Distraction Osteogenesis Overview
Distraction osteogenesis is a surgical procedure that corrects jaw and craniofacial deformities where the bone in the jaw region requires lengthening. This procedure is used in children with cleft palates, in adolescents whose upper or lower jaw did not grow properly, and in trauma victims who experience serious jaw injury. Distraction osteogenesis has been around for decades in use on other parts of the body. Modern maxillofacial surgeons have perfected the procedure so that outcomes on the face are safe and predictable. Palo Alto maxillofacial and plastic surgeon, Dr. Stephen Schendel, is a skilled expert in this procedure and has developed specific methods to produce excellent results for patients.
"I had some plastic surgery done to correct my a creator on head after a traumatic event. Dr Schendel gave me a few options to consider, which resulted with excellent results."- A.K. / Google / May 09, 2018
"I am taking the time to share the positive experiences I have had of Dr. Schendel because it is important that any public information is accurate. Firstly, the doctor went out of his way and..."- A.T. / Yahoo / Dec 03, 2017
"I am taking the time to share the positive experiences I have had of Dr. Schendel because it is important that any public information is accurate. Firstly, the doctor went out of his way and made room in his schedule to consult regarding my 8 year-old daughter's needs when we had no prior relationship with him and oral surgery was imminent. He was gentle with her and honest with me about our choices. His expertise and care allowed me to make the best choice for my child.Secondly, he has cared for more than one individual I hold dear. This family has faced over 20 years of medical intervention and combined, upward of 30 surgeries. Dr. Schendel has been steadfast, consistent, and brilliant in his care of my dear one and her child. As her friend, each time they have faced yet another intense physical challenge or surgery, I have rest assured that she was getting the absolute best treatment because she was in Dr. Schendel's care. The bottom line is I trust him, both to care for my family and those I cherish.Aneea Toomajian PPS, LMFTEducational and Behavioral Consultant"- A.T. / Yelp / Dec 03, 2017
"Dr. Schendel has been my surgeon since I was 15 years old, I am now 44. I have been incredibly grateful for his work and dedication to his field. He has performed several procedures on me to correct a severe unilateral cleft lip and palate. I was referred to him because my clefting was so unusual and other surgeons had been unsuccessful with my case. My cheekbones were non-existent, eye sockets sucken in, jaw extremely recessed, palate permanently open and I had existing scar tissue from previous cosmetic surgery attempts by another surgeon. These are ALL the things Dr. Schendel has fixed with expertise, compassion and dedication. californiacraniofacialin…Over the years, Dr. Schendel has carefully and compassionately rebuilt my face from the inside out. Giving me the bone structure that I was not born with due to the severity of my cranial facial anomalies.When I first met him(I was 14) he excused his entire team of fellows who were there to observe him. He gave me the privacy I needed, handed me a mirror and asked me, "What don't you like about your face?". As a teenager, I was given the space to communicate the things that were great sources of pain. I explained the various things about my cleft lip that caused other kids teased me about. From that moment Dr. Schendel set out to give me a normal face with nothing but determination, dedication and true compassion.Over the years, I have faced other complications with my bone structure and degeneration from my severe cleft. Dr. Schendel has fiercely, carefully and methodically worked to fix the constant erosion and instability in my face. He has striveded to continually find the newest, best techniques available. I have been able to have implants along with bone grafts to retabalize my eroding palate, stem cell procedures to improve the tissue and blood flow to my face and cosmetic revisions-- I have been incredibly grateful and happy with the results.Dr. Schendel's ability to listen and connect with me has been amazing. As a youth, I felt safe, validated and listened too as a patient. As an adult, he has heard my worries and validated the pain I have felt in my face and palate. He has worked tirelessly to fix my cranial facial anomalies. I believe that his ability to be so compassionate and careful with his patients comes from YEARS of working with cleft affected children here and in third world countries. A few years ago, I learned that Dr. Schendel has also volunteered countless hours of surgery in third world countries to operate on children. He has insisted that the surgeries are learning sessions for local doctors in those countries. He has created a learning environment to teach