Print

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

[yyes]

Hey guys,

I have finally decided that I want to go through with this procedure at the end of this year.
The question is, who should I go to and what method should I use?

Honestly, I am thinking of Dr Birkholtz, Dr Catagni, and Dr Pili. Im a little more nervous about Guichet.

My biggest concern as many of you know are issues such as amputation, death, non union, and permanently walking with a limp.

However, recently other concerns that Dr Catagni and Dr Pili brought about were the fact that they say that femur lengthening is not good aesthetically. They say you should only do Tibias . But then again, if I do tibias with Internals, I run the risk of permanent knee pain. But if I do externals, I would have to not work for almost a year in order to recover.

I am only looking to lengthen 52 mm which is exactly 2 inches.

But now more than ever I am confused.

In an ideal world, I would want to be out for 4 months come back to the states and work since I work in an office environment. But at the same time, I want aesthetics to look good and I want to have most of my athletic ability back as well.

Here is what I have as far as different methods

Internal femurs Pros:
Will be able to recover the fastest

Cons:
Possible fat embolism
Aesthetically speaking, it will look bad having long femurs but short tibias

External Tibias Pros:
Least risky procedure as far as long term consequences go
Aesthetically pleasing

Cons:
Long recovery time
Wont be able to work in frames
Pin site infection posibility

LON/LATN Pros:
Longer time than Precise but shorter time than externals
Can go back to work after frame removals.
Aesthetically pleasing tibias.

Cons:
Risk of permanent knee pain

So I guess I need your guys advice on how to proceed.

[TIBIKE200]

Aesthetically, it depends on the initial ratio between the two. normal ratio is 56/44 (or even 58/42 if I remember correctly) all the way to 52/48. Now, post op problem with tibial LL (especially big lengthening) might be that you won't be able to wear shoes which are not flat due to an already high knee post tibia LL.

 My guess is that docs like Catagni say this because he is truly a master of tibia LL (considered almost a god among CLL and those who do LL for non cosmetic purposes) while docs like rozbruch and Paley say exactly the opposite for the same reason.

 In the end, having a starting height of 5'8, 2 inches in either part will not cause any real visible disporoportion..

[682]

Hey guys,

I have finally decided that I want to go through with this procedure at the end of this year.
The question is, who should I go to and what method should I use?

Honestly, I am thinking of Dr Birkholtz, Dr Catagni, and Dr Pili. Im a little more nervous about Guichet.

Dr Franz Birkholtz.

My biggest concern as many of you know are issues such as amputation, death, non union, and permanently walking with a limp.


Amputation? Highly unlikely. Death? Highly Unlikely. Non-union? Unlikely but dependent on circumstances. Limp? Likely at the beginning, if soft tissue is damaged, equinus contracture occurs, misalignment. If done to a good standard, unlikely to be permanent.

However, recently other concerns that Dr Catagni and Dr Pili brought about were the fact that they say that femur lengthening is not good aesthetically. They say you should only do Tibias . But then again, if I do tibias with Internals, I run the risk of permanent knee pain. But if I do externals, I would have to not work for almost a year in order to recover.


This makes no sense. If someone has long tibias and lengthens them it will look worse than if they had lengthened their femur - proportions are important but the general rule is longer femurs look more natural in my opinion, I have seen some horrendous tibial lengthening on the 'other' forum. Neither look bad 'aesthetically' if not done excessively with proportions as a guide.

I am only looking to lengthen 52 mm which is exactly 2 inches.


Femurs will recover better.

But now more than ever I am confused.

In an ideal world, I would want to be out for 4 months come back to the states and work since I work in an office environment. But at the same time, I want aesthetics to look good and I want to have most of my athletic ability back as well.


Athletic loss is part of the deal, generally, femurs are easier to recover from.

Here is what I have as far as different methods

Internal femurs Pros:
Will be able to recover the fastest

Cons:
Possible fat embolism
Aesthetically speaking, it will look bad having long femurs but short tibias

External Tibias Pros:
Least risky procedure as far as long term consequences go
Aesthetically pleasing

Cons:
Long recovery time
Wont be able to work in frames
Pin site infection posibility


LON/LATN Pros:
Longer time than Precise but shorter time than externals
Can go back to work after frame removals.
Aesthetically pleasing tibias.

