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[athenian1984]

Hello fellow LLers.

I'm currently 5'5, maybe 5'5 and a 1/2, and would like to do the Femur procedure with Dr. Debiparshad. I live in Houston, TX. I was told he's the best Dr for this procedure, unless you guys have any suggestions?

My question is, how common are the complications? I'm afraid of nerve damage. I'm 38 years old, in very good shape/health.

I'm also nervous about only getting 1-2 inches from this surgery, and not the full 3... How common is it that patients only get some of the inches and not all?

Thanks!
Alexander

[DanishViking]

See this: Conclusion - almost everyone get to at least 7 cm.

http://www.limblengtheningforum.com/index.php?topic=65931.0

[KiloKAHN]

I would look up other surgeons in the US before making your decision. There are a number of other doctors here in the states with quite a bit more experience and proven track record than Dr D. 

[GrowGrow123]

Hello fellow LLers.

I'm currently 5'5, maybe 5'5 and a 1/2, and would like to do the Femur procedure with Dr. Debiparshad. I live in Houston, TX. I was told he's the best Dr for this procedure, unless you guys have any suggestions?

My question is, how common are the complications? I'm afraid of nerve damage. I'm 38 years old, in very good shape/health.

I'm also nervous about only getting 1-2 inches from this surgery, and not the full 3... How common is it that patients only get some of the inches and not all?

Thanks!
Alexander

The general consensus is that Dr. Paley in Palm Beach, Florida, is the “best” limb lengthening surgeon. That being said, Paley is considerably more expensive. Really can’t go wrong with any of the main 5 US surgeons though (Paley, Rozbruch, Mahboubian, Assayag, and Debiparshad). Just avoid Turkey, Greece, Russia, India or any other third world clinic no matter how cheap they may be lol.

Most people are able to get the full 3 inches on femurs.

As for complications, Paley has a pretty good summary of them here:

https://paleyinstitute.org/centers-of-excellence/stature-lengthening/complications/#/

[Sambollio]

I’d actually advise going with someone who isn’t just a proficient surgeon but also one that seems like they care about you. Payley is generally considered the best but is he also has a lot of stories about him being an   and having a massive ego. This is surgery has a mentally challenging, and for many people, scary aspect to it. So for me a surgeon who seems to genuinely care who you feel is invested in your well-being along with being skilled is important.

[DanishViking]

GrowGrow123 I don't agree with staying away from Dr. Giotikas in Greece. His basically the best bang for your buck inside Europe, by being the most experienced surgeon compared to the price his offers the surgery for. He even has his own clinic in London as well. There is barely any reliable negative feedback about him on this forum and in generel compared to the rest of surgeons in Europe.

[TheDream]

1 inch I’ve never heard of before.
2 inches is common.

If you lengthen the femur by 2 inches with a doctor in the states then serious complications are very unlikely.

The hard bit will be when you are lengthening. If you lengthen at a rate of 0.75 mm a day, then your two inches would take about (50mm)/(0.75mm/day) = 73.333 days so about two and a half months.

During this time it is advised to remain in the vicinity of the doctor, and to use their personal trainers who assist with stretching the muscles, and maintaining your range of motion.

While lengthening the internal devices (as of today) are not fully weight bearing, so you will have to use crutches while lengthening, and until your new bone has consolidated, in order to not place the full weight on one leg.

A new internal device (precise Max) is rumored to be coming out at the end of 2023 which has better weight bearing properties, but from what I know this is just a rumor, and it could take longer before it comes to use.

After a year or two they will remove the metal rods from the femur, and at this point you are considered fully recovered.

You should expect some permanent reduction in athletic ability afterwards. This is mainly due to the change in center of gravity, and the muscles becoming weaker when lengthened, as far as I know. The less you lengthen and the better the doctor, the less it tends to be. But you should expect not to be able to run and jump as well as you do now. Maybe it is only 5% less from your peak now, maybe 15%. But if this is a deal breaker you should know that going in.

