Jaw Surgery to Cure Sleep Apnea (Guest Post)

Many patients ask their doctors (and us) about alternatives to PAP therapy for obstructive sleep apnea (OSA). While PAP is the gold-standard for treating OSA, there are many patients who can’t tolerate it, refuse to use PAP every night or are looking for an occasional alternative to using PAP every night.

In this blog series, we will ask experts to explain alternative therapies. Each expert will detail how the therapy works, who is a good candidate (and who isn’t) and where to go for more information.

What if there were a one-time procedure that could cure your sleep apnea for good, no mask required? Bimaxillary advacement surgery–a complicated term for moving both the upper and lower jaw forward–attempts to do just that. 

Bimaxillary Advancement Surgery Basics

Bimaxillary advancement surgery, also known as maxillomandibular advancement (MMA) surgery, moves both the upper and lower jaw forward, creating a larger airway and making it easier for the patient to breathe. This surgery has a success rate of over 90 percent and the majority of patients do not have to continue using the CPAP device after the surgery is complete.

jaw-surgery-before-after-pictures

During the procedure, the surgeon will mobilize the upper and lower jaw and move them forward, securing them with small titanium plates and screws. In some cases, the surgery also involves inserting braces, arch bars, or rubber bands on the teeth for up to six weeks in order to stabilize the patient’s bite. The jaw is not wired shut and the patient can resume a diet of soft foods within seven to ten days of the operation.

Bimaxillary Advancement Surgery Advantages & Drawbacks

Some patients choose bimaxillary advancement surgery because:

  • It eliminates CPAP therapy and oral device use in a majority of cases.
  • It offers a permanent treatment for OSA.
  • It has a significantly higher rate of success than other sleep apnea surgeries.
  • A recent study of 50 patients found that bimaxillary advancement surgery improved sleep apnea symptoms while also decreasing patient blood pressure and body mass index (BMI) over time.

However, bimaxillary advancement surgery is not the best choice for all sleep apnea sufferers.

  • This surgery is not recommended for those with high BMIs or those with certain other serious health issues.
  • For those that are compliant and using their CPAP machine correctly there is no need to look for alternative solutions.
  • This surgery requires some amount of recovery time.

To learn more about bimaxillary advancement surgery as a treatment for OSA, speak with your doctor about the option and whether it might fit your needs.

Comments

  1. Mark Brogdon Reply

    I recently had this surgery at Shands Hospital at the Univ of Florida and it isn’t bad. It sounds way worse than it is and I have NO regrets.

    The surgery itself isn’t that painful. They controlled my pain with ibuprofen starting the night of surgery and after about 5 days, I didn’t need it anymore. The hardest part is the initial swelling, which lasts about 4 days. After that, you return to normal fairly quickly. The swelling doesn’t hurt, it just makes everything so tight and it does mess up your sinuses for a month or so. You feel like you have a bad sinus infection.

    The liquid diet you start out with suck, plain and simple. Your lips are numb the first few days and you have to eat through a syringe. It was on Day before I was drinking from a cup…. carefully. I still had some numbness and it would spill easy, but it makes you feel so much better to finally be in a cup and not a syringe.

    I don’t regret this surgery at all. By the 4th night, I was sleeping throughout the entire night and despite the swelling and congestion, I could already see a marked difference in my sleep quality. My morning 5, I was waking up and felt more refreshed after a nights sleep than I can even remember in recent times.

    The surgery was not hard to obtain. My insurance company initially denied it because they thought it was for cosmetic purposes. My doctor’s office immediately contacted them to do a peer-to-peer review and thoroughly discussed my xrays, CAT scan, and sleep study results. The surgery was approved at the end of their presentation. This was all on a Thursday and I was in surgery at 6am Monday morning.

    If CPAP isn’t working for you, I saw pursue this surgery. My blood pressure and pulse rate as well as my sleep quality, mood, and general attitude have improved ten fold. This surgery is well worth every minute of the initial discomfort.

    • Clara Pettorelli Reply

      Hi Mark,
      That is great and I am happy for you that it all worked out! May I ask your age? I am 55 and I will be doing the MMA surgery next month as I have very severe obstructive sleep apnea and I an not at all taking to the CPAP and also may have allergic reactions due to it but not sure on that yet.

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    • Sarah Snyder Reply

      I did not have it for sleep. It was horrible. I stayed in the hospital for 5 days. I barely got any sleep. They kept on taking my blood sugar. It was so hard to swallow and I basically drolled the majority of it. You can not talk at all and the nurses still ask questions that are not yes and no. Then you have a splint which means until you can take it off talking is painful and not very easy to understand. I had to go to school like that. After the syringe, I literally drank out of a sippy cup. Until I got the splint out I was constantly drolling. Your lip gets so irritated. I also through up twice. In the hospital, I was at risk for pneumonia because of all of the stuff in my lungs. I could not breathe very well. This surgery is the worst. I had to go for 7 weeks with the splint on. This is no easy surgery. I have not even talked about eating. I literally lost 20 pounds.

      • Patrick Reply

        What kind of pain meds and did they work?

