You will find all the answers to most of your questions.

If your question is not answered here, do not hesitate to email us!

Preparation

WHY SHOULD I PREPARE FOR THE OPERATION? WILL THE RESULTS BE WORSE IF I DO NOT PREPARE?

Yes, By preparing appropriately for the operation, your tendons, muscles, and body will be conditioned to accept the “shock” of the procedure. Like a university exam, the New York Marathon, or climbing the Himalayas, preparation is essential in order to avoid serious problems, and experience the lengthening procedure in a more positive way. If the body is not acclimatised to the process, like preparing a car for a Formula 1 race, there will be a greater chance of risk and may result in sequelae or serious complications. Is there not a risk of frostbite at high altitudes and should we not anticipate it?

I DO SPORTS AND I CONSIDER MYSELF ALREADY PREPARED – WHAT DO YOU MEAN BY PRE-OPERATIVE PREPARATION?

Preparing for a lengthening is much like how athletes train for the Olympics. Just because you practice sports, even strenuous ones, that does not mean you are prepared for the procedure. It is imperative to condition your body like a professional in order to avoid complications.

HOW LONG DOES IT TAKE TO PREPARE FOR SURGERY?

It depends on your initial condition, which will be checked during your initial clinic evaluation with Dr Guichet. It will also depend on the gain you are looking for, and how long you wish to spend in recovery. If you hope to return to functioning more quickly, you will need to do more work before the operation.

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.

I WANT A LENGTHENING RIGHT NOW, AND PERFORM ALL THE STEPS THROUGH THE INTERNET, LIKE WITH OTHER SURGEONS IN THE WORLD. IS THIS GOOD?

If you undergo surgery without preparation you will be exposed to significant risks, as well as complications. During adolescence, it took nearly five years for your femurs to grow by 6cm – at that rate, some children experience growing pains. This surgery enables you to grow 6cm in just two months – that’s 30 times faster! The ‘shock’ for the body is extremely violent. It’s like a bomb exploding in a pressure cooker.

Be careful! A surgeon who wishes to book surgery quickly is more concerned with marketing than in his patients’ safety. The patient must understand the risks and put all their cards on the table in order to ‘gain’ his lengthening. Consequently, a patient should be completely prepared in order to prevent complications. By following the recommended evaluation and preparation, you are far more likely to have a successful lengthening.

Surgery and Lengthening

I WAS OFFERED AN EXTERNAL FIXATOR. CAN I GET A NAIL?

Obviously, for a long bone such as the humerus, femur or tibia, the nail would generally used as a replacement for an external fixator in all cases provided that the surgeon has sufficient professional experience, as in the Team of Dr. Guichet.

I WAS TOLD THAT MY BONE IS NOT BIG ENOUGH, OR THAT THERE IS ASSOCIATED AXIS DEVIATION, OR THAT MY BACKGROUND PREVENTS THE USE OF A NAIL, AND AN EXTERNAL FIXATOR IS NEEDED. IS THIS RIGHT?

There are extremely few cases which would not benefit from the use of the Guichet® nail; the majority of contra-indications in certain teams would not be contra-indications for teams with more experience. Given Dr. Guichet’s level of professional experience, it would certainly be worth asking for his opinion.

I WANT A 10 CM GAIN. CAN I GET SURGERY NOW?

The amount of gain you can achieve is dependent on how you have prepared your body and how tolerant it will be to the lengthening procedure. You can’t do anything more than what your body can tolerate. An initial screening will inform you of how many cm (or inches) your body can tolerate. If you would like more of a gain than you are recommended following the screening, you will need to prepare far more, and the surgery will only be booked once your body can tolerate a 10cm gain. Excluding some exceptional cases (for example, if you are a professional dancer), you must accept what your body is able to tolerate (before complications and sequelae) if you want the surgery; this will all will be assessed by the initial consultation.

I DID NOT COME FOR A CONSULTATION YET. CAN YOU TELL ME HOW MANY CM I CAN GAIN WITHOUT RISK?

This is entirely dependent on your body, and these factors must be evaluated. Some patients stop at a 5 cm gain, while others may go to 9 or 10 cm. Not all patients share the same psychological capacity or body limitations. In Dr. Guichet’s practice, the average gain out of 115 cases is 68 mm in cosmetic lengthening.

HOW LONG WILL IT TAKE? HOW LONG SHOULD I STAY IN MARSEILLE?

The process takes 1 day per mm. The main risks come during the lengthening period, so it is advisable to spend this time in Marseille. This would not only apply to Dr. Guichet’s patients, but also for those of any surgeon – to say anything otherwise would be unfair to the patient.