[GrowGrow123]

GrowGrow123 I don't agree with staying away from Dr. Giotikas in Greece. His basically the best bang for your buck inside Europe, by being the most experienced surgeon compared to the price his offers the surgery for. He even has his own clinic in London as well. There is barely any reliable negative feedback about him on this forum and in generel compared to the rest of surgeons in Europe.

Dr. Giotikas does have at least one person who has died from LL. Whether that’s his fault or just bad luck, I don’t know.

The Guichet nail is also somewhat outdated. Just because it’s fully weight bearing does not mean it’s state-of-the-art.

But yes I think Dr. G doesn’t deserve to be placed in the same category as Turkish surgeons. But also not quite on the same level of safety as the upper tier of surgeons either.

[DanishViking]

Well we can agree to disagreeing then. However I believe that your're wrong about the death incident. According to other people on this forum he was a muslim who was fasting, which might have made him more exposed? Also Paley which is the most experienced surgeon in the world has had 3 close death calls with the same complication, which all were smokers but lied about it. He highlighted that in a interview with Cyborg4life, so we don't know whether this one patient were doing something similiar. The EU health agency (don't know the correct term) also investigated the case, and came to the conclusion that DR. Giotikas and his team, couldn't have done anything more than what they did. And almost every surgeon inside EU has at least 1 death out of many thousands cases, which in my opinion is a good track record. One day when it accidently happens in the US, everyone will call this procedure to dangerous and unsafe... So to conclude, please stop spreading misinformation about Greece being a bad choice because it's actually the oppisite.

[athenian1984]

I know it would be better to do the procedure with a doctor within my area , but I’m in Houston TX. Is there anybody in my area who can do this procedure well?

[jlk]

i had mucho nerve damage. it happens. but it also goes away because the repair themselves. takes about 1.5 years till you won't notice

[GrowGrow123]

Well we can agree to disagreeing then. However I believe that your're wrong about the death incident. According to other people on this forum he was a muslim who was fasting, which might have made him more exposed? Also Paley which is the most experienced surgeon in the world has had 3 close death calls with the same complication, which all were smokers but lied about it. He highlighted that in a interview with Cyborg4life, so we don't know whether this one patient were doing something similiar. The EU health agency (don't know the correct term) also investigated the case, and came to the conclusion that DR. Giotikas and his team, couldn't have done anything more than what they did. And almost every surgeon inside EU has at least 1 death out of many thousands cases, which in my opinion is a good track record. One day when it accidently happens in the US, everyone will call this procedure to dangerous and unsafe... So to conclude, please stop spreading misinformation about Greece being a bad choice because it's actually the oppisite.

Yes and Paley saved all three. No deaths. A great surgeon can handle complications when they inevitably arise. That’s a big part of what makes them great. If I tell you there are two clinics you can go to for surgery, one has a recorded death and the other does not, which one would you pick?

Also, in regards to the nail:

“He sought a fully implantable lengthening solution.
When the Albizzia femoral nail, developed by Guichet and Grammont, became available, he worked with the French company that made that nail to develop a tibial lengthening Albizzia for stature lengthening. He started using the femoral and tibial Albizzia in 1996.
The severe pain experienced by patients from the 15° rotation of the thigh through the break in the bone, as well as several implant failures, lead him to stop using this non-FDA approved device. This device is still being used in Europe under the name Guichet nail and Betz-Bone. While they have modified this nail to a small extent, it is still the original Albizzia nail that Dr.
Paley abandoned in the 1990's. There are much better devices now and the use of this older nail should be abandoned.”

There’s a reason these nails aren’t used in the US and why Precice is favored over them.

Again, I’m not saying Dr. G is terrible, but I’d say he’s clearly a tier below any of the big 5 US surgeons who do this. If money isn’t a factor, I would not go to Dr. G. If it is a factor, then he’s a reasonable choice at the price point I guess.

