The consultation was 30 minutes on the DOT, and it was the most expensive 30 minutes of my life of $200.
Cost for Surgery and Nail:
$45,000 USD for Precise Internal Femur
$15,000 for External Tibia.
He doesn't have STRYDE nails.
No flexibility on costs. Yes, I asked.
I really didn't want to do this consultation because all of the questions I already knew the answers to because the answers could be easily found online but it seemed like it was a requirement if you wanted to do the surgery at all.
Here are some of the answers from Parihar himself:
1) Would the consultation fee count towards surgery?
A: No
2) Which would be preferred regarding recovery and safety? Internal Femur or LON Tibia?
A: Internal Femur is "state of the art, the best", and so the preference would be for Femur.
3) Does the bone healing duration compare from external to internal?
A: They are roughly the same. But I would say the femur might possibly be faster. This is because there is much more Vascular Tissue surrounding the femur and this may perhaps cause quicker healing in the femur. But this difference is nothing crazy and definitely not months.
4) Is it possible to get surgery in another hospital?
A: No, because they are too far away and this type of surgery requires frequent visitations from doctors. We are working on developing a new facility but this will be in the future.
5) I understand you don't do externals on femurs, but I see that lots of other doctors do. What do you think about such methods?
A: There are just too many complications that occur in external lengthening on the femur because there is so much muscle around it. It is never worth it and therefore I will never do externals on femurs for cosmetic purposes.
6) Do you need a Medical Visa or could someone come with a tourist visa and extend it?
(I asked this question because I'm not sure how someone would get their doctor to sign off on Cosmetic Limb Lengthening in the US. Sounds crazy to convince a doctor.)
A: Medical Visa is definitely necessary and we never had a patient that came on a tourist visa.
7) LON Knee pain has been commonly discussed. Is this avoidable?
A: LON Knee pain is more theoretical in my personal opinion. In our facility, we are frequently putting nails for trauma pains and I would know if knee pain was ever an issue as it would come up much more. I'm not convinced about knee pain, and I don't think research has enough evidence to support this. It probably isn't a practical issue but more a theoretical one. 
Risk of infection, what do you do the mitigate risks?
A: There is always less than 1% theoretical risk for any surgery. Not just limb lengthening but all surgery. We minimize this risk by standard methods that are applied by all hospitals not just in India but in the states as well. We take all the safety precautions necessary to minimize all possible infection risks.
9) Fat Embolism, do you prescribe any blood thinners or Xarelto?
A: I don't prescribe any medication, just take precautions during surgery. We also stay very vigilant throughout the lengthening process to keep a high suspicion of complications.
10) Do you still hold the same philosophy of "function over length"?
A: Yes, that is why I keep a hard limit of 6cm in tibias. Let's say for example I have a 99% success rate and a 1% failure rate. For that 1% of that patient, it is basically a 100% failure rate as they are experiencing all the fails. It is important to be cautious, rather than being adventurous.
None of these were burning questions, and since not a lot of people had questions to ask him (on my post before requesting questions), I just asked questions that I thought were most relevant in under 30 minutes.
Thanks questpeanut.
I'm surprised he says no stryde because I had heard from one more patient that stryde is indeed available in India.
$200 is indeed a lot for a 30 minute consult lol. No idea why he charges that much.
Did you decide for or against going to him after the consult?
Quote from: 2020hope on December 14, 2020, 04:41:18 PMThanks questpeanut.
Did you decide for or against going to him after the consult?
The consultation literally made no difference to me. I did all my research before talking and I've been set on Parihar for a while.
The biggest concern for me is the Visa Situation. How in the world do you convince your doctor to sign off on something as crazy as cosmetic limb lengthening? Like Kilokhan was able to barely squeeze their way to do it but I can't begin to imagine talking to my doctor about this. I might have to switch doctors for this because I can't bear to tell him about this.
Quote from: questpeanut on December 14, 2020, 04:49:07 PMThe consultation literally made no difference to me. I did all my research before talking and I've been set on Parihar for a while.
The biggest concern for me is the Visa Situation. How in the world do you convince your doctor to sign off on something as crazy as cosmetic limb lengthening? Like Kilokhan was able to barely squeeze their way to do it but I can't begin to imagine talking to my doctor about this. I might have to switch doctors for this because I can't bear to tell him about this.
Yes and adding to that I doubt you can get a visa to India anytime soon due to covid.
That said, as far as I know, tourist visas let you stay in India for 6 months. I doubt you would want to extend your stay beyond that under any circumstances.
About 9).
Not prescribing a blood thinner, especially with internals, is really dangerous.
I did 20 days injections for external tibias which is way safer for embolism compared to internals, I can't believe how a doctor don't prescribe blood thinners at all even for internals.
Only for that I wouldn't go there.
If you add India which is maybe the worst place in the world (together with some african countries) for surgeries and 45k for precise 2 (not even stryde), I wouldn't even consider that place.
Giotikas is on a first world country, uses stryde with the same money and of course he'll use blood thinners like any sensible doctor that does LL, epsecially internals.
I really can't see any reason for someone to go to Parihar and Imdia compared to Giotikas.
Thanks! On his website, he mentions that patients might have to get a hotel since long term accomodation is hard in his place.
https://sites.google.com/site/cllrpatients/faqs/cosmeticlengthening
Say you pay for a hotel near him. Is he still cheaper than Giotikas even considering the hotel fees?
Wait we need to get an American doctor to give approval for us to go to Greece or India to do CLL? Really?
What are the worst things about doing surgery in India aside from dirty facilities?
Quote from: SpeedDialer on December 14, 2020, 09:47:19 PMWait we need to get an American doctor to give approval for us to go to Greece or India to do CLL? Really?
No.
Quote from: 2020hope on December 14, 2020, 04:41:18 PM$200 is indeed a lot for a 30 minute consult lol. No idea why he charges that much.
Probably to minimize the amount of inquiries into CLL that result in a bunch of questions and no follow up from the inquirer.
Quote from: SpeedDialer on December 14, 2020, 09:46:22 PMThanks! On his website, he mentions that patients might have to get a hotel since long term accomodation is hard in his place.
https://sites.google.com/site/cllrpatients/faqs/cosmeticlengthening
Say you pay for a hotel near him. Is he still cheaper than Giotikas even considering the hotel fees?
Most hotels have discount rates for long term stays. I was at a 3-star hotel for the discounted rate of $1,500 a month ($50 daily).
Quote from: questpeanut on December 14, 2020, 04:49:07 PMThe consultation literally made no difference to me. I did all my research before talking and I've been set on Parihar for a while.
The biggest concern for me is the Visa Situation. How in the world do you convince your doctor to sign off on something as crazy as cosmetic limb lengthening? Like Kilokhan was able to barely squeeze their way to do it but I can't begin to imagine talking to my doctor about this. I might have to switch doctors for this because I can't bear to tell him about this.
I think you can go to any doctor, all that's needed is a letter from the one you see. It doesn't even have to say that you are approved for cosmetic lengthening or that it's recommended you do it, just that you are not prohibited from going to India for the procedure. Regardless, I think you're better off just telling your doctor. If you have any surgery later on in life or are hospitalized for any reason, you may be asked if you've been operated on before and it's best to be honest when it comes to your health since it's not like you'll be seeing your doc in your personal life and they are supposed to follow patient-doctor confidentiality.
As to the unavailability of Stryde, if Dr Parihar doesn't offer it then it likely means they're not yet approved for use in the country, in which case a representative from Nuvasive would be the best person to ask if there are any plans for it. I haven't heard of any other docs using Stryde in India yet either, just the prior generation of Precice.
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