Your wordings maybe a bit too opinionated? There're currently a handful of quad patients at Paley including myself. What risks are you referring to? For sure the first 2-3 weeks after each surgery is quite a hardship. However, all the patients I knew have passed that & came to an OK state for lengthening.
First of all I wish you well and point out my position is obviously of principle, not concretely applicable to every case and surely you are in good technical hands and ready to what's needed to be done and endure.
I'm not a doctor but I have biomedical background and beyond this forum, I have read dozens of doctors' opinions, articles and enquires. I would say that even common sense would suggest that simultaneous quadrilateral is not good practice. It's extremely organically violent for all tissues and organs, catching up between them all, potentially double painful and, I imagine, doesn't facilitate the crucial intensive physiotherapy. Plus it makes any axial correction or other complications more difficult to treat.
Paley is not superman, and certainly not God. He's one of the best in the world technically but also a bit of a mercenary of LL. Just 5 examples: 1) He was directly involved with the "wonderful" Stryde development which apparently was not even tested in animals, 2) His colourful before/after drawing commercials are medically unethical, 3) He denies will ever have any infection cases (very clinical, very scientific, very honest!), 4) He takes advantage of people's despair and charges incredibly inflated prices, 5) He performs LL no matter what the initial height is because he has this twisted convenient opinion, contrary to all psychiatric science and most other serious colleagues, even in 3rd country countries, that height neurosis and body dysphoria are always independent of height and instead equivalent to a patient simple wish/request (capable of paying, of course), the view that only individual opinion counts and no psychological assessment is essential. Therefore he (conveniently) operates for example a 190 cm guy to achieve 195 cm. In my country this would be considered a gross violation of ethical, good medicine practice and Hypocrates precaution principles by the independent medical regulator, and, if some complication arises, he would be taken to court and possibly expelled from medicine practice. "Paley options X" , "Y" and "Z" are sold as diferent seductive, "one for all", packet sedan car models, as "express" fast routes to busy and demanding "clients". He's selling hope for non refundable money and not scientifically based "programs". Basically, despite his technical quality, it's mega *ull *hit . Everybody should at least seek additional advice before embarking in the wonderful LL paradise of Dr. Paley.
Ps-I know there are many good outcomes from Paley despite 100% recovery seems rare. However I cannot avoid pointing out those issues that for me are enough to get not totally emphatic/confident with him, despite having or not the money he requires and not living in the US.