the newest techniques to other physicians in these countries. He also spends months of his own time collecting supplies to take to these countries to donate for the surgeries. Dr. Schendel's passion for rebuilding faces generates from a desire to truly want to help rebuild lives--physically...and emotionally.Our son is also bilaterally cleft affected, he is now 13. Dr. Schendel has revised his soft palate and his lip. It is with tremendous gratitude that we have Dr. Schendel as our son's doctor. His revision is beautiful and his cleft is a non-issue. His speech has also VASTLY improved due to the titrated listening of Dr. Schendel in knowing how to revise our sons palate so skillfully so he can now make sounds like "J" "P" "K". I have referred Dr. Schendel to several family friends for various things that are not cleft related. Not because Dr. Schendel is an incredible oral maxillary and plastic surgeon. But because of his ability to connect with his patients, to hear them, to see them and then to use his dedication to medicine to help them."- V.L. / Yelp / Dec 03, 2017
"Dr. Schendel has been my surgeon since I was 15 years old, I am now 44. I have been incredibly grateful for his work and dedication to his field. He has performed several procedures on me to..."- V.L. / Yahoo / Dec 03, 2017
Distraction Osteogenesis Surgical Technique
Distraction osteogenesis is a surgery that is tailored per patient. Many times, the patients are children and so the procedure is structured accordingly. During this procedure, a break (osteotomy) is made to the abnormal bone and a special device (known as a distractor) is attached to both ends of the bone. This attachment is adjusted routinely over the course of weeks in order to stretch the osteotomy with the goal that new tissue fills it. This regenerated tissue heals and turns in to new bone, essentially creating a longer bone from a shorter one. Dr. Schendel will use distraction osteogenesis in conjunction with a LeFort osteotomy for the upper jaw, as well as during lower jaw surgery.
Distraction Osteogenesis During/After Surgery
Distraction osteogenesis is performed as an outpatient surgery in our accredited surgical facility. Patients undergoing this procedure will require general anesthesia. The procedure takes anywhere between 2-3 hours. The surgical techniques used during distraction osteogenesis have advanced greatly, which allow this surgery to be considered less invasive, which means that there is usually less swelling and pain involved during the recovery phase. Everything is done inside the mouth, thus there are not any scars associated with this procedure.
Distraction Osteogenesis Expected Cost
The cost for distraction osteogenesis will vary. In some cases, it will be combined with another jaw procedure. The technique itself starts at around $6,000 and increases (up to $12,000) depending on the severity of the condition being treated. In some cases, insurance may cover a portion of the procedure. During your initial consultation, our team of insurance coordinators will confirm if insurance benefits can apply to your specific procedure.
Plan Your Procedure
- Average Cost
- $6,000 - $12,000
- Recovery Time
- 1 Week
- Average Procedure Time
- 2-3 Hours
- Procedure Recovery Location
Distraction Osteogenesis FAQs
Distraction osteogenesis is a procedure that refers to a slow movement (distraction) of two bony segments. The entire procedure takes place inside the mouth and is less invasive than other procedures of this nature (bone lengthening). Patients go home the same day and turn the distractor slowly in order to produce the desired length of space for new bone growth. There is no scarring associated with this surgery since it all takes place internally.
Is It Painful?
During the procedure itself, there is no pain because patients will be under general anesthesia. Postoperatively, we will prescribe appropriate painkiller medications to help keep patients comfortable in the immediate days that follow surgery. The distraction device to lengthen the space between the two bone segments is a slow process. Most patients feel just a little discomfort during the distraction movement. Most compare it to the feeling of when you get your braces tightened.
Pros and Cons?
One benefit with distraction osteogenesis is that bone grafting is not necessary. While it does take time for new bone to fill in the gap, there is only one surgical site. Just like having braces, one disadvantage is that patients must return frequently so that the surgical site can be assessed and monitored so that the surgeon can ensure the device is doing its job.
In general, the younger the patient, the shorter the distraction period. Adults will require a longer period of distraction and consultation because as a person ages, the regenerative process slows down. With that said, distraction osteogenesis is a procedure that has been proven effective for individuals of all ages.