Great stuff! Came across searching information about the surgery. I started experiencing my tongue caving-in when I exhale whereas I used to have it only when I inhaled at night. Wondering if that is due to a worsening of my sleep apnea, or allergies in my environment while sleeping. Will be following up with my physician regarding this. I wake up with a dry mouse all the time, now.
Hi! I have severe obstructive sleep apnea and after a sleep endoscopy was performed, my ENT referred me to an oral surgeon for the MMA procedure due to tongue base obstruction. The surgeon felt the MMA would be too disfiguring for my face. He also said the recovery time is 8 months with the first month being housebound. Is this information correct? Does the procedure cause significant disfigurement? When I see before and after pics online I don’t see much of a change in people’s faces and some have an even better appearance?
Excellent questions. It depends on what variation of an MMA procedure is performed and which surgeon operates on you. Variations in the MMA procedure that may require more time to heal would be having segmental maxillary cuts and/or TMJ replacements. The typical timeline for healing is at least 1.5 weeks on a liquid diet, should be walking around frequently at this point in recovery, you'll be largely able to navigate life independently by 2-3 weeks, some people return to work at 4 weeks. Most people return to work in closer to 8 weeks. This will depend on your recovery and your job requirements. Speaking for long periods of time and eating will take time to regain strength and endurance. These activities are often tiring for the first 8 weeks after surgery. As for "disfigurement" of the face... This is an interesting word. The procedure IS quite invasive and you will likely look very different after the procure depending on how much advancement the surgeon performs and how much counterclockwise rotation is applied. Most surgeons use simulation software that will estimate your appearance based on their surgical plan. This is something you can ask your surgeon to be involved in. The simulation estimates are fairly accurate for the chin and the upper lip, but not as accurate for estimating where the soft tissue will settle on the nose and the tissue around the nose. The patients I have seen who have had this procedure typically look better and are more pleased with their appearance after the procedure. People who have a small/set-back lower jaw are typically more satisfied with their appearance after the MMA. People who do not have a small/set-back lower are typically less satisfied with their appearance after the procedure. That all being said, this procedure is still a viable option for some people. If you have sleep apnea, I recommend addressing several other aspects of your life PRIOR to resorting to surgery, if possible. Some of these include exercise, nutrition, supplements, sleep hygiene, head of bed elevation, etc. If your sleep apnea is severe, it may be worth beginning your investigation into surgery WHILE addressing these other things on the side. That way you are not losing time. I also suggest speaking with several surgeons prior to making a decision about surgery.
:17 I wish it was just my jaws. My midface and orbits are recessed as well, though maybe that's associated with the upper jaw? I really want to improve my cheek area but I think anything done about it would be really invasive. Do patients who have this see any improvements in the malar region?
Not much. I know that some surgeons do cheek implants to improve aesthetic outcomes. One of these surgeons is Dr. Gunson in Santa Barbara. He may be a good resource if you have further questions about this.
Had this surgery, mandibular only, and 14 months later, still have numbness in my lower lip. How long of a window does the nerve heal in? Does this indicate permanent nerve damage at this point?
It can take several months (usually 6 or slightly more) to regain sensation. It's likely this may indicate permanent nerve damage considering your timeline, but that's not definitive. Nerves heal slowly and are not entirely predictable. This is not uncommon for the procedure and is also surgeon-dependent (there are several ways to do the mandibular osteotomy which makes inferior alveolar nerve damage more or less likely).
hello, i have a lot of problem with the ears, nose and i have a lower back jaw as well as an oval shaped palate. I am told that I could undergo an enlargement of the palate with an expander. but I'm not told about the lower jaw at all at the moment. do you have braces and expander for future maxillofacial surgery?
The amount of expansion (whether dental or skeletal) you may be able to get in the upper jaw will be determined by the width of the lower jaw/dentition because you will need to be able to obtain good dental occlusion after expansion. If you expand the palate too much it may not be able to fit on the lower jaw. Yes, I have braces and upper/lower expanders for upcoming MMA surgery.
@@allsleepashley Thank you very much for your answer. my orthodontist offers me a palatal disjunction. and fitting braces. Is it painful the expanders?
@@guillaumemuzzin4713 What do you mean by palatal dysfunction? Do you mean rapid maxillary skeletal expansion in which the center suture separates? I currently have expanders that will primarily move the teeth... When initially placed, the expanders were painful. This was easily managed with ibuprofen and fully dissipated within a few days. The initial placement of the braces was more painful than the expanders and lasted for over 1 week.
@@guillaumemuzzin4713 Certain palate expanders are more bulky than others. Also, the location on the palate where the expander is placed matters in regards to speech and eating. When you first get them placed, they are very difficult to speak with, but within 1-2 weeks you will quickly learn how to compensate and you will notice your speech changes MUCH more than others will.
@@allsleepashley Exciting. Good luck! I hope to get MMA too, but I'm doubting myself now because I have read it will make TMD worse... Do you think it's worth the risk? (I'm pretty recessed)
@@royalrajasthan8654 There is an inherent risk to all surgeries. I know most about maxillomandibular advancement surgery and common risks for this include infection, resorption of the temporomandibular joint overtime, losing teeth, excessive bleeding, excessive vomiting, a mismatched bite, no being satisfied with one's appearance afterward, instability of the surgery (moves over time), among others. The question is always whether the potential reward is worth the risks.
