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Author Topic: Example of a Good Osteotomy Incision versus a Bad Osteotomy Incision  (Read 18980 times)
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SysOp
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« on: October 20, 2013, 02:40:38 PM »

There are different ways to do the initial surgery for leg lengthening with external fixators. I think it is important to show what I think is an example of a doctor who made a bad choice for his patients. I told this doctor he would have to change the way he did things or I would remove him from the Recommended Doctors List on this website, but he told me to my face that he cut corners on patient care to save money and make more profits. I then removed him from this site. I personally would not recommend him to anyone to do their LL surgery.

Below are two images. The first is a large "C" cut osteotomy done by a doctor I would not recommend, and the second image is a small incision done by a newer doctor that is showing great promise: Dr. Sringari. I want to help make leg lengthening affordable and available to everyone, and I think it is very important to call doctors out when they are cutting corners and not doing what is best for patients. There is no reason for a doctor to leave his patients with any more scarring than is necessary, and if a doctor chooses to leave you with larger scars because he is lazy you should not choose that doctor to do your surgery.


   
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checkmate
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« Reply #1 on: October 20, 2013, 03:22:08 PM »

Cut Difference is very visible. I would never like my legs to be filled with mathematical shaped scars.  Roll Eyes


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SysOp
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« Reply #2 on: October 20, 2013, 03:53:17 PM »

Cut Difference is very visible. I would never like my legs to be filled with mathematical shaped scars.  Roll Eyes

Scars are a part of leg lengthening, but it is unacceptable for a doctor to choose to leave a patient with larger scars than are necessary simply because it's an easier surgery for him to perform and will save him a little time.
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kneehowguys
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« Reply #3 on: October 20, 2013, 06:33:11 PM »

C cut seems like a perfectly legit reason to remove him from the website tbh. Don't understand the hate from S fans.

>>second image is a small incision done by a newer doctor that is showing great promise: Dr. Sringari


1. Is the main goal to bring cheaper, safe low scar internals to Sringai?

2. I was gone from MMT for some time and I gotta say now I'm totally confused what has happened tbh. Is there a post about the positives and minuses of Sringai somewhere? Can someone give me a short summary of what this Sringai and Dr S thing is? Aside from his skill and no C cut, is it because living costs in India are low?

2. I was absent during alot of the Dr S wars and I don't really understand what has happened.  It's like, there are so many more established doctors like Guichet, Betz, Paley, Mahoubian, Roz, and then MMT's Xia. Why not work with a  doctor with a longer record to get lower cost internals?

3. Like Xia? Didn't MMT do it with Xia? Why not work with Xia to bring internals there?  What about Jamal and his Jamal nail or the old Dragan nails? I'm like lost  Huh?

I don't really understand the Dr S wars and pm removing, I just want safe low scar lower cost internals like everyone else. I think most people here don't really care about the Dr S wars, who does business with who, just want to get taller and move on with our lives. If any of my questions don't seem appropriate, I'd be happy if sysop wanted them removed but basically I'm wondering if Sarin HLN is not safe, then are there plans in work to bring something like betzbone or other internals to Sringai?
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SysOp
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« Reply #4 on: October 20, 2013, 08:29:57 PM »

My goal is to bring cheaper leg lengthening to every doctor. I am working on bringing internal femur lengthening options to a number of different doctors, and yes, Dr. Sringari may be one of them. He happens to be a doctor I trust, and have supported him because I think he is a good option for low cost leg lengthening. I used to trust and support that other doctor until he started to get a lot of complications and he told me point blank that cared more about making money than providing his patients with good outcomes.

There is not a pros / cons section about Dr. Sringari although Stadiometer did a pretty good write up about him here: http://www.makemetaller.org/index.php/topic,6339.0.html Right now, his patient diaries are the best way to get information about him on this site. I have been supportive of him and believe he is a good doctor, but I don't think he has quite enough patient diaries here yet to be on the Recommended Doctors List.

