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[billsmafia]

I'm planning on having this within next few years. My top two are Paley or Dr. A. Paley is first choice but I hav been seeing many interviews with Dr. A where he seems more accessible during the process with time and attention which I think are important factors to approach for this surgery to reduce risk of any possible complication. Paley is the holy grail which is other side of the argument . Cost between both is similar in the States so isn't an issue.

[ChangeMyLife]

This is my honest opinion and not influenced by the fact that Dr. Assayag is on this forum. I am not a patient of either one, and have simply gleaned this from my consultations at both institutions, other patients and online resources.

Obviously Dr. Paley is considered a pioneer in LL so not taking anything away from that.

However Dr. Assayag, in my opinion, comes across as extremely empathetic, down-to-earth and understanding. And his level of expertise (having trained with the best and performed CLL for years) is no joke. Further, he is surrounded by a team of other expert LL surgeons (Dr. Conway, Herzenberg, Standard, McClure) that outnumbers the team at Paley's, and who have your back in case Dr. A is out of town. And for some reason, the fact that ICLL does not advertise/promote this procedure seems to convey that they take this very seriously and know that the right people will find them (versus tempting people to consider this procedure through aggressive marketing).

Dr. Assayag offers the best of both worlds - with his expertise and availability as a surgeon to the patient (all of his patients get his direct cell and he is very responsive). On the contrary, at Paley's, access to doctors seemed dicey when I consulted there (you don't get Paley's line. You only get the cell of some of his PAs and even their availability on weekends is spotty). Remember your legs don't care what day of the week it is.

All this would make me feel much more secure and assured at the hands of Dr. Assayag. Simply put, he feels more human.

[indication]

Dr. Assayag pros:

- very available and friendly
- has a large team of experts with him
- seems very accommodating of patient needs. For example, you can go home and lengthen and he will work it out with you.
- he will himself do the surgery
- slightly cheaper
- you can stay in HP house for cheap and it's right next door to Sinai

Dr. Assayag cons:

- Baltimore is not a good or safe city
- (I write this only because the topic is comparing him to Paley, otherwise I wouldn't even write this as a con) he is way younger than Paley and every day as a surgeon is a learning experience. but he has plenty of training and experience to safely do this procedure now.

Dr. Paley pros:

- possibly the most experienced in this field
- West Palm beach is lovely

Dr. Paley cons:

- slightly more expensive
- he might not do the surgery or follow-up, but Dr. Robbins who will likely do it is also very good
- not very personally reachable although he replies to emails very fast

Lastly I think we should also compare the hospitals: Sinai and St Mary's. Although Sinai is a good American hospital for an elective surgery like this, there are some general complaints I have heard. I don't know anything about St. Mary's.

[ChangeMyLife]

It's worth noting that most patients get surgery at Northwest hospital (vs Sinai), which is more affordable. I do not know how this hospital compares to Sinai.

[indication]

Oh.. thanks for the information

Most hospitals have poor ratings on Google. Even the positive reviews you can't really trust. We should ask the locals or just trust that American regulations are strict and ensure safety and quality. For elective surgeries my hope is that it will be a better experience because you and the staff are all prepared for it.

If anyone finds out anything more about hospitals do please share here

[Movie]

If you're considering them two, I'm assuming you already are open to traveling, curious as to why Paley and Assayag only? have you looked into Mahboubian in LA? I'm not promoting my own doctor with bias, but purely on logic and statistics, not saying Assayag is a bad doctor by any means but check this out ... Mahboubian has a longer track record at least on the forums, I didn't read or hear of Assayag diaries up until late 2019 or so where as Mahboubian has diaries from the old forums (so I hear, haven't seen myself personally) , but there are some here that I've seen dating from 2014-2015 with some digging into ... and also he's the best bang for your buck at 70-75K in terms of price/experience/service. Consider him too.

[DreamsComeTrue]

if I were you, I  will go for  Assayag for one main reason

Both are considered top-notch surgeons, so any of them is a good option at the end of the procedure, but in my own experience, I  was not a patient of any of them, but due to  my poor bone formation,  I contacted both of them for medical advice, Dr. Paley apologized for giving me any advice since I was  not his patient, and sure that's his right, but if he did advised  me he could help to avoid complication and could do so if he wanted  especially I contacted him in the early stage, and two months later I connected dr Assayag and  he was very kind and helpful,  I wished I did contact him early of my complications.

