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Dr. Mangal Parihar
From : https://sites.google.com/site/cllrpatients/faqs/cosmeticlengthening
Costs :
900,000 Indian Ruppes for the procedure
2,201,000 Indian Ruppes for the Precice 2 nails
Total Costs : 3,101,000 Indian Ruppes or 41,500 United Stated Dollar (Exchange rate, October 2021)

Dr. Dimitrios Giotikas
From : https://www.athensbjr.com/cost-pricing-of-cosmetic-limb-lengthening/
Costs :
40,310 EUR Femoral lengthening with Precise 2
47,000 USD Femoral lengthening with Precise 2 (Exchange rate, October 2021)
42,400 EUR Tibia lengthening with Precise 2
49,500 USD Tibia lengthening with Precise 2 (Exchange rate, October 2021)

Hi,

I am currently saving up money for CLL (Precise 2).  I am at 40,000 USD and I am hoping to have this operation around August 2022.  By then, I should have around 65,000 USD.  I also have 6,000 in credit card if needed.  I can't decide between Dr. Parihar or Dr. Giotikas for this operation.  I would like to have operation done around August 2022 because I am currently working from home until July 2023.  If I get this operation around August 2022, I have about 11 months of recovery time before heading back to the office.  Since Precise 2 is a non-weight bearing nail, I would need to recover first before going back to the office for work.

Height : 165 CM
Wingspan : 166 CM
Leg Reach : 88 CM
How to measure leg reach : https://howtheyplay.com/individual-sports/UFC-Fighters-With-The-Craziest-Leg-Reaches

I am thinking about lengthening my tibia by 4 CM because when Stryde or Stryde like comes back to the market, I have the option to add 5 CM to my femoral.  My wingspan isn't high enough to allows me to lengthen more. 

I need help deciding which doctor to go to.  I never been outside of the United States before.  Which country is better for CLL.  Thank you!

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[tripleogkush]

4cm? bro, keep your money. 170cm wont do much. You need 1,75cm+ to be in the normal range.

[Upgrade]

Yes sir, only 4 CM.  Lengthening the tiba by 4 CM allows me to have a better and faster recovery and I still have room for femoral lengthening in the future (if Stryde comes back) without looking funny with a wingspan of 166 CM. 
 
Money isn't the issue, the timing of the operation is.  I need to do this operation and have a decent recovery before going back to work.  I won't able to have this opportunity again in the future.

I don't really care about my height as much as I care about my leg length.  My leg inseam is about 27.5 inches, which is about 70 CM.  Super short legs, bro!

I just need help picking the doctor.

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[Arcon]

Just speak to both doctors and see whom you feel you can trust more.

[Thehighest]

Both are good docs, I think you can save money if you go to dr Parihar.

[Upgrade]

Just speak to both doctors and see whom you feel you can trust more.

I will do that.

I just need some help on deciding which country is easier for me to get CLL in.  I will be by myself in a different country with broken legs.  The more I know, the more I can prepare myself for CLL in India or Greece.
Any advice would be appreciated!

[V21]

You can do G Nail in Greece if you want to do femurs, as it's weightbearing too. I'm currently a patient here and soon will fly home. If you want to do tibia though... I think I'd just do externals rather than Precice. I can tell you from experience that walking is key for fast recovery.

[Arcon]

I will do that.

I just need some help on deciding which country is easier for me to get CLL in.  I will be by myself in a different country with broken legs.  The more I know, the more I can prepare myself for CLL in India or Greece.
Any advice would be appreciated!

I believe Greece, being in EU and Schengen area,  is a more regulated country compared to India. They must comply with relevant EU directives and standards so it may be closer to Western standards and more predictable in what to expect in a hospital, airport or when trading in a store for example.

[Upgrade]

You can do G Nail in Greece if you want to do femurs, as it's weightbearing too. I'm currently a patient here and soon will fly home. If you want to do tibia though... I think I'd just do externals rather than Precice. I can tell you from experience that walking is key for fast recovery.

I would consider doing externals, such as LATN or LON, but the scars are pretty bad. LATN and LON require three surgeries.  Lengthening with Precise only requires two surgeries.

[xianeffect]

Parihar > Giotikas

Parihar is more internationally recognized and has over 10 years more experience. India also has way more population and Parihar probably has thousands more deformity and injury cases under his belt. This is perfect for the cosmetic lengthening because there is no complications that Parihar has not seen. I am not convinced Giotikas is as great as some try to paint him especially because he is fine with using outdated internal nail that cannot reverse distraction and gives accidental clicks. Greece is not even at Western Europe standards either so you could go to the more experienced doctor in Parihar and then if you have extra money you can stay in the nice Mumbai hotels that all the traveling international people go to.

