What Is the Mid-Face Advancement Surgery and the RED device?

102 days from surgery.

A friend asked me the other night, "So what exactly will they be doing?" As many times as I've talked about this procedure, I surprised that I found myself a little stumped on how to answer. I can tell you what the device is called, how it is attached, what the purpose of it is...but anything more in depth gets a little fuzzy. So I went to Aiden's surgeon's website and pulled information that can explain it much better than I can. Below is a summary that answers some of the most common questions I receive about this procedure.

• The LeFort III brings the entire midface forward in one piece from the upper teeth to just above the cheekbones and the monobloc brings both the midface and the forehead forward together at the same operation.
   
• Although the LeFort III is a major operation, of all the different procedures done for Apert syndrome it has the greatest impact on normalizing a child’s appearance and improving breathing at night.
  
• In 1998 [Dr. Fearon] developed what is called a halo-distraction technique for the LeFort III. This technique utilizes a device called the RED, which is actually not red, but purple in color. It gets its name for being a Rigid External Distraction device.
  
• With the RED procedure the bones of the mid face are cut loose then the skin is closed and a halo is attached to the outside of the skull with 8-10 screws. A splint (U-shaped piece of plastic) is attached to the upper teeth and two wires extend forward from this splint to attach to the halo.
   
• The forward pull of the midface comes from the dental splint. The parents, or the child, turn two screws on the device 2 to 3-times day in order to slowly (and painlessly!) bring the midface forward.
  
• The children are allowed to eat soft foods, may go to school, and can even go swimming while wearing the RED. For some children wearing this device after surgery is easier than for others.
  
• Seven to eight weeks later, the device is removed with a 20-30 minute anesthetic.
  
• The greatest advantage of the RED device is that it enables surgeons to move the midface much further forward than is possible the traditional technique (based on a study done at our center).
  
• We have treated over 125 children with this technique, and continue to make fine improvements in this procedure.

Below are some photos shared with permission from friends in the craniofacial community who's children have undergone the RED surgery already. 

If you have any questions, please know that I am always happy to answer them! I may have to look it up myself, as I'm no expert on this by any means, but I will never be offended by the opportunity to learn and share. Just be warned that I do get emotional talking about it in person...so perhaps email would be better ;)