Cons:
Risk of permanent knee pain


This is a personal decision and based on a multitude of factors. Which are you leaning towards?

So I guess I need your guys advice on how to proceed.

[yyes]

Honestly before I spoke to Catagni and Pili I was leaning towards internal fémurs.

They do internal fémurs as well so they said they would respect my wishes.

I've been impressed with Birkholtz. He always responds and seems genuine. But at the same time I hear Catagni I's amazing so who wouldn't want to get precise done with him?

Price wise for internals Catagni and Birkholtz are roughly the same.

[yyes]

Aesthetically, it depends on the initial ratio between the two. normal ratio is 56/44 (or even 58/42 if I remember correctly) all the way to 52/48. Now, post op problem with tibial LL (especially big lengthening) might be that you won't be able to wear shoes which are not flat due to an already high knee post tibia LL.

 My guess is that docs like Catagni say this because he is truly a master of tibia LL (considered almost a god among CLL and those who do LL for non cosmetic purposes) while docs like rozbruch and Paley say exactly the opposite for the same reason.

 In the end, having a starting height of 5'8, 2 inches in either part will not cause any real visible disporoportion..

OK good to know. Lately though just to be fair,

I've been hearing a lot of people with issues as far as post op complications. The Guichet patient that hasn't grown any bone. That's freaking scary. I don't know why that happened to her. Is it because she lengthened to much? Or is it because she didn't walk on it?

Will bone ever grow again or has the body stopped trying? So many questions.

I work for the state and the state offers great insurance. If the state can cover hospital expenses I might just go with Rozbruch

[TIBIKE200]

You should ask those questions a specialist in LL. You should go to google, and search "ASAMI NORTH AMERICA". Go to the list of docs of your state in the US and contact one of them to know everything. Go even to a consultation (pay for it I mean) just to get as much info as you can from a doc who does this kind of stuff for people who suffer medical conditions so he wouldn't be biased towards promoting it

[6FeetSoon]

You should ask those questions a specialist in LL. You should go to google, and search "ASAMI NORTH AMERICA". Go to the list of docs of your state in the US and contact one of them to know everything. Go even to a consultation (pay for it I mean) just to get as much info as you can from a doc who does this kind of stuff for people who suffer medical conditions so he wouldn't be biased towards promoting it

That's the key. I'd much rather go to a doctor whose practice is 90% deformity correction and 10% cosmetic LL, than a doc who's mostly cosmetic. The cosmetic docs need you more than you need them and are inclined to say what is necessary to get you to do it. The other physicians who do mostly corrective surgery don't need you and in fact, you have to convince them why they should take on your case.

[Body Builder]

Yves why Monegal isn't in your options?

Also, I don't think that Catagni does internal femur, I think that only his student, Pili, does.
But his prices for precise 2 are about 55.000 euro which is too much imo compared to about 38.000 euro of Monegal (with fitbone) or to about 42.000 euro of Birkholz (and precise 2 too).

Guichet will never be a choice for me due to his ridiculous price, his old nail, his weird and not caring character and (the most important) his many bad outcomes.

[yyes]

Yves why Monegal isn't in your options?

Also, I don't think that Catagni does internal femur, I think that only his student, Pili, does.
But his prices for precise 2 are about 55.000 euro which is too much imo compared to about 38.000 euro of Monegal (with fitbone) or to about 42.000 euro of Birkholz (and precise 2 too).

Guichet will never be a choice for me due to his ridiculous price, his old nail, his weird and not caring character and (the most important) his many bad outcomes.

Monegal was one of my options but there's a user on this forum that made me worry about going to monegal.

Also I agree with 6feetsoon. Birkholtz deals with trauma on a regular basis and has only done 10 patients using precise. But most of his cases come from accidents. That gives me some peace of mind.

[Body Builder]

Monegal has one bad case with one woman and another one that we don't know exactly what happened (cooper) but Guichet has bad cases too with the most recent being Unicorn who has a diary here.

