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.