[DanishViking]

We seem to agree more than what I just thought. Your're right there is better options than him, but that of course come with an significant cost.

Personally I think both nails suck. Precice is likely to break if you a handful of times forget that you aren't allowed to walk without assistance. And with G-nail many patients experience different issues with: stopping early, more pain or troubling clicking. But at least your're not forced to a walker 24/7 and don't have to fear the nail breaking because of this.

Precice Max will most likely fix all these issues, and that's why I think waiting just a couple of months more is worth it!

[Marie_Bard]

imo  you are wrong to underestimate Giotikas and gnails for the following reasons:
1.Giotikas is  licenced to be working in the UK  for 12 years now. UK has the toughest regulations of all countries, including the US, about doctors practice . They even have repeated revalidations of all medical licences every 5 years!
2.With the exception of Paley (and maybe Rozbruch), Giotikas does more cases than Depiparshad, Mahboubian and Assyag and with more variable methods, like Gnail, LATN, Precise etc so he has wider experience.
3.Giotikas regularly treats complications fromTurkey and Germany. Complications are always harder to treat (and probably less profitable for the doctor) than the first surgery. Again with the exception of Paley and Rozbruch, I haven’t heard the other US doctors treating other doctor’s complications!
4.The embolism death happened almost 2 months after the surgery and it cannot even be directly related to it. Even so, they managed to save the patient on the day of the incident. Paley has had 3 cases of serious embolism (didn't know that to be honest!), probably because he does more cases!

5.G-nail has been used for 30 years without bone problems and it is  approved in the UK, if you don’t trust EU (see again my point 1 above about the strict regulations in the UK. Precise nails are still forbidden in the UK after the Stryde problem, pending further investigations!!)
6.In the absence of a more advanced weight bearing nail, how can you say gnail is outdated? The "sophisticated" FDA-approved Stryde failed with 2 years! (It was actually Giotikas and some other British and Danish doctors who first raised the flags about the problem). Pain was indeed a problem initially but anaesthetics has improved since the 90's and lengthening is not so painful anymore, if you speak with Giotikas’s patients you will be surprised.
7.Giotikas has lower pricing because he simply doesn’t care so much about the money imo. He comes from a rich family and has a strong view  that “medical treatments should be affordable to the many”.

[jerrytheman]

I had my femur surgery done with Dr. D in March 2023. Feel free to ask my Questions if you have. Surgery-wise for femur, he's just as good as any surgeons like Paley. I mean how many other Limb Lengthening surgeons are Harvard trained and specializes in Spine Orthopedics. He has one of the best resumes.

Communication with the employees at his clinics can be improved.

[GrowGrow123]

imo  you are wrong to underestimate Giotikas and gnails for the following reasons:
…

1) I don’t know that there is any way to quantify which country has the “toughest” regulations. What we do know is that the US has the best healthcare in the world (accessibility is of course a separate issue lol).

2) This isn’t a good metric by itself. The Turkish surgeons do way more limb lengthening surgeries than anyone else and they are still terrible.

3) Yes this is true that Giotikas has fixed bad jobs by Turkish surgeons especially but that’s mostly due to the proximity of Turkey to Greece. All the US doctors can do the same (but for way more money). Would also like to mention Dr. Gdalevitch in Canada as another great limb lengthening surgeon that should be considered before Giotikas. She’s on par with the US doctors in terms of quality, imo. She trained under Paley I believe.

4) it still happened. Probably just bad luck, imo. But the point still stands that no death has occurred under US surgeons.

5) if it’s not approved in the US, there’s a reason for it.

6) this is my point. The non-fully-weight bearing Precice nail is more advanced than the G-Nail. One shouldn’t trade safety for convenience. The LON device used by Turkish surgeons is also weight bearing, but you shouldn’t do that unless it’s financially not possible otherwise.

7) No, his pricing is lower because he’s based in a poor country. His costs would be much higher if he operated out of Beverly Hills, California, for example.