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Author Topic: Why aren't doctors in the US doing lon anymore?  (Read 1424 times)

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Beemer m3

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Why aren't doctors in the US doing lon anymore?
« on: November 01, 2020, 06:35:24 AM »

Why aren't doctors in the US doing lon anymore? If it would be done it would probably cost around 40k. The usa have gone to advance technology and pushing out the people from doing  ll. 75k is a whole tesla! Damn!
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exceeding2meters

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Re: Why aren't doctors in the US doing lon anymore?
« Reply #1 on: November 01, 2020, 07:53:44 AM »

I think you can do it with Donghoon for less than 40k
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marathonrunner

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Re: Why aren't doctors in the US doing lon anymore?
« Reply #2 on: November 01, 2020, 09:41:43 AM »

In the us, 75k is at the low end lol. And yea you can do it with Lee for less than 40k but high chance of some ugly permanent scars though as you have external rods running through your leg, so expect the skin to tear and skin healing to the tendons after removal etc.
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Skyisthelimit

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Re: Why aren't doctors in the US doing lon anymore?
« Reply #3 on: November 01, 2020, 10:58:35 AM »

I would take the LON method with permanent scars and all, over the 40k+ extra I would need for internals any day lol. With less than 5k I’ll get treatment for the scars and save myself 35k+. Personally I never cared much about scars, much less the ones on the legs. Already got many, so these might make a nice addition. But I can understand why some people would prefer not to have them. It all comes down to personal preference. The price difference on the other hand is a no-no for me. Triple, in some cases more than triple, the price of surgery for some comfort and less scars is ridiculous.
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Michael J. Assayag, MD

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Re: Why aren't doctors in the US doing lon anymore?
« Reply #4 on: November 01, 2020, 01:29:03 PM »

In baltimore we still do LON of the tibia.

Dr. Herzenberg and I had a discussion about offering LON femur, But the complication rate is quite high. to tell you the truth Herzenberg would be in favour of us still offering LoN femur !

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marathonrunner

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Re: Why aren't doctors in the US doing lon anymore?
« Reply #5 on: November 02, 2020, 02:53:27 PM »

I would take the LON method with permanent scars and all, over the 40k+ extra I would need for internals any day lol. With less than 5k I’ll get treatment for the scars and save myself 35k+. Personally I never cared much about scars, much less the ones on the legs. Already got many, so these might make a nice addition. But I can understand why some people would prefer not to have them. It all comes down to personal preference. The price difference on the other hand is a no-no for me. Triple, in some cases more than triple, the price of surgery for some comfort and less scars is ridiculous.

Check Giotakis, seems a lot of people are going there. His price is around 47k EUR? I forgot. But its probably more in the range you're looking for. And its Stryde not LON. But yea if you want to add to your scar collection then by all means. Personally I didn't have any scars until the surgery and the scars stand out quite a lot so personally I didn't like it.
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KiloKAHN

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Re: Why aren't doctors in the US doing lon anymore?
« Reply #6 on: November 02, 2020, 06:10:18 PM »

I would take the LON method with permanent scars and all, over the 40k+ extra I would need for internals any day lol. With less than 5k I’ll get treatment for the scars and save myself 35k+. Personally I never cared much about scars, much less the ones on the legs. Already got many, so these might make a nice addition. But I can understand why some people would prefer not to have them. It all comes down to personal preference. The price difference on the other hand is a no-no for me. Triple, in some cases more than triple, the price of surgery for some comfort and less scars is ridiculous.

The scarring could also have a functional impact though, like permanently reducing the range of motion in your knees. This is what my surgeon said about it in his Q & A thread:

"In the case of femoral lengthening, a longer lengthening may be possible, because it's surrounded by muscle (unlike the tibia where there are less muscles and more tendons - comparatively speaking). Having said that, external lengthening on the femur tends to cause more problems with muscle scarring and consequent stiffness, compared to the tibia, precisely because the femur is surrounded by muscle. So what one gains in length, one may lose in terms of function. This is the primary reason why most surgeons would not do external femoral lengthening for CLL."

http://www.limblengtheningforum.com/index.php?topic=2783.0
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Initial height: 164 cm / ~5'5" (Surgery on 6/25/2014)
Current height: 170 cm / 5'7" (Frames removed 6/29/2015)
External Tibia lengthening performed by Dr Mangal Parihar in Mumbai, India.
My Cosmetic Leg Lengthening Experience

Body Builder

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Re: Why aren't doctors in the US doing lon anymore?
« Reply #7 on: November 03, 2020, 02:08:22 AM »

No respectable doctor does externals (even LON or LATN) on femurs.
It is completely barbaric, it leads to major problems (like Kilokahn said) and generally, externals are only for tibias, where they are the best choice.a
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F_99

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Re: Why aren't doctors in the US doing lon anymore?
« Reply #8 on: November 04, 2020, 11:15:07 AM »

75k is a whole tesla! Damn!