Many of the established doctors already have their own internal options and cost structure so they can't lower costs or want to stick to their own technology. It's complicated. There are a lot of things going on in the background right now. There is also a lot of misinformation out there about what I am trying to do that I'm not particularly concerned about. I am doing my job and when things are ready you will know about it.

There is no proven track record for the HLN and I personally don't trust that doctor, so I would not recommend it.

The main reason I went to India recently was to discuss bringing an internal femur lengthening option to a few doctors there. My secondary reason was to verify the complaints of a number of patients in the guest house of a certain doctor. Obviously someone did not like their status quo being disrupted when their poor level of patient care was exposed.
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Gladiator2012
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« Reply #5 on: October 20, 2013, 08:39:54 PM »

1. Is the main goal to bring cheaper, safe low scar internals to Sringai?

It would be great to see if Dr. Sringari start doing internals in cheap affordable price.

2. I was gone from MMT for some time and I gotta say now I'm totally confused what has happened tbh. Is there a post about the positives and minuses of Sringai somewhere? Can someone give me a short summary of what this Sringai and Dr S thing is? Aside from his skill and no C cut, is it because living costs in India are low?

It will be best if someone did an unbiased comparison between that doctor & Dr. Sringari.

2. I was absent during alot of the Dr S wars and I don't really understand what has happened.  It's like, there are so many more established doctors like Guichet, Betz, Paley, Mahoubian, Roz, and then MMT's Xia. Why not work with a  doctor with a longer record to get lower cost internals?

This could be good idea but I don't think reputed doctors would agree to reduce their profit & prices.

3. Like Xia? Didn't MMT do it with Xia? Why not work with Xia to bring internals there?  What about Jamal and his Jamal nail or the old Dragan nails? I'm like lost  Huh?

Dr. Xia no longer does the surgeries himself.

I don't really understand the Dr S wars and pm removing, I just want safe low scar lower cost internals like everyone else. I think most people here don't really care about the Dr S wars, who does business with who, just want to get taller and move on with our lives. If any of my questions don't seem appropriate, I'd be happy if sysop wanted them removed but basically I'm wondering if my doctor HLN is not safe, then are there plans in work to bring something like betzbone or other internals to Sringai?

I see things exactly the same as you. We are not here to create or make drama. We just want to do the surgery and move forward.
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checkmate
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« Reply #6 on: October 20, 2013, 08:54:27 PM »

Scars are a part of leg lengthening, but it is unacceptable for a doctor to choose to leave a patient with larger scars than are necessary simply because it's an easier surgery for him to perform and will save him a little time.

I agree scars are part of LL but less scars are better than Circular scar.  Wink

Do you think opening so much skin on top of bone could have more chances of infection and nerve damage ?
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SysOp
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« Reply #7 on: October 20, 2013, 08:55:37 PM »

It will be best if someone did an unbiased comparison between that doctor & Dr. Sringari.

I don't think it is necessary to do a comparison between that doctor and Dr. Sringari. I don't see how anyone in their right mind would still go that doctor for their LL surgery now that they know the truth about him. Dr. Sringari has been open to input and suggestion and so far is providing good care for his patients. I don't see what needs to be compared other than that.
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Arche
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« Reply #8 on: October 20, 2013, 11:25:23 PM »

Thanks Sysop! Dr. Sringari seems to know what he is doing. I just hope he doesn't overload on patients as to make more profit.
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'"There is evil in your bones, Equality 7-2521, for your body has grown beyond the bodies of your brothers." But we cannot change our bones nor our body.' - Anthem, by Ayn Rand.
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« Reply #9 on: October 21, 2013, 08:31:28 PM »

The "C" cut was something which I noticed right in the first Indian doctor's diaries and I actually commented about it. There's really no excuse for that. Pure incompetence and/or greed.