So I will vote for  Assayag,  and I'm sure that You will get direct follow-up from him, and you will be sure that he is the one who will cut your leg not someone else ( under the name of paley ) . Plus, Dr. Assayag is very skiLL Forumulll, and if Dr. Paley is more expert has nothing to do with being more expert if both are skiLL Forumulll, it is enough,   after being capable and skiLL Forumul is just a matter of a number of cases , and age of doctor

NOTE, Paley is one of the most experts in LL Doctor, and this post  is just to show why do I prefer  Dr. Assayag 

[indication]

DreamsComesTrue were you asking for free advice from Paley and Assayag?

And what is "Forumul"?

[DreamsComeTrue]

DreamsComesTrue were you asking for free advice from Paley and Assayag?

And what is "Forumul"?

 "Forumul" is a typo error, each time i try to removed its show up,

I contact both of them, I did not basically asked for a FREE advice,  money was not an issue , I was okay to pay, and Dr, Paley did not advice me coze I'm not his patient, and he did not ask for consulting fee , and money was not an issue for both of us . Dr Assayag I did contacted  him also he gave me full medical report for a free. That's way I think he  is a good doctor to follow up with.

[billsmafia]

If you're considering them two, I'm assuming you already are open to traveling, curious as to why Paley and Assayag only? have you looked into Mahboubian in LA? I'm not promoting my own doctor with bias, but purely on logic and statistics, not saying Assayag is a bad doctor by any means but check this out ... Mahboubian has a longer track record at least on the forums, I didn't read or hear of Assayag diaries up until late 2019 or so where as Mahboubian has diaries from the old forums (so I hear, haven't seen myself personally) , but there are some here that I've seen dating from 2014-2015 with some digging into ... and also he's the best bang for your buck at 70-75K in terms of price/experience/service. Consider him too.

Valid statement. Dr. M is also one of my consideration. I’m going to be doing this solo so accessibility and living space is crucial for me which is a big pro for the HP House in Baltimore. Is Dr. M very accessible and responsive? Would it be difficult to do this solo in LA?

[Movie]

Gotcha yeah a place to stay with others is definitely a plus, but yes I actually met with someone who did it solo here, saw him a couple times and helped him on his day of discharge to get into his house safely, it's doable, but yes it would be difficult, mind you this was with Stryde. so he could at least stand up and with the walker go to the kitchen and cook for himself.

[Activatedxx]

Assayag seems very friendly and knowledgeable and is a very good choice but if same price the question whether to pick him or paley is a no brainer.

Obviously go with the guy who helped create precice/stryde nails development and also the most skilled ortho surgeon on the planet.

[Sambollio]

I’m going to blaspheme. I think at this point there is little reason to go with Paley. There are equally skilled surgeons who charge less, and care more. This is an intense surgery and can be pretty scary, and it’s important for me to feel like my doctor is both skilled and caring, I think Paley only has skill. He has a past of sketchy and very egotistical practices. This includes doing multiple peoples surgery at once, deleting negative reviews, and denying the possibility that a patient had an infection under his care. Dr. Assayag seems to not only be one of the most skilled surgeons but he genuinely seems to care about the LL community. I’d go with him even if he cost as much as Paley.

[6CMFemurs]

I had femurs done by Paley in 2014 and now Assayag will be removing the nails and fixing my tibs.

When I came for my consultation with Dr. A, my insurance policy only covered me in California and imaging would have cost me hundreds of dollars at his hospital. Instead of insisting I pay out of pocket at his hospital, Assayag personally called an Imaging tech 3,000 miles away and instructed him on how to perform the unique type of CT scan he needed to diagnose my condition, so I could get the scan covered by my insurance. Although Paley may be the most experienced in the field, I am choosing Assayag this time because I trust him to advocate for me through this process.

[ChangeMyLife]

I’m going to blaspheme. I think at this point there is little reason to go with Paley. There are equally skilled surgeons who charge less, and care more. This is an intense surgery and can be pretty scary, and it’s important for me to feel like my doctor is both skilled and caring, I think Paley only has skill. He has a past of sketchy and very egotistical practices. This includes doing multiple peoples surgery at once, deleting negative reviews, and denying the possibility that a patient had an infection under his care. Dr. Assayag seems to not only be one of the most skilled surgeons but he genuinely seems to care about the LL community. I’d go with him even if he cost as much as Paley.

I had femurs done by Paley in 2014 and now Assayag will be removing the nails and fixing my tibs.

