I’d like to walk you through what a typical patient’s journey looks like from the moment they arrive in South Africa until surgery.
This is a common question because the process can seem intimidating and overwhelming at first.
Patients usually fly into Cape Town International Airport, where they’re greeted by our driver at the International Arrivals Hall. From there, they’re taken to their hotel in Stellenbosch, where we book them for a two-night stay prior to surgery. This allows the patient to adjust to the environment, manage any time zone differences, and arrive at the hospital in a relaxed, comfortable state.
The day before surgery, we met for a pre-op consultation. During this visit, you’ll meet my team and I, and we’ll take new x-rays to assess. We’ll go over these images together, perform a clinical examination to check muscle strength, flexibility, proportions, and metrics like height and weight, and discuss every aspect of the surgery in detail.
Once we’ve confirmed everything and agreed to move forward, our multidisciplinary team will meet with you, one by one, to integrate you into our system and ensure that every aspect of your care is covered. After that, you’ll return to the hotel, and the next day is surgery day.
On the morning of surgery, our driver will pick you up from the hotel and bring you to the hospital for check-in. I’ll meet you early for a final ward round before the operating list begins. We’ll review the surgery once more to ensure everything is in place, and I’ll help put your mind at ease. The anesthesiologist will also meet with you at this time.
After a few routine pre-op blood tests, you’ll be prepped and taken into the operating theatre, where the life-changing surgery will take place.
Let’s break it down. Fat embolism syndrome happens when fat droplets from the bone marrow enter the bloodstream and travel to the lungs. This can impair the lungs’ ability to oxygenate the blood, much like what we saw during the COVID pandemic, where patients needed ventilation to maintain oxygen levels.
If this occurs, we can detect it quickly by monitoring a drop in the oxygen levels in your blood. That’s why we keep patients in a high-care unit post-surgery, to closely monitor oxygen levels and respond swiftly. If needed, we can provide oxygen through nasal prongs, which is a non-invasive method of delivering oxygen.
Thankfully, while about 4% of patients may experience some degree of fat embolism, not all of these cases are life-threatening. In fact, most are mild and respond well to treatment, becoming transient issues. Severe cases requiring more aggressive interventions are rare, and by choosing a well-structured, specialized system, you can be confident that every precaution is taken to minimize risk.
The second risk is related to blood clots, commonly referred to as DVT or thromboembolism. This occurs when a blood clot forms in the lower limbs after major surgery and can potentially travel through the bloodstream and lodge in the lungs, cutting off the lungs’ ability to oxygenate blood. In many ways, this is similar to fat embolism, but it arises from different causes.
We know from surgeries like hip and knee replacements that the risk of DVT is real, and the same concern applies to limb lengthening procedures. Reputable surgeons, like our team, use a range of strategies to lower this risk. One of the most effective methods is administering low molecular weight heparin injections for the first few days after surgery, followed by oral blood thinners once the patient is discharged. We routinely implement this protocol for an extended period post-surgery to ensure the risk of blood clots forming and traveling to the lungs is minimized.