And although Dr Sringari seems to be on a different league in terms of surgical technique and care, I've noticed that both him and the first Indian doctor use metal staples to close the wounds, something which I've never seen in Europe.

On a different note, I really appreciate SysOp's pro-activeness in trying to bring cheaper alternatives for internals to the wider public. It really goes beyond the mere administration of this website and is highly commendable.

I really want to do internal femurs but the two cheaper alternatives out there at the moment don't really tick all my boxes - Jamal because of too many surgeries and incision sites and NewBorn Hospital because of the unreliable ISKD - so I'd really like to see Dr Sringari offering the PRECICE for under 40k USD.

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SysOp
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« Reply #10 on: October 21, 2013, 09:30:20 PM »

The "C" cut was something which I noticed right in the first Indian doctor's diaries and I actually commented about it. There's really no excuse for that. Pure incompetence and/or greed.

And although Dr Sringari seems to be on a different league in terms of surgical technique and care, I've noticed that both him and the first Indian doctor use metal staples to close the wounds, something which I've never seen in Europe.

On a different note, I really appreciate SysOp's pro-activeness in trying to bring cheaper alternatives for internals to the wider public. It really goes beyond the mere administration of this website and is highly commendable.

I really want to do internal femurs but the two cheaper alternatives out there at the moment don't really tick all my boxes - Jamal because of too many surgeries and incision sites and NewBorn Hospital because of the unreliable ISKD - so I'd really like to see Dr Sringari offering the PRECICE for under 40k USD.

Great points all around. I am working on trying to help with or fix everything you mentioned and I hope to be able to make an announcement regarding them soon.
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« Reply #11 on: October 21, 2013, 10:37:32 PM »

Great points all around. I am working on trying to help with or fix everything you mentioned and I hope to be able to make an announcement regarding them soon.

sysop,
it will be great if you mange to set up precise or one of the fda/cee approved nail below 40k USD mark. When you say announcement soon, are we talking weeks.. Months or...longer?
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SysOp
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« Reply #12 on: October 21, 2013, 10:50:28 PM »

sysop,
it will be great if you mange to set up precise or one of the fda/cee approved nail below 40k USD mark. When you say announcement soon, are we talking weeks.. Months or...longer?

The new PRECICE won't be out until the end of the year, and negotiations with the manufacturer of the other nail keeps dragging on, so as soon as I have something solid, I will let everyone know. I am trying to get an internal femur option into the hands of a few lower priced doctors so there is some price competition and different options available for prospective patients. Ideally, each of these doctors would be able to offer internal femur lengthening with both the PRECICE 2.0 and a modified Albizzia Nail.
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COOPER
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« Reply #13 on: October 21, 2013, 11:06:40 PM »

Hey sysop, is it certain the precise will be out by end of the year or is it still lingering and might go pass 2014?You mentioned on other thread it will not be WB meaning will patient still be wheel chair bound? If that so than there is no benefit for the patient who are planning about 6.5 cm....please shed the light. I am going nuts right now and unable to make any definitive decision.

Appreciate you are working to make internal available with good doctors for lower price....indeed taking the leadership in to new height!!!
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Starting Height: 160
Lengthening Goal- 7 to 8
Walk6
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« Reply #14 on: October 22, 2013, 12:51:54 AM »


I really want to do internal femurs but the two cheaper alternatives out there at the moment don't really tick all my boxes - Jamal because of too many surgeries and incision sites and NewBorn Hospital because of the unreliable ISKD - so I'd really like to see Dr Sringari offering the PRECICE for under 40k USD.



Sorry to burst your bubble, but no competent doctor (even the cheapest one) is going to charge less than 40 or even 50k USD for internal lengthening with PRECICE when the device alone costs upwards of 35K.
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Achieved: +6.6 cm
Place: Seoul, South Korea (Cha Hospital)
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Walk6
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« Reply #15 on: October 22, 2013, 01:01:15 AM »

Hey sysop, is it certain the precise will be out by end of the year or is it still lingering and might go pass 2014?You mentioned on other thread it will not be WB meaning will patient still be wheel chair bound? If that so than there is no benefit for the patient who are planning about 6.5 cm....please shed the light. I am going nuts right now and unable to make any definitive decision.

