There is a reason why internal lengthening techniques were developed - the external methods have a high risk of infection and the patient would have the inconvenience of the external apparatus during every waking hour and sleep too. You can't even take a shower without risking infection! Furthermore externals are not good for femur lengthening as we note from Android's experience. Unicorn was very unlucky in choosing Guichet and his dated 'twist and shout' nail.
Rimming through the bone is a much more harder and riskier surgery than puting some nails in an external fixator and it also needs a major surgery to remove it while removing an external fixator is something very easy and without any risk.
Also, deep bone infection with internal nails can be disastrous but most of the times with externals the infections can easily subdue with a few days of common antibiotics (lime augmentin).
LL is a cosmetic procedure and having big scars and fixators for many months is not the best compared to having something invisible inside your bine and minimal scars.
Thats the only reason internals are so common for LL and it is easier for a doctor to put an internal nail than calibrating a hexapod.
But still, internal want 2 major surgeries, is more painful till the end (I was completely painfree in almost all my LL journey, something I never saw in any diary with internals where most patients are full into drugs to bear the pain) while externals are just a bulky and uncomfortable device for many months without any other disadvantage.
Even infection risk is very small if you do have safety measures and still, even if you have an infection it is very easily treatable.
For femurs though, internals is the only way.
For tibias, externals only is by far the safest way. Of course, compared to LON or LATN, internals only is better in everything except price.
And of course, when Insay internals I talk about Stryde. Any other nail is an obsolete joke compared to Stryde.
And no matter what Mahboubian or any other "merchant" like him says, externals are less painful and tsf frames is the most stable compared to anything else, even Stryde.
So his words have not much meaning, because we all know that with internals doctors earn more money with not much effort and they gain extra money for nail removal surgery .
No cosmetic doctors are much more to be trusted in topics like that compared to LL doctors who most of them are unfortunately moneythirsty.