What is height extension surgery?
What is height extension surgery?
"It is both plastic surgeries, and there are cases where height extension surgeries are mandatory. There are height standards that vary from society to society and differ from men to women. But usually, people under 1.50 in height are diagnosed with' constitutional short stature'. 1.35 to 1.40 six is in the dwarfism class. Dwarfs are considered diseases, and their treatment begins early. There are height extension treatments that are started at the age of 5. These are done in sessions between the ages of 5 and 10 and adolescence. Not only the legs but also the arms are extended. On the other hand, constitutional short stature occurs in people who stop growing taller at the end of puberty and below the standard. Patients who fall into this group suffer severely from their condition. In this group of cases, which are healthy people, height extension surgery can be performed after several preliminary examinations."
How long can the height be extended in aesthetic surgeries?
It is possible to do this medically, but it is not right to do this ethically. If we think that short stature in this person has become a spiritual obsession, we refer the person to psychiatric consultation. If a psychiatric consultation reports that 'if this treatment is not performed, the patient in question causes permanent psychiatric problems', then the patient can be treated by explaining all possible complications. The proportion of patients entering this class is 1 percent.
How is height extension surgery performed for people diagnosed with dwarfism? What techniques are used?
Such cases come to us at the age of 2-3 years with pediatricians' guidance or when they notice. At first, we make height measurements and calculate the average length of height in adolescence if they are not treated. In children, height extension treatments are performed from the outside without damaging the growth cartilage. According to the patient's condition and the applied section, extension treatments are used with devices that we attach to the leg in a way that wraps around the leg, such as a longitudinal or circle. It is preferred to have a ring below the knee and alongside above the knee. Combined techniques are applied to adult patients. Implants are placed inside the bone that will prevent slipping, curving, and shortening, and, most importantly, shorten the treatment time by two-thirds. For example, in conventional treatments with circles and rods, the process that takes six to seven months can be reduced to two to three months.in turn, increases the comfort of the patient.
What are the symptoms of dwarfism?
There are several exceptional external images in dwarfs. Parents can also diagnose this problem from images such as the Head's excessive growth and the arms and legs. The body, torso, and Head are not suitable for the arm-leg ratio. Parents come to know the problem with the symmetry of the body. We also show similar children's photos about this issue, making them enlightened. Thanks to the Internet, parents are already applying by learning many things. We even encounter many families who are knowledgeable enough to talk to us about surgical techniques.
We divide short stature into proportional and disproportionate. Except for growth hormone deficiencies in dwarfs, there is disproportionate dwarfism in those who often occur, such as 'achondroplasia' and 'hypochondroplasia'. The torso and Head continue to grow normally, while the arms and legs remain short. In these patients, extensions such as 10 - 15 inches can be made in each session because the arms and legs that remain short are trying to fit the torso's proportion with these sessions.
In proportional dwarfs due to growth hormone deficiency, the child grows, but Head, arms, and legs remain short in direct proportion. 1.50 and below the constitutional length of the body proportions remain normal. In these patients, no more than 8 centimeters per session should be extended because there is a risk of deterioration of body proportion. This is also noticeable if the patient is exceptionally long-legged and has a short body. This simulation is performed with the help of photoshop for our patients, and the situation is explained. Because patients come with a desire to grow 15-20 inches, this is not the easiest thing to do. It also disrupts aesthetics and proportion.
What techniques are used in height extension surgeries in people over the age of 18?
If the patient's bone structure is appropriate, the extension is made by placing an implant inside with the combined technique, with a device both from the outside and from the inside. The main advantage of the method is that two-thirds reduce the patient's treatment time. Another technique is performed with implants placed entirely inside. Remote control, magnetic or electro-motor based devices are used. On remote controls, telescopic nails are self-elongated. These are somewhat costly treatments because the implants used are brought in from abroad. Insurance also does not cover these implants.
Minimally invasive methods are used in all processes performed in the bone in extension with an external fixator. Operations are conducted from several incisions up to one inch in size without large skin incisions. A fracture is created by weakening the bone. Then a device called an external fixator is installed, and enough material is expected to form in the broken area for the first ten days. After this material is formed, an extension of one millimeter per day begins to be made by the patient himself or his relative, as if he extends the gum by pulling it from both ends.
A 0.25-millimeter extension is performed every six hours four times a day. This is a painless extension process. Patients are examined every 15 days. Our goal is to examine the extension period's course and diagnose the new bone tissue condition that is formed. If it is determined that the bone tissue does not develop well in control done, the extension speed can be slowed down and reduced from one millimeter to half a millimeter. Sometimes, on the contrary, when it is determined that the bone formation is going well, it can be increased to 1.5 millimeters. Of course, along with the bone, the muscles, connective tissues, nerves, and veins around it also elongate. Therefore, the controls' is there a problem that occurs in these tissues' is looked at. If the target amount of extension is reached, it is expected until the extended tissue reaches the bone's consistency and hardens. After that, the device called' external fixator' is removed. If there is dwarfism, one or two more treatment sessions are performed with an interval of 3-5 years.
What should patients pay attention to during this treatment?
Patients, especially 'our relationship with you begins with surgery. It doesn't end with surgery,' I say. In this type of intervention, if the patient is a child, parents, if the patient is an adult, we need to do intensive teamwork with the physiotherapist. Problems called contractures can occur in elongated joints. These should be opened with good physical therapy. And the bottom of the patient's nails needs to be cleaned two or three days a week. It is also essential that the patient's dialogue with his doctor is excellent. We have to be achievable with the slightest problem. We explain these to patients in great detail. We introduce patients who have already undergone this treatment to patients who are considering undergoing height extension surgery if they allow and wish. They convey their experiences as patients and relatives of patients to each other. That's how we guide treatments.