Physician at Work: Life-changing craniofacial procedures

For patients, the benefits are both functional and psychological

Having trained as both a dentist, and plastic and reconstructive surgeon, Derek M. Steinbacher, DMD, MD, is uniquely qualified to perform complex craniofacial surgery in both children and adults.

For children, he does cleft lip and palate surgery, and facial procedures for Crouzon and Apert syndromes, genetic diseases that affect the formation of the face and skull, as well as jaw (or orthognathic) surgery to correct structural defects of the jaw and face. For example, in children with airway obstruction due to a small jaw or severe sleep apnea, he uses distraction osteogenesis, a procedure that brings the jaw forward and helps open the airway. It may require only a day or two of hospitalization, but the patient’s parents continue the procedure at home by turning a device to slowly bring the jaw forward. It sounds uncomfortable, but is typically painless, according to Dr. Steinbacher, because it’s only one millimeter per day divided into two or three tiny turns.

To his young patients, the procedures he has mastered can be life-changing. He recently operated on a 12-year-old girl with Crouzon syndrome who had sleep apnea and craniofacial deformities. In addition to opening her airway, he was able to improve the appearance of her eyes, nose, cheeks and mouth. “Now she’s very happy, her breathing is improved, she is speaking and chewing well and is interacting better at school,” said Dr. Steinbacher. “She looks great.”

For adults, he provides nasal and facial reconstruction after skin cancer surgery, as well as rhinoplasty for deformities or airway problems, or following trauma. Since his arrival at Yale last year, he has also been doing facial, and head and neck reconstruction following the removal of tumors, as well as correcting skull defects and performing complex craniofacial reconstruction.

He enjoys facial reanimation procedures, which is useful for patients with Lyme disease, who can develop a permanent Bell’s palsy. “We use microsurgical techniques that involve transferring a nerve from their leg to their face, and then subsequently doing a free muscle transfer to restore their smile and facial mimetic capabilities,” he said.

Dr. Steinbacher is excited about the varied and complicated procedures he performs in his practice. “Reconstructing the bone and soft tissue of the face imparts both a functional benefit and a psychological advantage in terms of restoring and improving a patient’s appearance and improving his or her quality of life,” he said.

Name: Derek M. Steinbacher, DMD, MD

Title: Assistant professor of plastic surgery, craniomaxillofacial surgery

Area of expertise: Plastic surgery, craniofacial, maxillofacial and facial reconstruction surgery, rhinoplasty, facial and body cosmetic surgery

Place of birth: Fairfax, VA

Age: 36

Dental School: University of Pennsylvania

Medical School: Harvard Medical School

Training: Residency at Massachusetts General Hospital in oral and maxillofacial surgery and Johns Hopkins Hospital in plastic and reconstructive surgery; fellowship at Children’s Hospital of Philadelphia in craniofacial surgery

Family Married to Julie Paquette, engineer; Daughter Brooke, age 2

What is most challenging to you in academic medicine? Integrating new strategies for clinical and translational problem solving

What is most rewarding? Reconstituting normal form and function in the setting of complex reconstructive and craniofacial surgery

What do you like most about your practice? The ability to cognitively analyze a problem, generate a surgical plan and execute this to have a positive (and transformational) impact on a patient and his or her family. This is true for a myriad of interrelated problems across a wide spectrum of patients.

Personal interests or pastimes? Playing drums and percussion, camping, biking

Last book read: “The Fourth Hand,” by John Irving

What would you do to improve our clinical environment if you had a magic wand? I would enhance the ease of access and promote a more efficient system of health care delivery.