Mandibular Distraction (Jaw Distraction)

Children born with an abnormally small jawbone, or mandible, can have severe breathing difficulties when they are born or shortly after. This also can affect their ability to feed and sleep. Mandibular distraction (man-DIB-u-lar dis-TRACK-shon), or jaw distraction, is a method used to lengthen the jawbone. As the jaw is lengthened, it pulls the tongue forward and opens up the airway so the child can breathe clearly.

UPMC Children’s Hospital of Pittsburgh is among a small number of children’s hospitals with the multidisciplinary expertise to offer this surgery. Small jawbones may accompany other medical conditions such Pierre Robin Sequence.

Mandibular distraction is used to treat critically ill newborns and infants who can’t breathe on their own so they can avoid having a tracheostomy. It is not done for aesthetic reasons. We believe parents and guardians can contribute to the success of this surgery and invite you to participate. The following information can help you learn about the surgery and how you can help.

Why Choose UPMC Children’s

UPMC Children’s is a nationally ranked Top 10 children’s hospital. Our specialists perform dozens of jaw-related surgeries each year, including mandibular distraction. We are trained in complex craniofacial reconstruction, functional airway surgery, and facial aesthetics.

Our plastic surgery team at UPMC Children’s includes highly skilled surgeons, orthodontists, anesthesiologists, and nurses who are specially trained in caring for children and are dedicated to helping children function at the highest level by treating both common and complex surgical issues.

Children’s is the region’s leading pediatric referral facility and western Pennsylvania's only Level I Pediatric Trauma Center. Whether your child’s situation is severe or straightforward, a congenital impairment, or the result of an injury or trauma, you can be confident that we’ll apply our years of expertise, knowledge, and experience to help your child.

Fast Facts about Mandibular Distraction (Jaw Distraction)

  • Mandibular distraction is a method used to create new bone by slowly moving two bone segments away from each other.
  • It involves a surgical procedure to attach lengthening devices (distractors) on each side of the jawbone. To insert the distractors, small incisions are made under the jaw. These incisions will be almost invisible as the child grows older.
  • After surgery, only two small rods — called distractor arms — can be seen externally. These arms will be adjusted daily over a 2-week period to lengthen the lower jaw by increasing the space where the jaw is split. The jawbone grows to fill the space that is created.
  • This surgery takes about 1.5 hours.
  • Most babies stay in the hospital during this process. They usually are able to go home feeding orally within a month after surgery.
  • Approximately three or four months later, the distractor device is removed during a second surgery.

The Surgery

Your child’s surgery will take place at Children’s Hospital in Lawrenceville. Most newborns needing this surgery have been treated in our neonatal intensive care unit (NICU) since their birth.

The day of surgery, you will meet with one of the doctors on your child’s surgical team, including a doctor from anesthesia. They will answer any additional questions you might have.

When it is time for your child to go the operating room, you’ll be asked to wait in the surgical family waiting area.

A Parent's/Guardian's Role

During the surgery, at least one parent or guardian should remain in the surgical family waiting area at all times in case the family needs to be reached.

While Asleep

A general anesthesia will be given to your baby. While asleep, their heart rate, blood pressure, temperature, and blood oxygen level will be checked continuously.

After Surgery

After surgery, your baby will return to our NICU with a breathing tube in place. They will continue to be sedated for about a week.

You can expect your baby to remain in our care for about 1 month. You will be supported by a team dedicated to their care, including plastic surgeons, pulmonologists, feeding therapists, NICU nurses, and others. You’ll be shown how to care for your baby once home.

Follow Up

You’ll be given a detailed care plan before your baby leaves the hospital. Follow-up appointments will be scheduled with key members of the surgical team before you take your baby home.

At Home Care

You’ll be given information about how to help your child when you get home. This include any medicines to give your baby, how to adjust the distractor arms, and details on postoperative care.

If you see any signs of infection, you should contact the number given to you by your care team.

If you have ANY concerns, we are always happy to talk with you.

Special Needs

If your child has any special needs or health issues you feel the doctor needs to know about, or if you have any questions, please call 412-692-6845 before the surgery and ask to speak with the nurse. It is important to notify us in advance about any special needs your child might have.

If it is after hours, call the UPMC Children’s operator at 412-755-2318 and ask them to page the doctor who is on-call for procedure.

Contact Us

To schedule an appointment with the Division of Pediatric Plastic Surgery, call 412-692-8650. Online scheduling is also available for both in-person and video visits.

Our Location

UPMC Children’s Hospital of Pittsburgh
4401 Penn Ave.
Floor 3
Pittsburgh, PA 15224