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  2. Bruce McDonel Reply

    I’d like to know your age as well Mark. I just turned 59 and my Dr doesn’t like MMA saying it is only 75% successful and thinks I should not consider because of my age. And also..who was your surgeon please?

  3. Robert Sinclair Reply

    I live in England and would like to know how to get this operation as my hospital dose not seem to tell you about this and I can not tolerate CPAP

    • Andrew Chapman Reply

      Robert,
      From my research there are only two surgeon in the United Kingdom that had managed to obtain funding through the NHS for surgery related to Obstructive Sleep Apneoa.

      It would appear that Mr Vic Veer is one of the two surgeons who have this NHS funding. I have not been able to find out who the other surgeon is.

      Mr Vik Veer is one of few Consultant Surgeons in the country who is employed by the NHS to provide surgery for patients with Sleep Disordered Breathing. He works at the Royal National Throat Nose & Ear Hospital in central London and also at Queens Hospital in East London.

  4. Frank Müller Reply

    I had this surgery in Germany and I am very happy. Now, 6 Months later I have no more Sleep Apnea. I recommend this operation to everyone with sleep apnea.

    • Haley Schwanke Reply

      Was your sleep apnea severe or just average?

    • Sam Reply

      Hey frank
      How much cost u please

  5. Keith Mims Reply

    Mark & Frank sounds like the had great results ,,, I sent them both a message on facebook ,,I hope it was the correct people and Clara ,,,how did your surgery go ?,, Hope it was good ,, let me know ,, I am about to look into this and have the surgery ,, I just turned 60,and don’t want a cpap machine .. NO I DON’T …

  6. Brent Lindstrom Reply

    Hello,
    My name is Brent. I’m 56 years old and suffered from OSA. My surgery was performed last February, my braces are scheduled to be removed in early September.
    I would highly recommend the surgery. The first night home post surgery I slept an uninterupted 7 hours! No snoring. One additional benefit is that my spouse is sleeping much better because I’m not snoring and the CPAP noise and airflow release isn’t interfering with her sleep. The only issue I’m dealing with is numbness in my chin which may continue another 6 months.

  7. BD Reply

    how long was your recovery time….meaning missing work?

  8. Trish Aquino Reply

    Hi all! My name is Trish and I am 58 years old and have had insomnia my entire life. I have a defined chin and jawline and I am wondering if any of you who have had the surgery did too, pre-surgery. My surgeon has told me I will look toothy and horsey after the surgery. All the before and after photos she has are of patients with weak chins and no jawlines and their look was much improved after the surgery; she does not have any of patients who had defined jawlines pre-surgery. I have a high narrow palate and have had an ALF, a holistic palate expander, but it has flared my teeth quite badly and only widened my palate a tiny bit after 2.5 years of treatment. I am willing to do whatever it takes but would prefer not to look like a horse. I would be very interested if anyone out there had a strong jawline before surgery and what your outcome was. Thank you!

    • Leah Reply

      Hi Trish! I non surgically expanded my palate with what’s called an MSE. Took about 5 months, was painful but did the job! Then we put on braces. Check it out!

    • Patty (some friends call me Tricia) Simoni Reply

      Hi Trish
      I hope this message gets to you!
      I was just reading your post from 2019 and could definitely relate!
      I’m 63 y/o with severe sleep apnea and have had an underbite. My orthodontist told me with the braces my underbite would be worse (and it did make it worse). but they said they had to do it that way in preparation for double jaw surgery. My jaw surgeon said because he would be doing the surgery for sleep apnea he would have to move both jaws forward A LOT! I actually said I didn’t want a horsey face after but he said he has to move it that far (saying in essence it is what it is- if I want to cure the sleep apnea I will have both jaws far out)

      I too searched the internet for pictures of someone starting out with a lower jaw that was already forward a lot ( you are right you only see people with recessed chins and their post op pics look great

      I had braces in my late teens and the orthodontist tried the palate expander but it didn’t work (I think i was too old- my palate was already fused?). so he actually flared out my teeth to get the top teeth to go over the bottom teeth. My current orthodontist spent the past 2 years trying to fix the splayed teeth that i had.

      I’m wondering if you ever found anyone in our situation (strong chin) who had the DJS and has before and after pics.

      Did you end up getting the DJS?

      I hope to hear from you
      Thank you

  9. Joshua Reply

    Thank you for sharing. I see that not all people with sleep apnea can have this procedure also the recovery time to have well developed bite is like 6 months long recovery,.

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    Excellent article. Very interesting to read. I really love to read such a nice article. Thanks! keep rocking.

  13. Taylor Andrews Reply

    I have a second thought about getting this kind of surgery since I had a bad experience undergoing some kind of operation.

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  17. Lucy Reply

    I have insurance but it does nothing to help with a cap. I was just diagnosed with severe obstructive sleep apnea and my pulse ox also drops into the 70’s. I have a job but I cant afford to just fork out almost $4000 for a machine that I dont even know will help. I need suggestions on where to get help.

  18. Roland Reply

    Good day,
    Is it possible to use my cpap machine directly after double jaw surgery in the event the procedure was unsuccessful at removing apneas. Or given the air pressure the machine builds up inside the nose/ mouth is there a certain amount of time one should wait before using it.
    Thanks in advance

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