When I came for my consultation with Dr. A, my insurance policy only covered me in California and imaging would have cost me hundreds of dollars at his hospital. Instead of insisting I pay out of pocket at his hospital, Assayag personally called an Imaging tech 3,000 miles away and instructed him on how to perform the unique type of CT scan he needed to diagnose my condition, so I could get the scan covered by my insurance. Although Paley may be the most experienced in the field, I am choosing Assayag this time because I trust him to advocate for me through this process.

Can't agree with all of this more. At Paley institute you are literally dealing with a faceless entity (their team). Not to mention you are likely not even going to see him for the duration of your time there. While his team may be good, this arrangement doesn't feel very fair to the patient. Dr. Paley may be the best in this field, but what good is a doctor that you will never interact with? I'm paying 100k to have my legs broken and stretched, I damn well deserve full access to my doctor until I can walk out of there. Go for Dr. Assayag!

[ab608]

at the risk of not adding anything new here, want to quickly jump in to also give my vote of confidence in Dr Assayag (how can i not) - he did my femurs in April 2021 and managed the lengthening process so well - was 100% accessible, prompt in responding to my questions/concerns, and really careful to make sure we prevented any complications. he also takes the time to proactively reach out and make sure you're doing okay. i don't have any thoughts on Paley, I'm sure he's also great, but I really wouldn't worry about the process at all if you're going with Dr A.

[Waiting4stryde2.0]

at the risk of not adding anything new here, want to quickly jump in to also give my vote of confidence in Dr Assayag (how can i not) - he did my femurs in April 2021 and managed the lengthening process so well - was 100% accessible, prompt in responding to my questions/concerns, and really careful to make sure we prevented any complications. he also takes the time to proactively reach out and make sure you're doing okay. i don't have any thoughts on Paley, I'm sure he's also great, but I really wouldn't worry about the process at all if you're going with Dr A.

I was going to jump in here and say of course Paley is the GOAT, but from what I've heard Dr. Robbins usually follows up and both of them are busy. so Dr. A might be able to give you more 1 on 1 time if any complications occur

[Atomic]

Does Dr. Paley perform every lengthening surgeries ? Maybe Dr. Robbins performs some surgeries on his own.

[Waiting4stryde2.0]

Does Dr. Paley perform every lengthening surgeries ? Maybe Dr. Robbins performs some surgeries on his own.

From what I heard last from a patient I know, Paley does one leg on every patient while Robbins does the other. The person told me this was somewhat frustrated since he expected to be operated on by they GOAT (Paley), but it was really half and half.

[xianeffect]

I personally would choose Paley because of his history and how many expert surgeons he has taught, but Assayag would probably be great choice too. He works with Dr Herzenberg and if you dig deep into the literature he is very much Paley level, arguably even more.  So I would trust Assayag.

[Bantem]

I had femurs done by Paley in 2014 and now Assayag will be removing the nails and fixing my tibs.

When I came for my consultation with Dr. A, my insurance policy only covered me in California and imaging would have cost me hundreds of dollars at his hospital. Instead of insisting I pay out of pocket at his hospital, Assayag personally called an Imaging tech 3,000 miles away and instructed him on how to perform the unique type of CT scan he needed to diagnose my condition, so I could get the scan covered by my insurance. Although Paley may be the most experienced in the field, I am choosing Assayag this time because I trust him to advocate for me through this process.

You have had your nails in for 7 years?

[Waiting4stryde2.0]

You have had your nails in for 7 years?

curious too ^ precice I assume?

[ask.me]

I'm leaning towards Assayag, with a disclaimer that I hardly looked into either, so my opinion is highly prejudicial.

Paley
Pros

• Probably seen it all because they probably have the highest volume for this surgery
• Invented this device so probably knows all it's flaws the most about it
• Can't teach everything he knows to other doctors

Cons

• Probably too busy to deal with you directly
• Can feel like a salesman, has too much invested/too much to gain in this procedure

Assayag
Pros

• Seems highly empathetic, accessible, and honest
• Likely also has high volume
• Doesn't have as much invested in whether you undergo the procedure or not so has less to lose by being 100% honest
• Likely better outcomes due to higher investment in his patients

Cons

• Might have less volume than Paley
• Did not invent the device, so may not know it as intimately as Paley

[6CMFemurs]

You have had your nails in for 7 years?

Yep, they have been chilling in my thighs for a while now

[alwayslucky]

I'm worried about Dr. Paley's age. Even the most experienced doctor has to worry about whether he will make mistakes when he approaches the age of 70