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FAQ / Frequently Asked Questions

1 - Why should I prepare for the operation, will the results be worse if I do not prepare?

Yes, preparation allows muscles, tendons, and the body conditioning for accepting the operative ‘shock’. Like for any University exam, for the New York Marathon, or for climbing the Himalayas, preparation is necessary to prevent serious problems, and to live the lengthening procedure in a more positive way. If we do not 'tune' the body like for a Formula 1 race, risks are obviously much higher and can lead to serious complications or sequelae (Is there no a risk of frostbite at high altitudes and should we not anticipate it?)

2 - What do we mean by pre-operative preparation, because I do sports and I consider myself already prepared?

Preparation for a lengthening is similar to preparation of athletes for the Olympics. We can not consider ourselves well prepared by practicing sports, even if they are strenuous. You must condition your body like a professional to avoid risk of complications, serious or less serious.

3 - I was offered an external fixator. Can I get a nail?

Obviously, for a long bone (femur, tibia or humerus), there are very few cases where the nail is not used as a replacement for an external fixator, as long as the professional experience is sufficient, like in the Team of Dr. Guichet.

4 - I was told that my bone is not big enough, that there is asdsociated axis deviation, or that my background prevents using a nail, and an external fixator is needed. Is this right?

There are very few cases that can not benefit from the use of the Guichet® nail and most contra-indications in some teams are not contra-indications in more experienced teams. It all depends on experience, and at his level, the inventor of the Guichet® nail, it is worth asking him his opinion.

5 - How long do I prepare for surgery?

It depends on your initial condition (checked during the initial clinic evaluation with Dr Guiche), the gain you want and the recovery time you are aiming for. If you want to save time and recover function quicker, you will have to do more work before the operation.

6 - I want a 10 cm gain. Can I get surgery now?

The gain depends on the conditioning of your body and on its ‘tolerance’ to the lengthening procedure. You can’t do anything more than what your body can tolerate. The initial screening will allow you to know how many cm (inches) your body can tolerate. If your body can tolerate a 5 cm gain, but you want more, you will have to prepare far more. The surgery will be planned for when your body will tolerate 10 cm. Unless exceptional conditions are present (professional dancer, etc..). If you want the surgery now, you must accept what your body can tolerate (before complications and sequelae) and that will be assessed by the initial consultation.

7 - I do not want to come in for a consultation evaluation, because I do not need one, or I will not arrive until just before the operation. Can we still set a surgery date?

It is unreasonable not to have a thorough evaluation before surgery to prepare and to avoid complications. That would be like jumping from an airplane, in flight, without a parachute.

8 - I did not come for a consultation yet, but how many cm can I get without risk?

It depends on your body, and that must be evaluated. Some patients stop at a 5 cm gain, while others may go to 9 or 10 cm. All patients do not have the same body or psychological capacities. In Dr. Guichet’s practice, the average gain is 68 mm in cosmetic lengthening (115 cases).

9 - How long will it take? How long should I stay in Marseille?

It takes 1 day per mm. The main risks are during the lengthening period. It is therefore appropriate and desirable to stay throughout the lengthening period in Marseille. This is not only valid for patients of Dr. Guichet, but also for any surgeon, and saying anything to the contrary would not be fair to the patient.

10 - How long do I need to prepare for surgery?

It depends on your initial condition (checked at the initial consultation), the gain you aim at, and the time you need to get full functional recovery after surgery. If you want to save more time post-operatively and recover quicker, you will have to work more before surgery.

11 - I want a lenghtening right now, and to do all steps through the Internet, like with other surgeons in the world. Is this good?

NO. A surgery now, without preparation, exposes you to significant risks, including complications. Your body enabled you to grow 6 cm at the femurs in nearly 5 years during adolescence (some children at that slow rate experience growing pains). Surgery allows gaining these 6 cm in 2 months, which is 30 times faster! The ‘shock’ for the body is extremely violent. It's like a bomb exploding in a pressure cooker. Another exemple is that you do not enter a Formula 1 race without having prepared the car, because the risk of a crash is too high.
Be careful! A surgeon more concerned about booking a fast surgery is more concerned about marketing than about safe results for his patients. The patient must be aware of the risks and put all the cards on his side to 'gain' his lengthening. He should therefore do everything to avoid complications. He should first do the evaluation, then a good preparation and by doing things right, you will be much more likely to have a successful lengthening.

12 – Frequent E-mail from patients: How much does it cost for an extension (without specifying the indication, if one or 2 legs, femur or tibia, the expected gain, difficulty of the case, associated diseases, time to stay in Marseile, living optins in Marseille, etc.)?

