Infant plastic surgery comes to Fort Collins

Within hours of Alexandra Burkhart’s birth Sept. 26, her doctors knew she had a cleft palate and a jaw that was too small.

“Her tongue would fall back and she couldn’t breathe,” said her father, Jonathan Burkhart of Loveland.

Alexandra was born with a condition called Pierre Robin syndrome, which means her jaw is so small that her tongue blocks her airway.

The condition is typically seen in Northern Colorado only once every year or two and, until now, required surgery in Denver.

During the past two years, Poudre Valley Hospital has gained the expertise to perform plastic surgery on infants, allowing Larimer County families to be with their newborns in the hospital without having to travel to Denver.

Before Alexandra’s plastic surgeon, Dr. Mark Boustred, came to Fort Collins two years ago, there were no local surgeons who could perform surgery for Pierre Robin syndrome.

Boustred’s arrival from Pennsylvania State Univer-sity and advanced neonatologists and anesthesiologists who work with infants locally make the surgery possible.

For Alexandra’s jaw to grow normally, it needed to be lengthened, Boustred said.

Boustred cut her jaw bone near where it angles and installed a device that allows doctors to lengthen her jaw over a period of days. Plates were installed at the front and back of the cut, allowing a screw-like piece of metal to be turned to force the two parts of the jaw apart.

“We force them apart at 2 millimeters per day,” Boustred said.

Newborns, he said, “churn out” new bone, so the jaw bone grows the full 2 millimeters it’s pulled apart each day. Once the procedure is complete, Alexandra’s jaw will have grown by up to 17 millimeters, or about five-eighths of an inch, Boustred said.

Though Alexandra doesn’t have any other birth defects, it’s unclear if more jaw surgery will be required as she gets older.

“She will need her cleft palate repaired,” Boustred said. “We’ll probably wait until she’s about a year … before doing that.”

The only sign Alexandra should have as she grows older is a scar on the upper part of both sides of her neck, he said.

Alexandra’s mother, Kelley Burkhart, said the condition didn’t show up on an ultrasound, so she was a bit surprised when Alexandra was born with a cleft palate.

The surgery and the jaw expansion procedure has left Alexandra with a jaw that’s temporarily a little bigger than it should be, but it will grow and look normal over time, Kelley Burkhart said.