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Author Topic: Dr. Guichet is over rated, over priced, bad patient outcomes. Do you agree?  (Read 10110 times)

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Rod Thick

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When I first started thinking about limb lengthening I thought for sure I would have surgery with Dr. Guichet. Now, after reading this and the old forum, I think that Dr. Guichet is over rated and charges way too much for his service. He basically charges as much as Dr. Paley. His lengthening nail is very old technology, actually there's no technology in his nail at all, it's more like a medieval torture device, and I personally think his expensive training programs are a complete waste of time and money.

Most importantly his patients don't seem to have good outcomes. After reading through posts on this and the old forum, i've noticed a lot of complications with his patients. That's just among the patients that stick around to post throughout their lengthening, a number of his patients just abandon the forum before they even finish lengthening.

Does anyone else have the same opinion and notice the same problems with Dr. Guichet?
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Knik

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Over priced, yes.
But he stay one of the better for internal.
Also that's more dangerous to do internal for tibias, and most accidents are tibias patients
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Rod Thick

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I forgot to mention that in the very first email I ever received from him it says "you can do 10cm or more of lengthening in your femurs"

To me that is so unsafe and just insane for a doctor to allow a patient to lengthen that much in one bone segment, but then Dr. Guichet goes on to advertise it in his emails. Seems like a sleazy sales job to me.
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TIBIKE200

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I have my ideas of him.. But its not true that all patients had bad outcomes.. There a guy here who did 5cm who had good recovery and then there is guy on old forum who did approx 4 inches who also had a report on him who recovered well. All the others though.... Bad outcomes or simply very slow recovery
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Knik

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slow recovery not a very important except if you have a physically work
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0184946

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for quite awhile i was obsessed with guichet i agreed with his extreme training program and from his videos i could tell he had the personality that pushes patients to train hard which you will need the extra motivation however it seems to me that almost every doctor has bad outcomes. ive yet to hear about a doctor that hasnt been called a butcher by someone at least once. even paley has been attacked by that negativity. i just dont get my info from the internet anymore. u never know if people are spreading fake diaries/experiences to drive us away from the doctor because the doctor is competition to whoever. for all we know ur apo in disguise lol but u cant put the outcomes solely on the doctor but on how they take care of the problem i would ultimately rather have a pre-cautious,overly-safe doctor rather than a chill laid back one. every doctor has had patients with minor to major complications and if he hasnt then,to me, he is inexperienced. there are tons of good patient outcomes by him as well. never overlook that.
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1683131665

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I am now very confused, because I always want to go to guichet.
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google42

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I am now very confused, because I always want to go to guichet.


Yea, I assumed he was a good doctor. I don't know what to believe anymore.
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onemorefoot

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10 cm in one go??? Come on. Every surgeon I meet dont recommend going beyond 3 inches IN FEMURS: so if a guy offers you 10 cm........Hmmmmmm
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Body Builder

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Imo Guichet is totally overpriced and his work out routine is more like a body challenge than something that really works and has a true benefit in LL.
Also, his nail is completely outdated.

I don't think he is an incapable doctor but considering his weird character and his over the top price, I'd never consider him as a choice to do femur LL
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The Kaiser

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Re: Dr. Guichet is over rated, over priced, bad patient outcomes. Do you agree?
« Reply #10 on: February 28, 2017, 10:02:34 AM »

10 cm in one go??? Come on. Every surgeon I meet dont recommend going beyond 3 inches IN FEMURS: so if a guy offers you 10 cm........Hmmmmmm

That guy is lying if he didn't give us a proof from the email, am sure he misunderstood Dr Guichet, because Guichet told me when i asked him to do 10 cm, he said yes with repeated surgery only. That's mean i do 7 cm in my femur and after a year i will do the rest (3 cm) if i insist
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682

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Re: Dr. Guichet is over rated, over priced, bad patient outcomes. Do you agree?
« Reply #11 on: February 28, 2017, 10:44:35 AM »

When I first began researching and lurking these forums, I had the same opinion. You see the same names mentioned again and again in posts mentioning the best surgeons to undergo this procedure with. Paley and Guichet were consistently mentioned and I began to ask why these 2 names appeared so often. From diaries, reading their methods, their studies, expertise and experience in the field it was clear why people would choose Paley, I couldn't find the same rationale for choosing Guichet to such a great degree besides experience.