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tallwolf

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Dr. Parihar
« Reply #9 on: November 06, 2020, 05:49:19 AM »

The scarring could also have a functional impact though, like permanently reducing the range of motion in your knees. This is what my surgeon said about it in his Q & A thread:

"In the case of femoral lengthening, a longer lengthening may be possible, because it's surrounded by muscle (unlike the tibia where there are less muscles and more tendons - comparatively speaking). Having said that, external lengthening on the femur tends to cause more problems with muscle scarring and consequent stiffness, compared to the tibia, precisely because the femur is surrounded by muscle. So what one gains in length, one may lose in terms of function. This is the primary reason why most surgeons would not do external femoral lengthening for CLL."

http://www.limblengtheningforum.com/index.php?topic=2783.0

Man I love Dr. Parihar's writing. So clear and so much attention to detail. Also hard to believe he is from Inda going by his English alone. I went through that thread you linked and it sounds like he really knows this stuff.

I wish he did more CLL tbh. It instills fear that he doesn't do as much CLL as other doctors. For this reason alone I tend to feel more comfortable with Dr. M or Dr. D here. I am an Indian  working in the west coast of the US and consider going back to India to get Stryde femurs done with Dr. Parihar or here with Dr. D or Dr. M. Both Dr. M and Dr. D are relatively inexperienced but their marketing is too seductive and makes it feel safe. Dr. Parihar's lack of interest in CLL makes me feel scared that the procedure is "dangerous".

Also being the first to do Stryde in India is a little scary. How does India with a population of 1.4 billion not have enough rich and short people to want to Stryde LL in the 2 years the nail has been around? Privileged Indian people tend to migrate to western countries and being shorter than average, it must feel more necessary to do this. I for example felt almost average when I lived in India but my first vacation to Europe in my early 20s made me feel so short.

I'm not sure why there is such a lack of interest in India given the obsession towards the west + Instagram culture among the privileged youth.
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KiloKAHN

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Re: Dr. Parihar
« Reply #10 on: November 07, 2020, 03:58:35 AM »

He spent a lot of time in both England and the US, and when I spoke to him I could definitely pick up on the British-English, like when he'd refer to a random guy as a "chap". I was fortunate that his English was so good because I ran into far fewer in Mumbai that could understand English compared to New Delhi.

Although he hasn't used the Stryde version of Precice yet (as far as I'm aware), he's had three cosmetic femur patients with the first generation of Precice and two tibial Precice patients being treated for a leg length discrepancy.

If you saw some of the cases he was treating when I was there, like car accident patients, bomb injury patients, deformities, etc, you'd think that lengthening for a cosmetic case would comparatively be a piece of cake. I've asked him why he has so few cosmetic patients despite his years of practice, and according to him it's a mixture of 1) not his primary interest 2) cosmetic patients are the most demanding sub-group of patients because they're going from perfectly functional to temporarily handicapped and therefore tolerate the frames and such worse than deformity/injury patients, 3) issues of cost (for internals), 4) being located in Mumbai, India isn't the most appealing for international patients who can afford the procedure, 5) his criteria is more strict than many patients are okay with (lengthen no more than 6 cm with CLL on tibia, requirement of informing a contact what you're doing and giving Dr Parihar a way to reach that person, and agree to remain in Mumbai during the distraction phase).

There are a lot of Indians interested in the procedure, but from what I'm seeing they go to the ones who advertise. Seemingly, most of those doctors are located in New Delhi.

Man I love Dr. Parihar's writing. So clear and so much attention to detail. Also hard to believe he is from Inda going by his English alone. I went through that thread you linked and it sounds like he really knows this stuff.

I wish he did more CLL tbh. It instills fear that he doesn't do as much CLL as other doctors. For this reason alone I tend to feel more comfortable with Dr. M or Dr. D here. I am an Indian  working in the west coast of the US and consider going back to India to get Stryde femurs done with Dr. Parihar or here with Dr. D or Dr. M. Both Dr. M and Dr. D are relatively inexperienced but their marketing is too seductive and makes it feel safe. Dr. Parihar's lack of interest in CLL makes me feel scared that the procedure is "dangerous".

Also being the first to do Stryde in India is a little scary. How does India with a population of 1.4 billion not have enough rich and short people to want to Stryde LL in the 2 years the nail has been around? Privileged Indian people tend to migrate to western countries and being shorter than average, it must feel more necessary to do this. I for example felt almost average when I lived in India but my first vacation to Europe in my early 20s made me feel so short.

I'm not sure why there is such a lack of interest in India given the obsession towards the west + Instagram culture among the privileged youth.
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Initial height: 164 cm / ~5'5" (Surgery on 6/25/2014)
Current height: 170 cm / 5'7" (Frames removed 6/29/2015)
External Tibia lengthening performed by Dr Mangal Parihar in Mumbai, India.
My Cosmetic Leg Lengthening Experience

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Re: Why aren't doctors in the US doing lon anymore?
« Reply #11 on: June 10, 2021, 08:49:58 AM »

In baltimore we still do LON of the tibia.

Dr. Herzenberg and I had a discussion about offering LON femur, But the complication rate is quite high. to tell you the truth Herzenberg would be in favour of us still offering LoN femur !
How much is it for lon of tibia?i want 5~6cm on tibia. Do you use monorail racks or circular racks? Can I return to California for the extension during the extended period after surgery?
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