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[patientprivacy]

Can you get permanent vascular and circulatory problems after LL? I have read that, in this sense, calf and ankle liposuction is riskier than thigh liposuction for anatomical reasons. Would you say the same about tibial lengthening (as opposed to femur lengthening)?

[myloginacc]

Sadly, we would need to have access to a study that followed CLL patients into their old age, and compare their rates of vascular problems vs the average population of their same background. I do not know about the existence of any such study.

I e-mailed one CLL doctor about this particular question (vascular risks) once, since we are indeed stretching blood vessels along the soft tissue, but he told me the main concern/risk was mostly just nerve damage. I'd still take that with a grain of salt, not because of the doctor or his answer in particular, but because of the lack of long-term studies.

In terms of anecdotal evidence rather than empirical research, we have users like Chistopherbulder who seem fine even a decade later. He had not any kind of blood cots, strokes or a myocardial infarction.

[myloginacc]

Then, at 6cm, Dr Mahboubian advised me once again to stop because it could narrow my veins and I had blood clots.

Some information, apparently straight from a doctor, from fallen774's diary. I know there were other people besides myself worried with the stretching of blood vessels, and not just the soft tissues.

[fokid]

in dogs it was observed that blood vessels stay the same after lengthening https://www.ncbi.nlm.nih.gov/pubmed/10573344

observations in dogs cannot be applied to humans, but it might be indicative.

also lengthening is physiologically a lot like natural growth, only a lot faster.

[Johnson1111]

in dogs it was observed that blood vessels stay the same after lengthening https://www.ncbi.nlm.nih.gov/pubmed/10573344

observations in dogs cannot be applied to humans, but it might be indicative.

also lengthening is physiologically a lot like natural growth, only a lot faster.

Exactly and at something like 2 inches I do not see how it could be so taxing as to be life threatening in that area.

Then once your bones consolidate that is you and it is natural. I think what matters more is making sure one doesn’t lengthen too fast at more than 1mm a day

[myloginacc]

Yes. Lots of kids undergo DO to correct limb length discrepancies, and they are doing fine today - otherwise we'd have found some study about a higher prevalence or incidence of vascular problems in that group, during their adulthood years.

However, limb length discrepancy correction generally involves much smaller amounts lengthened than most cosmetic patients. In children and teenagers, their body hasn't stopped growing yet, so they might adapt to any stretching of vessels better too.

Anyway, thanks for the link, Fokid. Interesting to find research on that.

[fokid]

In children and teenagers, their body hasn't stopped growing yet, so they might adapt to any stretching of vessels better too.

isn't stoppage of growth a bone thing? growth plates fusion is the reason why people stop growing.

[myloginacc]

isn't stoppage of growth a bone thing? growth plates fusion is the reason why people stop growing.

Yes, the closure of epiphyseal plates (epiphyseal closure, or growth plate fusion) is what causes bones to stop growing permanently. However, there are still a lot of other processes going on inside a growing adolescent's body that aren't comparable to that of fully grown adults.

I'll see about e-mailing other doctors about this issue.

[fokid]

However, there are still a lot of other processes going on inside a growing adolescent's body that aren't comparable to that of fully grown adults.

i don't know if this is true. worth finding out more about.

[myloginacc]

i don't know if this is true. worth finding out more about.

I mean, just in hormonal and metabolic aspects, 15 year old you and 25 year old you would be two different persons.

Regarding the blood vessels themselves:

https://en.wikipedia.org/wiki/Elastin

https://en.wikipedia.org/wiki/Elastic_fiber

https://en.wikipedia.org/wiki/Tunica_media

https://en.wikipedia.org/wiki/Adventitia (or https://en.wikipedia.org/wiki/Tunica_externa)

These fibers can stretch up to 1.5 times their length, and snap back to their original length when relaxed.

The dog study you found is more reassuring, though.

This is the only worrying part about it (so far):

no increase of collagenous or elastic fibers could be found

Tunica media and externa rely on elastic fibers/elastin and collagen, respectively.

Not a big deal, but confirms they're unnaturally stretched and the (canine) body isn't naturally adapting to it. At least, not up to the point the dogs were killed.

Even with the conclusion of:

No significant difference in thickness of the vascular wall, tunica media, and adventitia could be observed between the lengthened and the control side in both dog groups. It seems that blood vessels can adapt to continuous tension during callus distraction without suffering structural damage and are the least limiting factor concerning distraction speed, distraction rhythm, and distraction length during callus distraction.

So they still consider it a factor, just the least limiting one (which is reassuring). I think it's one more reason to not overlength.

I wish I knew the typical size of a beagle's lower leg to know how much 2.5cm is, in terms of initial bone length increase. Not even Wolfram Alpha is helping.

[myloginacc]

Looking through Google scholar I've found that Dr. Gavriil Ilizarov himself seemed interested in this subject, and he published a bit on it. (Sort by ascending date.)

https://europepmc.org/abstract/med/2912628/

This paper here is seemingly quite historic in the history of DO LL. They were just figuring out the best distraction rates.

At any... rate:

I wanted to leave a few keywords in this thread: for search engines, web crawlers, scraping bots, etc.


Behavior of blood vessels during lower-leg lengthening using the Ilizarov method.
(PMID:10573344)

Bernd Fink; Joachim Singer; Stephan Braunstein; Gerhard Schwinger; Gudrun Schmielau; Wolfgang Rüther

Journal of Pediatric Orthopedics [01 Nov 1999, 19(6):748-753]
Type: Comparative Study, Journal Article
DOI: 10.1097/00004694-199911000-00011

[myloginacc]

I've also learned that angiogenic treatments have developed and evolved a lot since then.

This is from 2003.

https://europepmc.org/abstract/MED/14643161
(PMID:14643161)

Meanwhile:

https://en.wikipedia.org/wiki/Angiogenesis#Application_in_medicine

I also could be wrong here (reminder that I don't have a medical background and you're reading things online), but:

https://en.wikipedia.org/wiki/Angiogenesis#Exercise
https://en.wikipedia.org/wiki/Arteriogenesis#Exercise

I don't think that maintaining yourself fairly (aerobically & anaerobically) active after your recovery from LL would lead to a poorer health result over someone with no regimen of aerobic exercising at all. You might want to ask the opinion of your lengthening doctor(s).