Personally speaking and my greatest issue with Guichet is I believe he lengthens at a rate that, from the information I have gathered isn't beneficial for soft tissue recovery and adaptation nor consolidation. From the large distraction during surgery to the rapid lengthening throughout the lengthening phase. Coincidentally, the 'horror' stories have more issues with non-union rather than the much preferable pre-consolidation. I believe his 'success' stories appear to have recovered so well is because they were in excellent shape prior to the surgery as Guichet recommends meaning the hit they took was considerably less noticeable and appears better than someone who did no preparation but potentially have damaged their soft tissues much more than had they lengthened at a reasonable rate. Add the fact that his method appears to have become outdated and offers no tangible benefit over other, newer and in my opinion better methods and his cost which rivals the very best orthopedic surgeons - as of 2017, I would not go to him for this procedure as I believe there are better candidates for a similar if not better price. His bedside manner is a contentious issue but is completely irrelevant if the results are satisfactory.

Of course, this is just my personal conjecture and the method Guichet uses could be the most optimal for limb lengthening and he may have his own reasons which I am unaware of as to why he does the procedure in this manner - there just isn't the research out there to definitively say that one way is better or worse than another, just hypothesis, vastly varied anecdotes with no controls and semi-relevant research.


That guy is lying if he didn't give us a proof from the email, am sure he misunderstood Dr Guichet, because Guichet told me when i asked him to do 10 cm, he said yes with repeated surgery only. That's mean i do 7 cm in my femur and after a year i will do the rest (3 cm) if i insist

Further lengthening in the femur or 3CM of tibial lengthening? If 2 femoral lengthening procedures, resulting in a total gain of 10CM, waiting a year before further surgery will offer negligible benefits if the soft tissue is over lengthened and already damaged, which it likely will be at 7CM and will only result in further damage which it definitely will be at 10CM. Primarily, I would advise a more conservative and 'safe' amount to lengthen, if not, it would probably be more beneficial to lengthen 5CM and then the remaining 5CM a year later meaning the soft tissue has initially been 'less' damaged and more stretched meaning that year will allow your body to adapt to some degree. Good luck with whatever you do.
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Annalisa

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I don't think so. I never read any very negative long-term consequences of Guichet surgery. Slow recovery or complications are part of the game, they don't make Guichet a bad doctor. Guichet lengthening method is way safer an faster than the tibias one, and is very scrupolos in assuring you gain the best physical shape before doing any surgery. Plus, I don't know what's the problem with 10 cm lengthening. If you train to gain the right amount of physical mass and flexibility, you can reach that level. I know 6 cm would be safer, but if you're 150 cm like me, 10 cm is the minimum, and tibias are too risky and slow to recover; I think is better to do everything on femurs.
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682

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Plus, I don't know what's the problem with 10 cm lengthening. If you train to gain the right amount of physical mass and flexibility, you can reach that level.

This is completely false. 10CM on one segment at any height is completely excessive, filled with risk and complication and will almost certainly leave long term issues but even more so at 150CM. You can train to the level of an olympic athlete, it will barely make a difference to the huge damage that will occur on your soft tissues at 10CM of lengthening on one segment. I know this may not be what you wish to hear but it is the truth, lengthening to 10CM is risky, dangerous and damaging.
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Annalisa

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I might ask  what do you mean by segment? One bone or one lengthening session? I didn't deny the fact there are more complications, but permanent issue, if you're body is prepared and you do internal femurs, which are the safer option, are not too probable. And I have only heard  normal complications with Guichet, no unfixable damage. Anyhow, what would you advise for a short girl who want her 10 cm and do not want to touch the tibias? Two different lengthening periods, with one year of break? Is it worth to overcomplicating things this way?
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Body Builder

