We have received many questions concerning our site. There appeared the necessity to give more detailed information about the internal method of lengthening. I have assembled a dialogue (questions and answers) between the prospective patient and the surgeon.

What do you call your center? 
What other specialists could you recommend?

Our medical center BONAMED is situated in Kiev – the capital of Ukraine. The address you can find on our site in the issue “Useful Information”

The leading specialist of  our center – doctor-orthopedist Vladimir Dragan. Dr.Dragan was at the sources of the internal method, he was professor  Bliskunov’s team-made. He has wide experience in practical and scientific work, he created a new generation of devices for inner lengthening that made the technology of performing the operations much easier and made the method more accessible to specialists.

We work side by side with the medical firm LADISTEN. It’s chief, doctor-scientist Vitaliy Vecklich is an excellent  specialist and skilled surgeon. Dr. Vecklich carries out great scientific work, he has his own author’s work-out of the external method. Great experience and skill of a surgeon help to achieve good results. If you want to lengthen your limbs with external method, address to the medical firm LADISTEN.

I’d like to draw your attention to the fact that the patients with very different orthopedic diseases address to our doctors. They have their problems solved here and get care and wonderful medical service.

Question: I want to choose the most preferable method for lengthening for myself. You consider your method to be the best. Why? Help me to make up my mind.

I don’t think it’s correct to say, that one of the  methods of lengthening is the best. Any doctor-scientist, author of his unique method, always solves the same task – to make his method more effective, foolproof and safe for the patients. A quantity of different ideas and approaches, interchange of experience, perfection of technologies instigate the  development of this branch of medical science. So it would be correct to say that the best method is the future method. And answering the question about the way to increase height naturally every doctor will offer his technology. One should take into consideration who performs the operation in course of this or that method. For surgeon’s qualification and experience are the most important constituents of success. 

Every method has its pro and contra. There are also secret author’s workings-out KNOW HOW, which far promote effectiveness of such a widespread method as external. That’s why it would be correct to speak only about general trends and problems of modern cosmetic orthopedics when using well-known information. Bilateral, mutual choice “patient-doctor” would give the best results.

The best advise while looking for answer to the questions “Where? Who? How?” is to analyze concrete results of work of  the concrete doctor, at that to try to get information from real patients those who have finished the program of lengthening. It’s necessary to understand that there are many minds and points of view (such as below-mentioned). One should scrutinize the information consider carefully all “for” and “against”.

So, at first, I'd like to help you see the difference between the internal method and the external one. Modern cosmetic orthopedics has already made their choice in the internal method's favor. L.O.N., the Albizzia intramedullary rod, ISKD Internal Limb Lengthener (Orthofix), Fitbone - all these are the way to the internal method. 
Why did it happen? The reason is the necessity of creating the best conditions for "the new bone" formation. And the main cause of it is a stronger fixation of the bone parts - fixation and possibility to lengthen the spacing interval in the regenerating zone (the zone of bone growth). Any movement of the parts of the bone causes pain and the loss of time. The internal rod provides the strong fixation, especially, during the lengthening period.

How is the lengthening going on?

According to the external method the lengthening is accomplished with the help of the external system. While the internal method is used -the device (the rod) is lengthening itself. Imagine the telescope (an ancient long glass). The mechanism is inside of it. The clicker is attached to the mechanism. Everything is inside of the body and does not bother the patient. The patient makes prescribed leg movement and the clicking sound can be heard. It means, that the device has been put to work, so " the telescope" was lengthened.

Here you can watch the patient clicking and lengthening his femur

The fixation is strong and process of the new bone formation goes well. On the photo below you may see the devices for the femur and for the tibia. They work on the same principle.

I want to tell you about one more important advantage of the internal method. It is the time factor. Bliskunov`s method is the "fastest" method of lengthening. 

Why?

1. The lengthening is going on simultaneously on both legs (either femurs or tibias).
2. The implantation of the devices for both legs can be performed during one and the same surgery.
3. The patient can accomplish a part of the lengthening himself, independently, at home.
4. The best conditions for the lengthening and full recovery are made.

What conditions?

The lengthening process is more natural with the help of Bliskunov ‘s method.
Because the Bliskunov method lengthens from within, the whole segment of the thigh or shin is lengthened as well. The muscles are lengthened on the whole extent of the thigh or shins. There are no external devices to prevent muscles from stretching. It allows making lengthening on the average up to 10-12 cm on a femur and up to 6- 8 cm on an tibia. 
Thus while using our method we have much less complications and nearly all started programs of lengthening were completed.

By the way, tell me more about complications.

I want to state that there is no surgery without complications. If you were told that someone has made thousands of operations and had only 1-2 complications - do not trust this. The patient should know, there is always  risk.

And still, did you have such complication as
ostheoarthroses?

The osteoarthroses is caused by the restriction of movements in the joints combined with the permanent loads on them. We did not have such complications (the operations have been performed since 1982). The patient, after he or she is implanted the devices becomes active very soon. The patient starts doing exercises and uses crutches several days after having the operation.

5 days after the operation

The loads on joints while using the internal method aren't that great and don't cause any pathological changes. By the way, the early activity of the patient reduces the duration of the program.

Is there any risk of the infectious complications?

