One of life's small pleasures is looking into the face of a happy, smiling child. Unfortunately, there are many children who because of congenital or growth problems are living with bony facial deformities which affect their lives in many ways. Facial deformities do not only affect a child's self-perception. There can also be problems affecting the child's speech and ability to breathe, chew and digest their food.

Martin (R) with Dr. Graper after his surgery

This new technique is called craniofacial distraction osteogenesis and is used to gradually lengthen bones of the upper and lower face while growing new bone and soft tissue. Children whose upper and/or lower jaw is underdeveloped can now be helped to attain a more normal appearance and improve their speech and chewing functions. The procedure involves both surgery and a device to gradually increase the length of the bone.

In order to determine if this procedure is right for the child, extensive x-rays and computer analysis are done by the maxillofacial surgeon. After reviewing the results of the analysis, the surgeon plans the procedure with the help of the parents and the child who are integral parts of making the treatment plan successful as part of the treatment is carried out by the parents.

When the patient and family are prepared to proceed, the child is scheduled for surgery. Under general anesthesia, the cranio-maxillofacial surgeon accesses the bone, which needs to be lengthened, and creates two segments by surgically cutting the bone. The distraction device is then implanted into the bone segments with an external port for the parents to place the distraction "key." The child usually spends two days in the hospital to recover.

Upon the child's discharge, the parents begin the process of distraction by placing the "key" in the external port and turning it the prescribed number of times each day. This allows the jaw to separate gradually while allowing the generation of new bone and the remodeling of the soft tissue of the face. Over a period of a few weeks, the child's face will gradually change with the bones lengthening and forming a more functional and aesthetic appearance.

While craniofacial distraction osteogenesis may not replace all conventional surgical techniques for facial deformities, it does represent a less invasive surgery and can benefit children with a variety of disorders including Apert's syndrome, Crouzon's syndrome, hemifacial deformities, cleft patients, children with an underdeveloped lower jaw, Pierre Robin syndrome, and Treacher Collins syndrome.

There are a variety of devices now available for use with craniofacial distraction osteogenesis. Each child must be evaluated on an individual basis and have an individual treatment plan with proposed distraction device. The patients are carefully chosen, as they are a part of the total plan. Without the child's cooperation, the technique is not successful.

Martin completed his distraction treatment almost two years ago. His face is now more symmetrical and his overall function has improved dramatically. His lower jaw was moved almost 25 mm. which allowed him to chew properly, close his lips together, and gave him an overall more pleasing appearance. He has gained more self-confidence in his appearance and has gained weight since his surgery as his digestion has improved.

This new technology will bring a smile to children who now hide behind their deformities. You can learn more about this new technology which is making the lives of hundreds of children better by calling Dr. Graper's office. Changing their faces makes children happy and happy children make the world a better place for all of us to live.