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I might ask  what do you mean by segment? One bone or one lengthening session? I didn't deny the fact there are more complications, but permanent issue, if you're body is prepared and you do internal femurs, which are the safer option, are not too probable. And I have only heard  normal complications with Guichet, no unfixable damage. Anyhow, what would you advise for a short girl who want her 10 cm and do not want to touch the tibias? Two different lengthening periods, with one year of break? Is it worth to overcomplicating things this way?
If you don't want to touch your tibias then you should forget a 10cm lengthening.

First you will be ridiculously disproportionate if you have a 10cm longer femur, especially if we consider that you are really short now.

But the most important is that only a few people could get away with a 10cm lengthening, even in femurs, and not be permanently damaged and maybe can't even walk relatively normal.
And for people at your initial height it is impossible and no respectable doctor will let you lengthen too much.

So, stick to about 6 cm at femurs which will put you in a good height for women or consider doing 2 LLs and gain about 10-11 cm.
There is no other option, especially for your height.
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Annalisa

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I do not get what it means that for people of my height is impossible to lengthen so much. It's just people of my  height that need huge lengthening, not someone who is 170cm and wants to gain few cms for vanity issue. Guichet is a respectable doctor, and he say you can lengthen 10 cm on the femurs. There is the proportion issue, but he will show me mock-up pictures for idea of what I'll look like. It's so difficult and confusing. I really feel the need to be at least 160 cm, but also think that including tibias would include more risks and slow things down a lot. Anyway, for internal femurs at least 8 cms isn't too risky.
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Body Builder

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I do not get what it means that for people of my height is impossible to lengthen so much. It's just people of my  height that need huge lengthening, not someone who is 170cm and wants to gain few cms for vanity issue. Guichet is a respectable doctor, and he say you can lengthen 10 cm on the femurs. There is the proportion issue, but he will show me mock-up pictures for idea of what I'll look like. It's so difficult and confusing. I really feel the need to be at least 160 cm, but also think that including tibias would include more risks and slow things down a lot. Anyway, for internal femurs at least 8 cms isn't too risky.
With 1.50 initial height 10cm added is impossible. Unless you are one of the most flexible women in the world, none 1.50cm person's body can tolerate a 10cm lengthening in one segment.

8cm in femurs are risky for the majority of patients, moreover for a so short person like you.
10cm are insane for you (amd most of LL'ers too) so if you want to risk your abilities for becoming 1.60, even though you can become about 1.56 (an ok height for women and many men like me really like short girls) without much risks, then it is your choice.
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Jack1066

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I can see why you'd want to be a few inches taller but that is a lot in one segment. Typically doctors only recommend lengthening a maximum of 20% of the bone. You could go for two surgeries though.

Try a couple of inches. Yes you'll still be pretty short but you'll have gone over 5'0". I'm not a short woman myself but I imagine that'll be enough to make life substantially easier.
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Jack1066

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-- I mean, 20% of the initial length of the bone.
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Whereintheworld?

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Guichet lengthening method is way safer an faster than the tibias one, and is very scrupolos in assuring you gain the best physical shape before doing any surgery....and tibias are too risky and slow to recover...


Yet again Annalisa, femurs are indeed faster, but by no means are they safer.
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yyes

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Yet again Annalisa, femurs are indeed faster, but by no means are they safer.