As to the risk of infection I should mention that the direct contact with environment is experienced during the operation only. These are the maximum sterile conditions. After the skin has been cut and the muscles have been moved apart, the device has been implanted the wound is closed and there could be no infection.  We also did not experience any kind of the infections that appeared in several years after the operation. The point is that the human body reacts immediately. After the operation the defending forces of the body get down to work. The man's body scans the operated place and tries to exclude any contacts with the environment to bar all the ways for possible microbes' attack.
 The risk of the infectious complications is minimum when our method is used.  We use up-to-date effective antibiotics during the postoperative period. So all the wounds are quickly repaired. The patient may take shower and water procedures in 4-5 days after the operation.

Could you tell about postoperative scars.

Our internal Method.
There is one big scar on the femur (about 3-4 cm). Though I would like to say that the length of this scar might be less. This length depends on the patient's muscles volume. This cut is made to have an access to the bone. The skin is cut and the muscles are moved apart. 
The surgeon makes the cut as small as possible, and if there in an access to the bone the cut remains of the minimal size. Though the cut may become a little bit bigger during the lengthening process. This cut is sewed with a cosmetic seam. So the scar is very thin, it heals well and it is practically invisible after healing. If it is necessary, we practice the scar polishing for the better cosmetic result. This scar is only cosmetic skin problem.  During the surgery the muscles are not cut, they only are moved apart. 

Scars after using an internal method are the smallest. Pay attention to the following:

The  cut of skin ( access to bone for bone’s cutting ) is inevitable while using any method (external and internal) of limb lengthening.

 It is necessary to make some cuts of skin to fix the internal device (as well as two parts of the bone) when any internal method is practiced. The screws are used in any case when internal rods (devices) are present inside the bone. We make these  penetrations through the skin as small as possible (like punctures).

By the way, the largest cut is at most 2-2,5 cm. long when our internal method is used on the shanks.

O.K. Let's presuppose, I`ve chosen the internal
method. Why should it be yours?

We have the wide experience of lengthening with the help of the internal method. The professor Bliskunov  was  the  first  surgeon  in  the world who started using the fully implanted apparatus. The method  has  improved greatly since then. Our apparatus has no complicated details, no built-in electronic units. Just fine mechanics – trustworthy and reliable as Swiss watches. Joints are never damaged and remain absolutly intact when our device is implanted. Our devices are the smallest and as a result less traumatic. Our device for the thighs lengthening is 11,5 mm in diameter, for the shanks lengthening – 10 mm. The devices operate safely even when  making a bone much longer.

The parts  of  our internal device do not rotate.

So the young “new” bone  can  grow safely. We cut the bone in its upper third. This zone has the best regenerating abilities. The device has the additional function - the function of  protection and maintenance  of the newer bone. The newly formed bone should not be bent or twisted. What is  a new bone like? Imagine the "cloud" of the newly created young bone cells. They are surrounded with the smallest vessels which feed them. These vessels grow and brunch like a tree. The bone cells get necessary elements to live on with the help of the roots and branches of the tree. The tree of vessels cannot be broken! 

I want to tell you  one  secret. The internal vehicle  is  not  the most important for lengthening. The main thing  is  the equipment  and  special  technologies that  are necessary for careful implantation  of  the vehicle inside the bone. One  of  the main Bliskunov`s method advantages is the fact that its implantation causes  less trauma (and less scars).  

Our internal method allows to eliminate such cosmetic defects of bones as deformation (Varus/Valgus), along with the process of lengthening that makes no impact upon continuance/endurance and cost of the program.

By the way, I would like to discuss such complications  as  embolism. I agree that the interior  of  the bone is damaged in case of any fixing rod intrusion. I'd like to state that the implanting of the rod into the bone is an ordinary surgery. It is practiced in traumatology and orthopedics all over the world.  This technology is well studied, perfected and polished. We have made our device implanting even safer.  We insert the device through a small cut  ( 1/2 inch)  and we use special apparatus. This is an important achievement of our method that we are so proud of.  This is a very precise hi-tech manipulation We did  not observe embolism, even  at the early 1980s, when the surgery technique was not so accomplished, as it is now.

On the photo you can see the scars. It has been 45 day after the operation and the lengthening was 4,0 cm. By the way, now we use cosmetic scars polishing during lengthening period.

On the x-ray you may see the femurs in the process of simultaneous leg lengthening.

Should I do exercises to get ready, or take  vitamins, etc.?

It would be better to do the exercises for the muscles stretching. Pay special attention to the group of back muscles of the thighs and shins. These exercises are available to everybody, they are widely used by the sportsmen while they are warming up. 4-5 weeks before the lengthening it would be better to take multi Vitamins, those including Magnesium, Calsium, vitamin C, Glucosamine Sulface.

How could the devices be taken out? In what period
of time could it be done?

We take the devices out in 1-1,5 year after the surgery was performed. 
The devices do not restrict legs functioning. The patient does not feel their presence. However, they create a long term protection for the new bone. It also allows the patient to put weight on the leg earlier (comparing with the external method) without any complications. 
This is also one of the advantages of our method. The extracting of the devices for both legs is carried out during one surgery. This surgery lasts for 15-20 minutes and causes little trauma.

Thanks for the information. I should think it over.