Also, all the patients of Monegal except fro m Cooper write good things about his personality while for Guichet, even patients with good outcomes doesn't write good things about his character.

I don't know if Monegal is a so good doctor as his patients say but I think that you should go for a consultation with him before your final decision.
Birkholz seems to be a professional doctor with sensible prices but s. Africa is too far for me.

Anyway, my opinion is to go to at least 3-4 doctors before you take your final decision.
I'm very curious about Pili however. He has a very good price for externals compared to other respectable doctors but his price for internals is expensive. I hope his price for precise 2 was about 10.000 euros less and I'd consider him as a very good choice.

[onemorefoot]

Body, who would you recommend for external/ Lon tibias?

[Body Builder]

Body, who would you recommend for external/ Lon tibias?

Catagni would have been my first choice, although I completely disagree with him for doing achilles tendon lengthening. He is a very experienced doctor and has done hundreds of tibial lengthenings and most of the times not for cosmetic reasons.
He is a truly capable doctor and I believe his student, Pili, is capable to so I'd easily trust them for tibia LL.

Also, for tibias I'd prefer externals only, not LON. If you lengthen reasonably (about 6cm) you'll have the frames for 9-10 months and you are completely done, with no need for further surgeries to remove the nail some years after or possible knee pains due to nail etc.

Imo the best option for tibias is external only with good frames like taylor spatial and for femurs internals only with a good nail like precise or fitbone.

[yyes]

Catagni would have been my first choice, although I completely disagree with him for doing achilles tendon lengthening. He is a very experienced doctor and has done hundreds of tibial lengthenings and most of the times not for cosmetic reasons.
He is a truly capable doctor and I believe his student, Pili, is capable to so I'd easily trust them for tibia LL.

Also, for tibias I'd prefer externals only, not LON. If you lengthen reasonably (about 6cm) you'll have the frames for 9-10 months and you are completely done, with no need for further surgeries to remove the nail some years after or possible knee pains due to nail etc.

Imo the best option for tibias is external only with good frames like taylor spatial and for femurs internals only with a good nail like precise or fitbone.

Those 10 months are too long though. Unless you have alot of funds and don't care about losing job or seeing friends and family.

What do you say to someone if they ask did you get taller?

[onemorefoot]

Also, in my case I will be in university in those years, what would you recommend.

[fivetenneeded2016]

Hey guys,

I have finally decided that I want to go through with this procedure at the end of this year.
The question is, who should I go to and what method should I use?

Honestly, I am thinking of Dr Birkholtz, Dr Catagni, and Dr Pili. Im a little more nervous about Guichet.

My biggest concern as many of you know are issues such as amputation, death, non union, and permanently walking with a limp.

However, recently other concerns that Dr Catagni and Dr Pili brought about were the fact that they say that femur lengthening is not good aesthetically. They say you should only do Tibias . But then again, if I do tibias with Internals, I run the risk of permanent knee pain. But if I do externals, I would have to not work for almost a year in order to recover.

I am only looking to lengthen 52 mm which is exactly 2 inches.

But now more than ever I am confused.

In an ideal world, I would want to be out for 4 months come back to the states and work since I work in an office environment. But at the same time, I want aesthetics to look good and I want to have most of my athletic ability back as well.

Here is what I have as far as different methods

Internal femurs Pros:
Will be able to recover the fastest

Cons:
Possible fat embolism
Aesthetically speaking, it will look bad having long femurs but short tibias

External Tibias Pros:
Least risky procedure as far as long term consequences go
Aesthetically pleasing

Cons:
Long recovery time
Wont be able to work in frames
Pin site infection posibility

LON/LATN Pros:
Longer time than Precise but shorter time than externals
Can go back to work after frame removals.
Aesthetically pleasing tibias.

Cons:
Risk of permanent knee pain

So I guess I need your guys advice on how to proceed.

Hi, i dont mean to hijack his thread, but any idea if catagni does external tibias with LON/LATN? Also any idea on how much length people shrink by on an average with his externals?

