IntroductionHey everyone, I'm doing femur lengthening with Dr. Assayag. I have gone back and forth on starting a diary but would have appreciated some more diaries from precise patients when I was doing research on the procedure (I read basically every patient experience I could find!!) so I think I will start one. Also it will be nice to have a record of this time in my life in the future. I stole the formatting for this post from a previous diary so thank you "belowthemean" and I hope it is ok I have borrowed your formatting!
I am doing staged femur lengthening with precise nails. I had my first surgery a few weeks ago and my second surgery last week. I'll make another post after my intro post about how things have been so far.
Basic StatsDemographics: late 20s, female, USA
Starting Height: 153 cm (5'0.25")
Wingspan: not sure
Lengthening Goal: 5-8 cm
Starting weight: 102.8 lb going into first surgery, 100.2 lb going into second surgery (a bit higher with shoes/clothing on)
Starting Inseam: not sure
Staring Tibia-to-Femur Ratio: not sure
Starting Height and Lengthening GoalI was 5'0.25 at my pre op appointment so I'm going to go with that for my starting height. My starting goal is/was 8 cm but I have planned from the beginning to get to 5 cm and then re-evaluate periodically from there.
Physical ShapeI would say I went into the surgery in decent shape. I had had a very difficult and busy month at work up until 24 hours prior to my initial surgery so was exhausted going into things. My upper body strength is probably above average for my age/gender but my flexibility is significantly below average. I did a decent amount of stretching pre op (about an hour a day for 3 months) but not sure if it helped at all.
SportsNone currently. I do a lot of biking and play tennis casually with friends. I played tennis competitively throughout my childhood through high school. Before COVID I would go skiing as much as I could but I haven't had the chance recently.
FlexibilitySee above
Health StatusI think I'm reasonably healthy. I have a well-controlled chronic illness that may have some impact on my recovery but we will see. My pre-op labs were all normal.
My BackstoryI have known about cosmetic limb lengthening since the age of 12 and I have been determined to get the surgery since age 16. I can try to explain why. I was born at a significantly smaller size than would be expected for a normal full-term pregnancy (the medical term is SGA) and never caught up as one would expect throughout my childhood. I would say my height bothered me from as early as age 4-5 when people started commenting that my younger brother towered over me. My parents were offered growth hormone treatment but told best case scenario I would be 2-3 inches taller after 10+ years of daily shots at a cost of $100k an inch. I was a reasonably mature kid and made the decision multiple times with my parents to defer growth hormone treatment. I would make a different decision now but the data on the use of growth hormone for this indication just wasn't available 10-20 years ago when we made this decision. Anyway, from age 5 I would think about my height very frequently, multiple times a day. I was never bullied (I can't actually recall a peer ever making a negative comment about my height until I was an adult), always had a really great group of friends in school, did well in school, played sports, and got to travel around the world as a kid. But I thought about my height many many times a day. So fast forward to the age of 12, I would read old medical school textbooks for fun and came across the ilizarov method. I did some research online and decided that that was what I was going to do. My plan at the time was to do the surgery after my first year of college. I would actually say as a child my parents were probably more distressed by my height than I was so I knew they would be supportive if I could find a way to do this safely. I started talking to them about it after watching a grey's anatomy episode with them about a patient who got limb lengthening and had complications. I was in high school and about 4'8 at the time and decided that I would do the surgery if I was not 5'2 once fully grown (my predicted height based on my parents would be 5'6). Fast forward a few more years and I start college at around 5'. I strongly considered surgery at Hospital for Special Surgery during the summer after my first year of college. I was incredibly fortunate that my parents were willing/able to pay for the surgery. However, I ended up with plans for the summer and life just happened and I didn't do the surgery. Life went on, more school, then work and I really haven't had any block of time off since high school until now. So this seemed like the right time since I would like to have it completed prior to marriage/pregnancies. I know this is a long-winded explanation (will this website even allow me to post something this long?) but I think it is important for people to know where I am coming from. I can't think of any objective or tangible benefits I will get from the surgery (my career is on a pretty defined path, I have an amazing partner and my height never had any impact on dating for me anyway, I don't think I will be treated any differently by people if I'm 2-3 inches taller, I wouldn't say I lack confidence or that this surgery will give me more confidence or higher self esteem). But my goal is just to make height something I don't have to think about anymore.
Who Knows About ThisMy partner and a total of 3 friends. Plus my parents. Everyone else knows I had an elective orthopedic procedure but nothing else. I'm not going to lie if anyone asks me directly but I may say I don't want to talk about it if someone asks and not actually confirm to anyone I did this.
Cost of the ProcedurePrices are pretty similar to what is on Dr. Assayag's website. My parents were/are happy to pay for the procedure but it was important for me to pay for it myself even though I am incredibly grateful for their support (and they are my "emergency fund" if mine runs out).
How I’m PayingDue to COVID we had the opportunity to pick up extra shifts at work. I worked about 30 extra shifts (16-24 hours each) over 18 months to cover the cost of surgery and an emergency fund. I already work 80-100+ hours a week so it was ridiculously hard work but for whatever crazy reason it was important for me to cover the cost myself. Dr. Assayag ended up being a significant cost savings over the initial hospital I planned on so who knows what I will do with the extra $.
Time Off WorkI work in healthcare. We are entitled to 3 weeks of vacation a year and 1-2 months of research time (which can be done remotely these days) a year. I never got to take any of that time off since 2019 because of COVID staffing issues. Technically until now I haven't had more than maybe the occasional 3 day weekend off since fall 2019. So I was able to cluster a 5 month block with no clinical obligations but the opportunity to pick up shifts or cover clinic if I feel up to it. I still have frequent meetings and constant emails but I can mostly work from home and attend meetings via zoom.
Why Dr. Assayag?Like most prospective patients I did a significant amount of research into all cosmetic limb lengthening surgeons in the US but really ended up choosing based on gut instinct. My perspective on this is that all the surgeons in the US performing cosmetic limb lengthening are probably equally capable of implanting the nail and getting you safely through the initial surgery. My priorities when choosing a surgeon were:
1. A surgeon who does not mainly do cosmetic procedures.
2. A surgeon who works at an institution with a track record for limb lengthening.
3. A surgeon willing to set limits with me and not bend the rules/protocols too much. I wanted to do bilateral femurs as an outpatient procedure and avoid a hospital admission and Dr. Assayag was the first surgeon to flat out say he was uncomfortable with that which confirmed to me I had made the right decision even if it wasn't the answer I wanted to hear.
4. I also had a bunch of things about ICU capabilities, anesthesiologist vs CRNA etc.
So I made a very extensive spreadsheet with all the above details. I was leaning towards a different institution but saw some youtube videos with Dr. Assayag. So I decided to speak to him and it just seemed like the best fit for me. So that is how I ended up in baltimore even though technically it didn't win on my spreadsheet. As of now, I feel very confident I made the right decision.
Next StepsIf you made it this far I'm impressed! I'll summarize my experience thus far in the next few posts. I will likely bypass recapping the first surgery since it was a very easy recovery, but things have gotten more challenging (but still not too bad!!) with the second surgery for sure!