initial consultation

INITIAL CONSULTATION

The consultation starts with a specialized standing x-ray called an EOS scan. This is a low-radiation dose scan of your entire body from head to foot in a biplanar fashion (front and side at the same time). This scan may be performed the day before your consultation.

You will meet with our Stature Lengthening Coordinator, Angelique, and one of our Physician Assistants (PAs), Vera, John, or Allan. They will obtain your medical history and explain the lengthening process in detail.

Drs. Paley and Robbins will then come in and evaluate you, your x-rays, and perform a thorough physical exam including range of motion and flexibility testing of the hips, knees, and ankles. They will explain the various lengthening strategies and formulate a personalized surgical treatment plan.

After the consultation with Drs. Paley & Robbins, the PA and Angelique will stay to answer any additional questions. They will then take you over to the physical therapy department for a tour. If possible, we will try and introduce you to other stature lengthening patients. This may not be possible. We respect and guarantee all patients’ privacy.

Although the information provided via email is very educational, it is preferable to have a formal consultation in advance to scheduling surgery. We have found that patients who do not have an initial consultation prior to arriving for their pre-surgery meeting are not as prepared for the surgery and have much more difficulty during the lengthening process. Since we now offer virtual consultations online there is no reason not to do a consultation before booking surgery.

BOOKING YOUR CONSULTATION
To book your consultation, please contact Angelique Keller at the Paley Institute at 561.844.5255 Ext:286, via email at akeller@limblengthening.org. Alternatively, you can get in touch with Angelique through WeChat ID: DrPaley. You can also call our toll-free number at 844.714.5293 or request an appointment online at Request an Appointment.

BOOKING YOUR SURGERY
To book your surgery, please contact Angelique Keller at the Paley Institute at 561.844.5255 x286, via email at akeller@limblengthening.org. Alternatively, you can get in touch with Angelique through WeChat ID: Dr Paley. Once you are given a surgery date you need to secure this date with a $10,000 deposit. This can be paid via credit card or wire transfer and will go towards the balance of the surgery fee.

PRIVACY AND HIPAA
At the Paley Institute we are HIPAA compliant. We cannot and will not release your name or medical information to anyone unless you authorize it. The only exception to this is minor patients (under the age of 18) whose information can be released to their parent or legal guardian.

PREPARING FOR SURGERY
There are a number of things you can do to prepare for stature lengthening. First, you should read all the materials we provide on the website or download and read the Frequently Asked Questions (FAQs booklet). Second, book a consultation and have your questions written down so that you can get all the answers you need. Lastly, email us any questions you may think of later or do so via Contact Us form on the website.

It is important to be socio-economically prepared for lengthening. Organize your life so that you can put it on hold for at least three months. This is the average duration of time from surgery to the end of the lengthening phase. Prepare your finances so you can not only afford this surgery but also afford any possible complications from the surgery that can arise. These are not common but can be costly (approximately $30,000) when they do occur.

Be prepared to be single-minded and not distracted during your stay so you can devote all your energy and attention to the limb lengthening process and rehabilitation. Visit West Palm Beach and check out where you will live and the lay of the land. Arrange for someone to come with you or be prepared to hire a home health assistant. Organize a leave of absence from your job so that you don’t feel the pressure to return to work immediately after you return home.

MEDICATIONS
Please inform the surgical team of all prescription and over-the-counter medications and supplements you are taking. Some of these (e.g. fish oil, asparin, anti-inflamatories) can affect bleeding or bone healing (e.g. Acutane, steroids, antiinflamatories, antiepilepitcs, nicotine) during and after surgery. Prescription blood thinners will need to be stopped prior to surgery—our medical staff with confer with your prescribing physician to arrange this. Stop taking anti-inflammatories which can slow bone healing (eg Motrin, aspirin, ibuprofen, Naproxen, Aleve) at least two weeks before surgery.

SMOKING
Stop smoking, vaping, use of any nicotine containing products, and exposure to second-hand smoke at least 2 months before surgery.

STRETCHES & EXERCISES
Stretching exercises prior to surgery may help minimize pain and discomfort during the lengthening. See examples in the Physical Therapy section.

PSYCHOLOGICAL EVALUATION
A psychological evaluation is not required before surgery. Dr. Paley initially used a psychologist for the first twenty years of performing cosmetic lengthening procedures. Drs. Paley & Robbins will perform an assessment during the initial consultation and ensure that patients have realistic expectations and have the proper support required to undergo this procedure successfully.

THE DAY BEFORE SURGERY
You will have a preoperative visit with the surgical team to review your treatment plan and surgery in detail. You will also have an appointment with our preoperative nurse and anesthesiologist. You will be given instructions for surgery. You should not eat or drink after midnight and you should come in two hours before your scheduled surgery to the preoperative area on the first floor of the Kimmel building at St. Mary’s Medical Center, 901 45th Street.

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