I read lumiere shrunk around 1.5-2cm.

[The Kaiser]

External Tibias Pros:
Least risky procedure as far as long term consequences go
Aesthetically pleasing

just lol. Tibia is more risky because you have to cut two bones, then who's this doctor that favor tibia among femur!!, Man if you have a good budget go to Guichet, Paley or Rozbruch trust me. Faster walking unaided Guichet, Most experienced Paley and best external is Rozbruch. your choice, Good luck

[yyes]

External Tibias Pros:
Least risky procedure as far as long term consequences go
Aesthetically pleasing

just lol. Tibia is more risky because you have to cut two bones, then who's this doctor that favor tibia among femur!!, Man if you have a good budget go to Guichet, Paley or Rozbruch trust me. Faster walking unaided Guichet, Most experienced Paley and best external is Rozbruch. your choice, Good luck

That's what Catagni said as far as better aesthetics.

Why Guichet and not Birkholtz?

[YourSpaceBoyfriend]

That's what Catagni said as far as better aesthetics.

Why Guichet and not Birkholtz?

Because kaiser is a guichet fanboy, nothing new here.

Go birkholtz for femurs or catagni for tibias.

I would never go to monegal since he prefers to use fitbone for CLL without any weight bearing which is an absolute joke if you are considering breaking both of your legs.

[Bander72]

That's what Catagni said as far as better aesthetics.

Why Guichet and not Birkholtz?

There's a reason why Paley charges more for tibia and recommends to do femurs first. Even in external there is more risk with tibia. If it was not so painful and produced horrible scars more doctors would do externals on the femur.

[Jack1066]

Incidentally, are there any threads that post photos of scars on this forum?

[yyes]

There's a reason why Paley charges more for tibia and recommends to do femurs first. Even in external there is more risk with tibia. If it was not so painful and produced horrible scars more doctors would do externals on the femur.

More risk for what though? Athletic ability, death, tendon issues,?

What exactly would more risk entail?

[Body Builder]

Those 10 months are too long though. Unless you have alot of funds and don't care about losing job or seeing friends and family.

What do you say to someone if they ask did you get taller?

Even if you do Lon, you should have the frames for about 5 months and then you won't be able to do all the things you used to with your kegs like running, jumping, dancing etc cuase of the risk of nail bending.
Furthermore, with Lon you need another one (not so minor) surgery to put out the nail about 2 years after you stopped lengthening.

Imo, if you have time and patience, external only in tibias with good fixators is always better than external with LON.
If I turned back time I'd again do external only but this time with Ilizarov and not monorails. The second is more convenient but with Ilizarov you can walk as it is weight bearing and this decreases the risks of muscle atrophy and ballerina foot.
I haven't walked at all for more than 5 months when I had monorails and I am maybe lucky that my leg muscles are somewhat back to normal.

To people, I told that I had a bike accident and thats why I wore external fixators.
The height is something that almost all saw but hardly anyone mentioned to me and after some times they comoletely forgot about that and I think they thought that it was just because they have to see me for a long time due to my "accident" and nothing changed in my height.

I don't know what they thought to be honest.
But when I'll do my second LL then I don't think I can hide the new height. I will never admit that I did anything like LL but I'm sure that many people would understand that something has changed.
Anyway, I don't really care for the others, I just want to be relatively tall and hut 5.11. Thats only matters for me.

@ yourspaceboyfriend: if you prefer Birkholz or any other doctor who uses precise 2 from monegal who uses fitbone because this nail is not weight bearing, you would be dissapointed to read that precise 2 is not weight bearing too.
So do a better research before writing things that you don't know. You have many posts here so your knowledge about LL should be better than thinking that fitbone is not weight bearable while precise 2 is.
The only weight bearing nails are the obsolete guichetnail and betzbone, no else, at least for now.

[YourSpaceBoyfriend]

@ yourspaceboyfriend: if you prefer Birkholz or any other doctor who uses precise 2 from monegal who uses fitbone because this nail is not weight bearing, you would be dissapointed to read that precise 2 is not weight bearing too.
So do a better research before writing things that you don't know. You have many posts here so your knowledge about LL should be better than thinking that fitbone is not weight bearable while precise 2 is.
The only weight bearing nails are the obsolete guichetnail and betzbone, no else, at least for now.