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?

Generally speaking, lengthening one leg at a time means two separate procedures will be necessary. Dr Guichet’s patients have only 2 to 3 surgeries in total when 2 legs are operated on simultaneously. Do you want to spend more time on the operating table, endure twice the post-operative pain, and a doubled rehabilitation period? There are no benefits to having two operations, except in cases of lack of surgical knowledge (defective control of blood pressure and loss, etc.) or follow-up. There is no scientific reason to operate separately on two sides of the body, and American studies on bilateral operations have concluded that the cumulative risk of a 2 step bilateral surgery is 1 +1 = 2. The cumulative risks associated with undergoing 2 operations at once is only 1.6! Do you want to run more risks and feel worse?

WILL YOU OPERATE ON, AND FOLLOW ME YOURSELF?

Unlike some other surgeons, Dr. Guichet, who spearheaded this technique of nail extension, continues to operate on his own patients. He is also responsible for planning the pre-operative preparation, the parameters of the operation, and for monitoring all patients after the operation. This is the best method of eliminating any complications. As the inventor of the Albizzia® and Guichet® nails, he has more experience than any surgeon or assistant when it comes to internal lengthening. Dr. Guichet’s own custom-made controls prevent ‘dilution’ of responsibility for the treatment and therefore any increased risks.

This doesn’t mean that he works with a small team, as having a complete team of personal trainers, anaesthetists and many others, who follow the patient from the consultation to operations, increases competency. To have the inventor operate on you himself is a guarantee of result with the minimum risks, much like being personally dressed by Yves Saint-Laurent or Karl Lagerfeld, having your hair cut by Jean-Louis David himself, or having your Mercedes tuned by the Mercedes Racing Team!

Patient testimonies will tell you that Dr. Guichet makes himself available for his patients at any time.

I FOUND A SURGEON WHO HAS NOT USED YOUR TECHNIQUE BUT IS WILLING TO DO IT FOR ME. WHERE CAN I GET IMPLANTS?

Although this sounds logical, it demonstrates complete immaturity. Even in experienced hands, this can sometimes be difficult to do well every time. On the other hand, it would be too dangerous for an inexperienced surgeon to operate on you without a specialised background in lengthening. The associated health risks are not worth the false security of being close to home.

WHERE CAN I GET YOUR TECHNIQUE CLOSE TO MY HOME? DO YOU KNOW A SURGEON NEAR ME WHO USES YOUR TECHNIQUE?

Unless an experienced colleague trained by Dr. Guichet works close to your home, it would be immature to have a surgeon who lacks significant experience in the field of internal lengthening operating on you. Offering your body and health to a surgeon who only uses 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 (but is more like ego) exposes you to high risks.

The ethical guidelines are simple: complex, demanding operations should be performed by teams who are experienced in these techniques and understand their complications – this means dozens of cases annually. To be operated on by the inventor of a technique, who has great experience, guarantees success with minimum risk, and this applies in many areas.

Cost

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 MARSEILLE, LIVING OPTIONS IN MARSEILLE, ETC.)?

The cost of the procedure is dependent on what you want, and which options you decide upon. An evaluation informs you of the following:

– how many segments need to be operated on
– the intended (or necessary) gain, and therefore the potential duration
– what additional options you would like, such as personal trainer, category of hotel, exchange rates etc.

You will receive an accurate quote, as well as your desired options, following the consultation. There are ways to save on everything, including coaching and personal training after the operation; the logic behind this is that you are old enough to manage your own training. However, by doing this, you will expose yourself to risks to which you will have accept and face by yourself. You must also accept that you will be left with a lower functional result and a longer recovery, as well as possible complications, such as the need for bone grafting due to the delayed healing process. It would be far more beneficial to follow Dr. Guichet’s advice. Ultimately, it would be a better idea to plan for higher costs, even if you do not spend all of what you expected. Use the leftover money for your next holiday!

I AM 1.49 M (WOMEN, I.E. 4’10” 1/2”) OR 1.54 M (MALE, I.E. 5’ 2/3”) TALL. CAN MY HEALTH INSURANCE (OR SOCIAL SECURITY (CPAM) IN FRANCE) COVER THE SURGERY?

Health Insurance only covers ‘official’ dwarfism (achondroplasia, Turner syndrome, etc.) or discrepancy of over 1-1.5 inches. Otherwise, everything is cosmetic. Regarding health insurance controls, you would be liable for reimbursing not only the health insurance, but also to pay a penalty, which would amount to 15,000 Euros in France.

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?

Please see the previous answer.