The cost varies on what you want and options you decide on. The evaluation will allow you to know the number of segments to operate, the aimed (or necessary) gain (and therefore the potential duration), options desired (personal trainer 5 h / day x 6 days / 7, or less, category of hotel, exchange rates for those who want the cost in their home country currency, e.g. Dollars, etc.). An accurate quote with options will be delivered after the consultation. You can save on everything, including coaching, and post-operative personal training. the thinking is that you are old enough to manage your own training, but if you do this, you expose yourself to risks that you need to face and accept. You need to accept also that you will have a lower functional result with a longer recovery, and eventually complications (need of bone grafting due to delayed healing, etc.). It is better to follow the advice of the professionals (Dr Guichet). In the end, it will be better to expect and plan higher costs, even if you do not spend all of what you expected. Use the remaining money for the next holiday!

13 - I am 1.49 m (women, i.e. 4’10” 1/2”) or 1.54 m (male, i.e. 5’ 2/3”) tall. Can Health Insurance (or Social Security (CPAM) in France) cover the surgery?

NO. Health Insurance only covers ‘official’ dwarfism (achondroplasia, Turner syndrome, etc.) or discrepancy (generally ove 1 or 1.5 inches). Otherwise everything is cosmetic. In the case of health nsurance controls, you are liable to reimburse not only the health insurance, but also to pay a penalty (in France, 15,000 Euros).

14 – Patient demand: a surgeon proposed for me to charge Health Insurance for one leg, then secondarily the next one, as discrepancy treatments. Can you do it?

NO. Health Insurance only covers ‘official’ dwarfism (achondroplasia, Turner syndrome, etc.) or discrepancy (generally ove 1 or 1.5 inches). Otherwise everything is cosmetic. In the case of health nsurance controls, you are liable to reimburse not only the health insurance, but also to pay a penalty (in France, 15,000 Euros).

15 - I was told that an operation on both legs at once was too heavy and it was better to do both legs separately. Is that correct?

NO. One leg at a time means two separate procedures (Dr Guichet’patients have only 2 to 3 surgeries in total when he operate 2 legs at once). Unless you want to spend more time on the operating table, have twice the post-operative pain, and a twice as long period of rehabilitation. It has no benefits, except in cases of lack of surgical knowledge (defective control of blood pressure and loss, etc.) or follow-up. Operating separately on two sides has no real scientific reasons. U.S. studies on bilateral operations show that the cumulative risk of a 2 step bilateral surgery is 1 +1 = 2, while that of 2 operations at once is only 1.6! Do you want to run more risks and feel worse?

16 - Will you operate on me and follow me yourself?

Dr. Guichet, inventor of the technique of nail extension, still operates on his own patients, unlike some other surgeons.He also plans the pre-operative preparation, operative parameters, and monitors all patients post-operatively. This is the best way to reduce or eliminate risks of complications. He has more experience than any assistant or surgeon with little experience with internal lengthening. Indeed, he has far more experience, as the Inventor, on the Albizzia® and Guichet® nails than any other surgeon. The personal/custom-made controls performed by Dr Guichet himself prevent ‘dilution’ of responsibility for the treatment and thus increased risks. This does not mean that the team is small, because having a complete team increases competency (personal trainers, anesthetists who follow the patient from the consultation to operations, etc.). To be operated on by the inventor is a guarantee of result with the minimum risks. It is similar to having Yves Saint-Laurent or Lagerfield themsleves dressing you, or getting a haircut by Jean-Louis David himself, or getting your Mercedes tuned by the Mercedes Racing Team!

Dr. Guichet makes himself available at any time for his patients, as evidenced by their testimonies.

17 - I found a surgeon who has not used your technique but is willing to do it for me. Where can I get implants?

This sounds logical but shows complete immaturity. Indeed, even in experienced hands, it is sometimes difficult to always do well. On the other hand, it's too dangerous to be operated on by a surgeon without experience in such a specialized field as lengthening. The risk for ones health is not worth the false security of being close to home.

18 - Where can I get your technique close to my home? Do you know a surgeon near me who uses your technique?

Except where an experienced colleague trained by Dr. Guichet is close to your home, it is immature to be operated on by a surgeon without significant experience in this field of internal lengthening. Offering your body and health to a surgeon who is using 1 to 3 lengthening nails every 1 or 2 years or less, and who is ready to operate on you with what he presents as his strong experience (ego) exposes you to high risks. The ethical guidelines are simple: highly demanding operations should be done by teams experienced in these techniques and their complications, which requires dozens of cases every year. Being operated on by the inventor of a technique who has great experience is a guarantee of success with minimum risk, and this is true in many areas.