Monegals patients can walk unaided between 2 weeks to 1 month after the lengthning phase, depending on bone regeneration.

Im also a bit concerned about Takanori and Unicorn888 because they suddenly stopped updating their diaries.

I do think that precise and fitbone are one step ahead of Guichet's albizzia nail because his nail is simply outdated.

[LLSouthAmerica]

I believe there is a bit too much propaganda about Dr. Monegal in the forum. The Fitbone is only partial weight bearing. Why would anyone choose Fitbone over Precise (FDA approved , much more research done)? I've read many cases about Fitbone malfunctioning, patients requiring multiple surgeries, etc. For Precise and GNail you only need 2.

About the difference in surgical skill, the learning curve is about numbers. Of course Dr. Paley and Dr. Guichet are better than Dr. Monegal. In my humble opinion, Dr Paley is a "extra safe" Iphone 7 , Dr. Guichet is a "weight-bearing , sportive" Iphone 7 and Dr. Monegal is that Chinese smart phone which in many cases is as successful as the others, but it's just not the same.

[Auron]

I believe there is a bit too much propaganda about Dr. Monegal in the forum. The Fitbone is only partial weight bearing. Why would anyone choose Fitbone over Precise (FDA approved , much more research done)? I've read many cases about Fitbone malfunctioning, patients requiring multiple surgeries, etc. For Precise and GNail you only need 2.

About the difference in surgical skill, the learning curve is about numbers. Of course Dr. Paley and Dr. Guichet are better than Dr. Monegal. In my humble opinion, Dr Paley is a "extra safe" Iphone 7 , Dr. Guichet is a "weight-bearing , sportive" Iphone 7 and Dr. Monegal is that Chinese smart phone which in many cases is as successful as the others, but it's just not the same.

I don't know who you're trying to fool but their have been Precise and Gnail patients who required multiple surgeries as well. While I agree that precise is a good nail, Gnail can only be a stone age iphone 7.

[LLSouthAmerica]

As I said, the main advantage of the Gnail is the weightbearing, but we can agree to disagree on that one. However, it is a fact that it is more likely that a Fitbone user requires more surgeries and the nail malfunctions more than the Precise.

[Auron]

As I said, the main advantage of the Gnail is the weightbearing, but we can agree to disagree on that one. However, it is a fact that it is more likely that a Fitbone user requires more surgeries and the nail malfunctions more than the Precise.

Btw and even though we haven't had many precise diaries lately, I'd like to point out that the latest precise diary that we have in this forum reported a malfunction with 1 nail.

[LLSouthAmerica]

Btw and even though we haven't had many precise diaries lately, I'd like to point out that the latest precise diary that we have in this forum reported a malfunction with 1 nail.

Of course I did not say Precise is infallible, merely that it is a safer bet than Fitbone. Also, I didn't say Dr. Monegal is a bad doctor, I merely highlighted that Dr. Guichet and Dr. Paley are much more experienced. In any case, this is a diary not a discussion board for a brand of nail or other. Neither is it a competition board among LL doctors. I will be having limb lengthening with Dr. Guichet and I intend to be 100% truthful about surgery and post op recovery.

[Auron]

Of course I did not say Precise is infallible, merely that it is a safer bet than Fitbone. Also, I didn't say Dr. Monegal is a bad doctor, I merely highlighted that Dr. Guichet and Dr. Paley are much more experienced. In any case, this is a diary not a discussion board for a brand of nail or other. Neither is it a competition board among LL doctors. I will be having limb lengthening with Dr. Guichet and I intend to be 100% truthful about surgery and post op recovery.

I didn't even notice it was a diary until now lmao.

Good luck with your LL journey, stay safe.

[goldenegg]

lol at all the marketing for dr monegal

hey LLsouthamerica- not a current LLer, but I also did the operation with dr guichet in milan back in 2015 so feel free to message me if you ever need any advice

since you're doing the pre op training, I'd recommend not only training hard for that month, but also to see the sights and enjoy any other touristy things too while you can.  it was so much harder to do those things after the surgery. best of luck!

[TIBIKE200]

 funny how its only monegal's patients who praise him that much in an almost childish fashion... This and the fact there isnt a single monegal's diary on old forum adds alot of suspition.... I will not even talk about cooper's case and MM's hiding the fact she was not ok for months...

Tell monegal to stop sending you guys for marketing... Its just sad

[Lubak]

funny how its only monegal's patients who praise him that much in an almost childish fashion... This and the fact there isnt a single monegal's diary on old forum adds alot of suspition.... I will not even talk about cooper's case and MM's hiding the fact she was not ok for months...

Tell monegal to stop sending you guys for marketing... Its just sad

Exactly! I can honestly say I would not have surgery with Dr. Monegal even if someone else way paying for it. The horrible results of Cooper & Musicmaker are just the tip of the iceberg when it comes to Dr. Monegal. As with icebergs the majority of it is underneath the waterline where you can't see it. For every disaster like Cooper & Musicmaker there are likely 4-5 other patients we will never know about who are ruined for life.

[Auron]

funny how its only monegal's patients who praise him that much in an almost childish fashion... This and the fact there isnt a single monegal's diary on old forum adds alot of suspition.... I will not even talk about cooper's case and MM's hiding the fact she was not ok for months...

Tell monegal to stop sending you guys for marketing... Its just sad

If you're talking about me let me tell you that in 1 post you have mentioned Monegal's name more than I've done in this entire thread and I only mentioned his name to answer a question.