[V21]

Parihar > Giotikas

Parihar is more internationally recognized and has over 10 years more experience. India also has way more population and Parihar probably has thousands more deformity and injury cases under his belt. This is perfect for the cosmetic lengthening because there is no complications that Parihar has not seen. I am not convinced Giotikas is as great as some try to paint him especially because he is fine with using outdated internal nail that cannot reverse distraction and gives accidental clicks. Greece is not even at Western Europe standards either so you could go to the more experienced doctor in Parihar and then if you have extra money you can stay in the nice Mumbai hotels that all the traveling international people go to.

Saying G nail is outdated is stupid when it is the only internail nail that currently allows full weight bearing. It was outdated when Stryde was available, but it's not anymore. How can it be outdated then? I don't say the nail is perfect, and I've had lots of pain with it, but I walk since day one, whereas with Precice I would have been on a wheelchair. Concerns about accidental clicks are idiotic too, as no one has had bad issues with that here.

Look, I know very little about Parihar and I don't know if he is better or not than Giotikas. I don't like Greece either. But saying tht mechanical nails are outdated when they are the only weighbearing options for femurs... just stupid. Nuvasive circle jerk lol

[indication]

Saying G nail is outdated is stupid when it is the only internail nail that currently allows full weight bearing. It was outdated when Stryde was available, but it's not anymore. How can it be outdated then? I don't say the nail is perfect, and I've had lots of pain with it, but I walk since day one, whereas with Precice I would have been on a wheelchair. Concerns about accidental clicks are idiotic too, as no one has had bad issues with that here.

Look, I know very little about Parihar and I don't know if he is better or not than Giotikas. I don't like Greece either. But saying tht mechanical nails are outdated when they are the only weighbearing options for femurs... just stupid. Nuvasive circle jerk lol

My observations about G nail:

- No research studies published like there are many with Precice and Stryde. Can you check peer reviewed studies showing the rate of complications with Gnail? You just have to ask the doctors and believe what they say
- No way to reverse the nail
- most surgeons use fat G nails. Like why did Giotikas use the thickest rod for you? It makes no difference because you can weight bear on the thinner G nail also.
- No latency period before lengthening. That is correct Ilizarov way of doing it which most surgeons follow world wide except with G nail.

With stryde problems were quickly caught because it's used by hundreds of surgeons worldwide. It was actually detected first by a surgeon in UK. Volume of G nail cases is so low and only 2 surgeons use it.

Many patients do get great results with G nail (some of the best actually) but I think my overall skepticism is valid.


Future patients need to ask:

- How many g nails have been used world wide till date? Its 12.000+ for Precice
- How many doctors use g nail in its 15+ years of existence
- Does NHS support the use of g nail?
- Are there are any published research papers about it?

[Arcon]

I think, G-nail is approved for use in the UK.

[indication]

I think, G-nail is approved for use in the UK.

NHS uses it? That would be a stamp of credibility.

[V21]

My observations about G nail:

- No research studies published like there are many with Precice and Stryde. Can you check peer reviewed studies showing the rate of complications with Gnail? You just have to ask the doctors and believe what they say
- No way to reverse the nail
- most surgeons use fat G nails. Like why did Giotikas use the thickest rod for you? It makes no difference because you can weight bear on the thinner G nail also.
- No latency period before lengthening. That is correct Ilizarov way of doing it which most surgeons follow world wide except with G nail.

With stryde problems were quickly caught because it's used by hundreds of surgeons worldwide. It was actually detected first by a surgeon in UK. Volume of G nail cases is so low and only 2 surgeons use it.

Many patients do get great results with G nail (some of the best actually) but I think my overall skepticism is valid.


Future patients need to ask:

- How many g nails have been used world wide till date? Its 12.000+ for Precice
- How many doctors use g nail in its 15+ years of existence
- Does NHS support the use of g nail?
- Are there are any published research papers about it?

Those concerns are perfectly valid. That's exactly why I hesitated a lot between G Nail and Precice. In fact, that's the reason I have been really paranoid about bending or breaking the nail, as I did not know how trustworthy it is. However, I do think it's stupid to call mechanical nails "outdated" or "crap", specially when you can find in the last year lots of Betz diaries with Stryde-like results.

People just seem to love Nuvasive ignoring the Stryde debacle and their continuous lies regarding Precice coming back in Europe. Hell, they I got an email from them saying it would come back "much earlier than September": first they said July, then August, then September... I will finish lenghtening in 5 days, and if had chosen Precice I would be having surgery now lol.

Again, I'm not a G nail apologist, and it's perfectly possible I still get some complication (besides the pain). I just think people are being biased regarding mechanical nails, and there are lots of prejudice.

[zaozari]

4cm? bro, keep your money. 170cm wont do much. You need 1,75cm+ to be in the normal range.

With 170 cm or even 169 cm he will be in the "normal" range, whatever you mean by your "normal". He will be within 1 Standard deviation from the average in the US (176 cm).
Standard deviation is 7,47.
If you want to be taller it's ok, but don't say incorrectly that people are in an ABnormal "range".