I was under the impression that they are safer. As an example, if you were to install a nail in the tibia, you will get permanent knee pain forever. That doesnt happen with Femurs
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helloworld

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I personally think a full weight bearing nail is great.
Dr. Monegal has told me that he thinks Guichet is an excellent surgeon and a money making machine.
However, Dr. Monegal thinks that inserting the nail from the hip can easily cause side fractures of the bone, as the implant is straight and the bone is curved (as happened to Unicorn and Musicmaker), so Dr. Monegal is only doing insertions from the knee.
I also think, like 682, from my experience that 1 mm a day is too fast and can lead to non-union and soft tissue complications. So while at the beginning I was following Dr. Monegal standard of 0.81 mm per day, I soon realised that I had much less tension and slep much better at 0,6 mm per day. So while before I wanted to push the limit doing 1 mm rather than 0,81 mmm I have in fact done the opposite, just lengthening enough to not have a consolodation yet. As a result I stopped taking pain medications 6 weeks ago and sleep without much problem.


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TrueSpartan

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Hello world,

I understand for soft tissue lengthening limit, it is better to lengthen at a slower rate but how do you know you will not get consolidation at 0.81mm per day. Does the bone not regenerate at 1mm per day? Are you not taking a risk by lengthening slower?
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Annalisa

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I can understand it. The true is, I have a strong desire to exploit the operation  as much as I can, as it will cost plenty of money. And paying double and wasting double the time, it isn't actually a very comforting thought. However, increasing the risk and worsening proportion only for few cm of difference, it doesn't seem very rational. So, I will now try to happy with 7 cms. Maybe when I will add these cms and using some hills, I will be good with myself without the need of growing futher.  Could someone tell me if Guichet external tibias lengthening is the same price as the femurs operation? Because if it is, then will be impossible for me to even think about doing two operations (not without waiting years at least), but if it's like 20000k more, then maybe it could be a possibility.

If I did 7 of femurs and 5 on the tibias, it would be a 12 cms increase. My legs would be significantly longer than my torso, but I also think that, for women, having longer legs is actually sexy. Some opinions about?
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YourSpaceBoyfriend

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Dwarf on stilts aren't sexy.

Going for such an amounts of lengthening will kill your mobility, don't go ever past 10cm(both segments included).

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Annalisa

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I'm sure I wouldn't look dwarf. Pretty the contrary. Plus, considering the fact that my arms are long comparing to the body, adding  10-12 cm, will not make them look too short and the longer legs will make my body looks more elegant. And I don't see why a 2 cms of difference would kill my mobility. All the problem is about not stretching one segment too much. If you don't go over 7 cms on the femurs and over 5cms on the tibias (which is considered a safe lengthening), and take a break between the operation, you will be able to gain more than 10 cms, without stressing a single segment too much.

But my question was about the price difference between internal femurs and external tibias offered by Guichet. Someone know it?
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Jack1066

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What is the initial length of the bone, though? Don't go over 20% on each bone. And 20% is the recommended maximum- 10% is better.
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Annalisa

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This percent thing seems like an internet bull. Who made up it? Is it more like a proportion related calculus, or a safety one?

My target is: 7 cms minimum on the femurs, and 10-11 cm  ideal overall. Anything lower isn't worth it, and won't cure the neurosis I have since I was a little girl.
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YourSpaceBoyfriend

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I'm sure I wouldn't look dwarf. Pretty the contrary. Plus, considering the fact that my arms are long comparing to the body, adding  10-12 cm, will not make them look too short and the longer legs will make my body looks more elegant. And I don't see why a 2 cms of difference would kill my mobility. All the problem is about not stretching one segment too much. If you don't go over 7 cms on the femurs and over 5cms on the tibias (which is considered a safe lengthening), and take a break between the operation, you will be able to gain more than 10 cms, without stressing a single segment too much.

But my question was about the price difference between internal femurs and external tibias offered by Guichet. Someone know it?

That's why:

Hi, it is possible, but risks of knee contracture is quite high. Maximum length around 10cm, but depends on whether range of motion can be maintained.
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Annalisa

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A knee contracture isn't like something permanent though. It can be treated, it isn't something you can't take risks for. Moreover, since we're talking about the knee, it wouldn't be very effected by the lengthening done on the femurs. Anyway, of course I will be happy with 10 cms. It will be a world of difference for me.
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