Precise 2 is partially weightbearing. 150lbs in total.

Because kaiser is a guichet fanboy, nothing new here.

Go birkholtz for femurs or catagni for tibias.

I would never go to monegal since he prefers to use fitbone for CLL without any weight bearing which is an absolute joke if you are considering breaking both of your legs.

I would never go to monegal since he prefers to use fitbone for CLL without any weight bearing which is an absolute joke if you are considering breaking both of your legs.

any

learn to read. Fitbone has barely any weight bearing(something around 10-15kgs as i remember?) so ye almost nothing.

[Body Builder]

Fitbone can handle about 22kg.
 
If each precise 2 nail could hold 150lb (about 70kg) then it could have considered a fully weight bearable nail.
But in every precise 2 patient's diary I read they haven't walked at all until they finished lengthening.
That proves with the most obvious way that precise 2 is not a fully weight bearing nail and patients can't walk durong lengthening so there is not any real difference compared to fitbone.

[YourSpaceBoyfriend]

people cannot fully weigthbear. They van load 15 kg straight away after surgery

And i said 150lbs in total.

I personally weight around 140lbs so at least i wouldn't worry that much about piece of metal snaping inside my legs.

[Ozymandias]

I am convinced that the weight-bearing "limits" of internal nails -at least if we are talking about precice and fitbone- depend much more on the "cautiousness" of the manufacturer than on the real physical limits of the nail.

Every fitbone patient I talked to said they have stood unaided while lengthening, even those who did bilateral. Obviously, you can not walk unaided (although some patients who did two-stage procedures have took some steps towards the end of the lengthening phase) but a non-faulty nail will not bend/break if you simply apply half of your weight on it.

The Fitbone can sustain weight *far greater* than it says. The German engineers specifically minimize the guaranteed weight in writing because they wish to avoid users doing absurdities like jumping and running—one dipcrap went alpine skiing like one month post-procedure in the past and bent them. Apparently, the metal nails themselves pose no threat, but rather the screws can loosen in their holes a little.

I can walk and stand and I feel strong—but no matter who you are, if you do bi-femural with Dr. Monegal you will be relegated to a wheelchair for at least a month simply on principle of safety. And the wheelchair becomes second nature within a day.

*inb4 the samefagging troll pops in to say he has seen millions of broken fitbones, very bad cases, etc*

[notimportant]

You deluded troll. Some nails broke down. Musixmaker's leg snapped in half. Paco's nail was bent and leg got deformed. Other guy got his nail broken and bent. Many people had loose screws. Many nails stopped working. You can ask. It's true.

[jbc]

At your starting height, my suggestion, FWIW, is internal femurs. As far as the docs you listed, Dr. Birkholtz, hands down. As I said in another thread, if time zone were not a factor, Dr. Birkholtz would be my first choice.

Best of luck!!

[yyes]

At your starting height, my suggestion, FWIW, is internal femurs. As far as the docs you listed, Dr. Birkholtz, hands down. As I said in another thread, if time zone were not a factor, Dr. Birkholtz would be my first choice.

Best of luck!!

Thank you jbc. I was thinking that as well. Hopefully I get really lucky and end up avoiding complications that many on here end up getting.

In fact, it seems that just about everyone on here has gotten complications :/

[TheLichKing]

why not also consider Parihar for Internals? And yes, go for internal femurs first since they allow you to gain a greater height of 1-2 cm than tibia lengthening and are less invasive plus recovery is better. Both Parihar and Birkholtz are great choices for femur lengthening.

[yyes]

why not also consider Parihar for Internals? And yes, go for internal femurs first since they allow you to gain a greater height of 1-2 cm than tibia lengthening and are less invasive plus recovery is better. Both Parihar and Birkholtz are great choices for femur lengthening.

They both are talked about positively here. However, I don't know of any patients that have gone to them. Actually for parihar yes but Birkholtz I couldn't find any diaries :/