The Complete RED Survival Guide

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If you're clueless about RED and still think it's just the color of firetrucks, you're probably at the wrong site.  However, here's a little background on the Rigid External Distraction procedure.

      RED stands for Rigid External Distraction and is a procedure designed to correct (in part) a number of craniofacial syndromes including Apert's, Pfieffer's, and Crouzon's.  Way back in medical history (a few years ago), "craniofacial kids" most always had a traditional midface advancement where the entire midface was isolated and advanced in surgery.  While this procedure did often provide satisfactory results, the length and complexity of the surgery, along with the long recovery time required of the patient, made this procedure seem less than ideal.

        The RED, as everyone who's been through it knows, is hardly a fun or easy process.  However, the concept of moving the midface bone forward gradually and allowing new bone to form between the gaps seemed less painful and less dramatic than the traditional LaFort III procedure.  Because I have not had the older traditional midface advancement, I don't know how the patient experience of the "old" way compares with the newer RED way.  However, according to my surgeon and several others I've talked with, RED is more effective in maintaining long term results. 

      The RED device is attached while in surgery.  Screws attach the halo-like device to the head, and pins and/or wires under the skin attached the  vertical crossbar that runs in front of the center of the face to the skull. It is rather complicated to describe accurately with words, so I suggest that anyone considering this have a good conversation with their surgeon.  How the device is attached to the skull often depends on the individual's case.

       After the surgery, the screws are then turned a little bit each day (or several times a day) with a special wrench, gradually advancing the midface forward.  The screw-turning continues for however long the surgeon "prescribes" to attain the goal.  This is usually a few weeks.  Once the turning is stopped, the patient must (patiently) continue to wear bulky device for another month as a retention device. 

        Obviously, this doesn't sound fun.  To be honest, it's not.  To be blunt: it's really unfun.  However, several people, including myself, have been through this procedure and can tell you that all of this was worth it.  This site is to help you as much as possible to be comfortable during this procedure.


Does it hurt? Yes.

Are you sure? Yes.

Really? Yes.

Then why do all these articles tell me it's 'pain free' and so 'wondeful'? They've never been through it.

Are you TRYING to stress me out? No.

SHOULD I stress out and act like a chicken with it's head cut off? No, I've already tried that, it didn't work

Does it hurt like you're going to die? No.

Does it hurt as much as the traditional way*? Probably not.**

Does it get a better result than the traditional way? Usually, yes.**

Do you heal faster? Usually, yes.**

Will you have to have the RED done as many times as the traditional way? Usually, no.**

*The traditional is to have the midface is brought fo rward wIthin one big surgery.

**Since I have never been through the "traditional" way, these answers are based on what others have told me.

The answer to question #1 (and #2 and #3) really varies with everyone. If you have never gone through this before, you have probably heard the sugar-coated version of the experience from your surgeon or the RED company, and various people who have never gone through it. Yes, it does hurt, but you'll pull through. Everyone who has contributed to the site knows this. Please don't let this site scare you, I'm only being honest so you can have it straight. Sometimes, the anticipation up until O-Day (Operation Day) is worse than O-Day itself.

Please talk to your surgeon with any of your other questions!