Craniofacial Distraction

The initial procedure to cut the bone and attach the distractor takes place while your child is under general anesthesia. When they wake up from the anesthesia, the distractor will be in place. You can then go home to begin the recovery process.

Depending on the correction being made, the distractor may be completely internal — placed beneath the skin — or it may include an external frame. The ends of the distractor attach to the bone with special medical screws called pins.

All devices used in craniofacial distraction are FDA-approved and made of titanium, a lightweight metal that does not cause tissue irritation.

Once they recover from the short-term effects of the surgery, children report little discomfort. Older children and adolescents who have had dental braces and bone distraction typically say that distraction causes less discomfort than orthodontic treatment. External distractors’ design keeps patients’ comfort in mind, and children generally report having no trouble sleeping. 

Once the distractor is in place, treatment occurs in three phases.

• Latency phase: The distractor remains in place for one to five days, without increasing the gap between the separated sections of bone. This phase allows new bone to begin growing, initially in the form of soft callus, a sticky tissue without the rigidity or strength of mature bone.
• Active distraction phase: Adjusting the gap between the bone sections in small increments, usually once or twice a day, encourages the growth of additional soft callus. While new soft callus grows at the ends of the bone segments, the earliest callus to develop begins to harden into bone. This distraction process continues until the patient achieves the desired bone length and shape. In most cases, the parent or caregiver adjusts the distractor at home, following the doctor’s instructions. You will have regular appointments at the doctor’s office during the active distraction phase to monitor progress.
• Consolidation or healing phase: The distractor stays in place for several weeks, without changing the space between the bone sections. This process allows the soft callus and immature bone to harden into mature bone. The distractor holds the bone in place while this natural process occurs, much like a cast or brace holds bones in place after a break due to injury.

Once the new bone has matured and hardened, Dr. Vyas removes the distractor, typically a brief outpatient surgical procedure.

Dr. Vyas will give you complete instructions on caring for your child at each stage of the distraction process and will train you in making adjustments to the distractor spacing at home. Depending on the desired correction, there may be some restrictions on your child’s activities. For example, in a treatment to extend the jaw, your child will need to eat soft foods throughout the distraction and healing process.