Cosmetic & Congenital Short Stature Lengthening
Generally, a patient requests cosmetic lengthening because their short-stature (lower than average height) has had a negative psychological impact. However, some requests for lengthening are backed by a professional agenda. Careers such as modelling, police and military work and business require confidence, and people require the self-esteem boost a lengthening procedure can provide.
Cosmetic patients have no pathological need for surgery; no disability or physical ailment. So, they are really asking the surgeon for a solution to their psychological issue or insecurity. This means that we have to carefully evaluate and coach the patient psychiatrically to ensure their informed decision will have the best possible results.
Patients will be keen to return to their normal routine, and will initially function normally. This means that patients sometimes do not wish to sit and wait for optimal recovery. The Guichet® nail allows a faster return to full, functional movement and Dr. Guichet’s team ensure that this is possible. Patients who followed and completed Dr. Guichet’s lengthening programme and recommendations have a 0% fracture rate, compared to the 5% of fractures that didn’t stay the course of the treatment and a 14% rate in those who didn’t follow the recommended training plan.
Dr Guichet provides a preparatory service to cosmetic patients, as well as having mastered bone-healing capacities in order to optimise bone fusion and prioritise recovery. On average patients have a speedy return to every-day activities and gain around 6.7 cm of length.
The process can be repeated so that a patient can achieve up to 15 cm of additional length. It is preferable to aim for two 35 day procedures with gains of around 5 or 6 cm each, than to attempt 10 or 12 cm in 4 months, for example. Separating the lengthening into two shorter procedures reduces pain and minimises complications. The second procedure is virtually painless for some patients.
Congenital/Constitutional Short Stature
Those with constitutional (or congenital) short stature are typical chromosomally, unlike people with dwarfism. In relation to the distribution (or Gaussian) curve of height, the person is comparatively short in stature. But this depends on the reference population and their collective height curves.
It is also worth noting that the social impact of elongation varies between countries and regions. For example, a person measuring 1.6m (5ft 2.5”) would be recognised as tall in the Altiplano of Peru, but could be described as short in Norway.
The results of lengthening the femora and tibiae with the Guichet® nail are far better in terms of function that when length is gained using external fixators or non weight-bearing nails. Use of an internal nail means that the need for an external fixator is no longer indicated.