Appreciate you are working to make internal available with good doctors for lower price....indeed taking the leadership in to new height!!!

That's right Cooper..Non-weight bearing means you will be confined to a wheelchair during the entire lengthening period. There was actually one instance here in which I witnessed a patient (an almost 90 kg one) momentarily lose balance as he was getting from his bed onto his wheelchair and he was forced to bear all his weight on the device for a second or two. Fortunately, the device was able to withstand his weight and did not break, so it is not as weak as some may believe. But it is still a very delicate and expensive mechanism.
« Last Edit: October 22, 2013, 01:13:21 AM by Walk6 » Logged

Achieved: +6.6 cm
Place: Seoul, South Korea (Cha Hospital)
Surgeon: Dr. Donghoon Lee
Method: LATN (Tibias)
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« Reply #16 on: October 22, 2013, 02:47:18 AM »

The new PRECICE won't be out until the end of the year, and negotiations with the manufacturer of the other nail keeps dragging on, so as soon as I have something solid, I will let everyone know. I am trying to get an internal femur option into the hands of a few lower priced doctors so there is some price competition and different options available for prospective patients. Ideally, each of these doctors would be able to offer internal femur lengthening with both the PRECICE 2.0 and a modified Albizzia Nail.

These are the news I have been waiting for Cheesy
Keep it up buddy!!

U r changing lives of many sad men for the better. Bravo


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Andre01
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« Reply #17 on: October 22, 2013, 02:50:30 AM »

Sorry to burst your bubble, but no competent doctor (even the cheapest one) is going to charge less than 40 or even 50k USD for internal lengthening with PRECICE when the device alone costs upwards of 35K.

Where does it say the precise nails and magnetic devise cost over 35K alone?
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giant
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« Reply #18 on: October 22, 2013, 02:21:40 PM »

Sorry to burst your bubble, but no competent doctor (even the cheapest one) is going to charge less than 40 or even 50k USD for internal lengthening with PRECICE when the device alone costs upwards of 35K.

You should read the following post by Stadiometer with information about the PRECICE directly from Dr Dror Paley, where it clearly states that each PRECICE nail costs 13.000 USD:
http://www.makemetaller.org/index.php/topic,6073.0.html

Let's now do the math for Dr Sringari:

 - 2 PRECICE nails = 2 x 13.000 = 26.000 USD

 - His current fee for surgery, accomodation, medications, etc = 14.000 USD

 - If he was able to use the PRECICE, you could get something like: 26.000 + 14.000 = 40.000 USD

(actually, you should even be able to get a discount on that, since you don't have to buy the LON devices that he currently uses, which are also included in his 14.000 price)

Then we must convince him to use something else other than those awful metal staples. IonMed's plasma tissue welding would be a dream come true, but I'll settle for a more cosmetic suture (it can't cost more than those dreadful metal staples).

And there you have it. A PRECICE alternative for under 40k, with a (so far) promising doctor that used to work in the UK.

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Walk6
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« Reply #19 on: October 22, 2013, 11:36:51 PM »

I was mistaken, sorry for that. I was under the impression that the cost of each nail was in the 15-20K US range. Thanks for providing the link.
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Achieved: +6.6 cm
Place: Seoul, South Korea (Cha Hospital)
Surgeon: Dr. Donghoon Lee
Method: LATN (Tibias)
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Make Me Taller! The world's number one elective leg lengthening site! Come here for information about LL, things to make you taller, how to get taller permanently, Ilizarov, Betzbone, Guichet Nail, PRECICE, height growth and other height related issues. This is the number one leg lengthening forum for height seekers and people trying to become taller. It was created and run by people who have actually done leg lengthening surgery (LL).

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