“It is both plastic surgery and there are situations where height enlargement surgeries must be performed. There are height standards that vary from society to society and differ for men and women. But generally, people whose height is below 1.50 are diagnosed with 'constitutional short stature'. If it is below 1.35 and 1.40, it is classified as dwarfism. Dwarfism is considered a disease and its treatment is started early. There are height increase treatments that start at the age of 5. These are done in sessions between the ages of 5 and 10 and in adolescence. Not only the legs but also the arms are extended. Constitutional short stature is seen in people who stop growing in height after adolescence and whose height remains below the standard. Patients in this group suffer severely from their condition. In this group of cases, which are actually healthy people, height enlargement surgery can be performed after some preliminary examinations.”
How much height can be increased in aesthetic surgeries?
“Medically it is possible to do this, but ethically it is not possible.” It is not right to do. If we think that this person's short stature has become a spiritual obsession, we refer the person to a psychiatric consultation. If the psychiatric consultation reports, "If this treatment is not administered, the patient in question will have permanent mental disorders," then the patient can be treated by explaining all possible complications. The rate of patients falling into this class is 1 percent.”
“It is essential not to harm children's growth spurs.”
How is height increase surgery performed on people diagnosed with dwarfism, and what techniques are used?
“Such cases come to us at the age of 2-3 with the guidance of pediatricians or when the family notices them. Height increase treatments in children are performed externally without damaging the growth cartilages. Depending on the patient's condition and the part applied, lengthening treatments are applied with devices that are attached to the side of the leg longitudinally or in a circle-like manner that surrounds the leg. The one that resembles a circle below the knee, and the one that is sideways above the knee is preferred. Combined techniques are applied to adult patients. Implants are placed inside the bone to prevent slippage, curvature and shortening, and most importantly, to shorten the treatment time by two thirds. r.
“THE EXISTENCE OF Dwarfism CAN BE UNDERSTOOD FROM THE SYMMETRY OF THE BODY”
Is it easy for parents to be convinced that a child aged four or five will remain a dwarf in the future?
“There is something in dwarfism. The team has special external displays. Parents can also diagnose this problem from images such as the excessive growth of the head compared to the arms and legs, and the body, trunk and head not being in accordance with the arm-leg proportions. Parents come knowing the problem with the symmetry of the body. We provide enlightenment by showing similar children's photographs on this subject. Thanks to the internet, parents are already learning many things and applying. We even encounter many families who are knowledgeable enough to talk to us about surgical techniques.”
We divide short stature into two: proportional and disproportionate. Except for growth hormone deficiencies, disproportionate dwarfism is seen in very common dwarfism such as 'achondroplasia' and 'hypochondroplasia'. In this case, while the trunk and head continue to grow normally, the arms and legs remain short. For these patients, lengthening of 10-15 centimeters can be done in each session. Because these sessions try to adapt the short arms and legs to the proportions of the body.
In proportional dwarfism due to growth hormone deficiency, the child grows, but the trunk, head, arms and legs remain proportionally short. Body proportions remain normal in constitutionally short people who are 1.50 and below. In these patients, no more than 8 centimeters of lengthening should be done per session. Because there is a risk of deterioration of body proportions. If the patient has extremely long legs and a short torso, this is also an eye-catching situation. This simulation is performed with the help of Photoshop and the situation is explained to our patients.”
“HEIGHT ENLARGEMENT SURGERY CAN BE DONE IN ADULTS WITH TWO METHODS.”
Which techniques do you use in height enlargement surgeries for people over the age of 18?
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“If the patient's bone structure is suitable, lengthening is performed with a device both externally and internally by placing an implant inside with a combined technique. Another method is performed with implants placed completely inside. Use remote controlled, magnetic or electro-motor based devices It's okay. Telescopic spikes on remote controls extend on their own. These are somewhat costly treatments because the implants used are brought from abroad. These implants are not covered by insurance. Insurance pays the cost of treatment for pathological diseases such as dwarfism."
"EXTENSION OF 1 MILLIMETER PER DAY IS POSSIBLE IN TREATMENT."
Can you detail the applications during the treatment process?
"External fixator Minimally invasive methods are used in all bone lengthening procedures. The operation is performed through a few incisions, at most one centimeter in size, without making large skin incisions. A fracture is created by weakening the bone. Then, a device called an external fixator is attached and sufficient material is waited to form in the fractured area for the first 10 days. After that material is formed, the patient or his/her relative begins to lengthen one millimeter a day, as if stretching the gum by pulling from both ends.
0.25 millimeter lengthening is performed four times a day, every six hours. This is a painless extension process. Patients are examined every 15 days. Our aim is to examine the course of the extension period and to diagnose the condition of the new bone tissue formed. If it is determined that the bone tissue is not well formed during the control, the lengthening speed can be slowed down and reduced from one millimeter to half a millimeter. Sometimes, on the contrary, when it is determined that bone formation is going well, it can be increased to 1.5 millimeters. Of course, in the meantime, the muscles, connective tissues, nerves and vessels around the bone also lengthen. Therefore, during the checks, it is checked whether there is a problem in these tissues. When the targeted lengthening amount is reached, the lengthened tissue is waited until it reaches bone consistency and hardens. Afterwards, the device called 'external fixator' is removed. If there is dwarfism, one or two more sessions of treatment are performed, 3-5 years apart.”
“THE PATIENT'S DIALOGUE WITH THE DOCTOR IS VERY IMPORTANT.”
What should patients pay attention to during this treatment? What do they need to do?
Problems called contractures may occur in the extending joints. These need to be opened with good physical therapy. The bottoms of the patient's nails should be cleaned weekly. It also needs to be cleaned for two to three days. It is also extremely important that the patient has a very good dialogue with his doctor.
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