@@royalrajasthan8654 It is often not an easy decision. I suggest using surgery as a last resort in most cases. I’d be happy to discuss your case over a zoom consultation with you to offer any advice I may have. If that sounds useful you can reserve time on my website.
She is fantastic in explaining this, great choice for
presenting this subject.
Hi are you able to provide an insight on maxilla descent (lowering) surgery please?
Great stuff! Came across searching information about the surgery. I started experiencing my tongue caving-in when I exhale whereas I used to have it only when I inhaled at night. Wondering if that is due to a worsening of my sleep apnea, or allergies in my environment while sleeping. Will be following up with my physician regarding this. I wake up with a dry mouse all the time, now.
Do you reckon in most cases of a deep overbite (class 2 division 2 maloclusion) is necessary for both jaws to be moved or just the mandibula?
Hello Ashley
Who are the recommended surgeons, who perform this surgery in india ( MMA surgery)
Hi! I have severe obstructive sleep apnea and after a sleep endoscopy was performed, my ENT referred me to an oral surgeon for the MMA procedure due to tongue base obstruction. The surgeon felt the MMA would be too disfiguring for my face. He also said the recovery time is 8 months with the first month being housebound. Is this information correct?
Does the procedure cause significant disfigurement? When I see before and after pics online I don’t see much of a change in people’s faces and some have an even better appearance?
Excellent questions. It depends on what variation of an MMA procedure is performed and which surgeon operates on you. Variations in the MMA procedure that may require more time to heal would be having segmental maxillary cuts and/or TMJ replacements. The typical timeline for healing is at least 1.5 weeks on a liquid diet, should be walking around frequently at this point in recovery, you'll be largely able to navigate life independently by 2-3 weeks, some people return to work at 4 weeks. Most people return to work in closer to 8 weeks. This will depend on your recovery and your job requirements. Speaking for long periods of time and eating will take time to regain strength and endurance. These activities are often tiring for the first 8 weeks after surgery.
As for "disfigurement" of the face... This is an interesting word. The procedure IS quite invasive and you will likely look very different after the procure depending on how much advancement the surgeon performs and how much counterclockwise rotation is applied. Most surgeons use simulation software that will estimate your appearance based on their surgical plan. This is something you can ask your surgeon to be involved in. The simulation estimates are fairly accurate for the chin and the upper lip, but not as accurate for estimating where the soft tissue will settle on the nose and the tissue around the nose.
The patients I have seen who have had this procedure typically look better and are more pleased with their appearance after the procedure. People who have a small/set-back lower jaw are typically more satisfied with their appearance after the MMA. People who do not have a small/set-back lower are typically less satisfied with their appearance after the procedure.
That all being said, this procedure is still a viable option for some people. If you have sleep apnea, I recommend addressing several other aspects of your life PRIOR to resorting to surgery, if possible. Some of these include exercise, nutrition, supplements, sleep hygiene, head of bed elevation, etc. If your sleep apnea is severe, it may be worth beginning your investigation into surgery WHILE addressing these other things on the side. That way you are not losing time. I also suggest speaking with several surgeons prior to making a decision about surgery.
:17 I wish it was just my jaws.
My midface and orbits are recessed as well, though maybe that's associated with the upper jaw? I really want to improve my cheek area but I think anything done about it would be really invasive. Do patients who have this see any improvements in the malar region?
Not much. I know that some surgeons do cheek implants to improve aesthetic outcomes. One of these surgeons is Dr. Gunson in Santa Barbara. He may be a good resource if you have further questions about this.
Had this surgery, mandibular only, and 14 months later, still have numbness in my lower lip. How long of a window does the nerve heal in? Does this indicate permanent nerve damage at this point?
It can take several months (usually 6 or slightly more) to regain sensation. It's likely this may indicate permanent nerve damage considering your timeline, but that's not definitive. Nerves heal slowly and are not entirely predictable. This is not uncommon for the procedure and is also surgeon-dependent (there are several ways to do the mandibular osteotomy which makes inferior alveolar nerve damage more or less likely).
Will the patients skull look weird after the surgery?
No.
hello, i have a lot of problem with the ears, nose and i have a lower back jaw as well as an oval shaped palate. I am told that I could undergo an enlargement of the palate with an expander. but I'm not told about the lower jaw at all at the moment. do you have braces and expander for future maxillofacial surgery?
The amount of expansion (whether dental or skeletal) you may be able to get in the upper jaw will be determined by the width of the lower jaw/dentition because you will need to be able to obtain good dental occlusion after expansion. If you expand the palate too much it may not be able to fit on the lower jaw.
Yes, I have braces and upper/lower expanders for upcoming MMA surgery.
@@allsleepashley Thank you very much for your answer. my orthodontist offers me a palatal disjunction. and fitting braces. Is it painful the expanders?
@@guillaumemuzzin4713 What do you mean by palatal dysfunction? Do you mean rapid maxillary skeletal expansion in which the center suture separates? I currently have expanders that will primarily move the teeth... When initially placed, the expanders were painful. This was easily managed with ibuprofen and fully dissipated within a few days. The initial placement of the braces was more painful than the expanders and lasted for over 1 week.
@@allsleepashley I have a very oval palate. they want to give me a palate expander, but I'm very afraid of not being able to eat or speak properly
@@guillaumemuzzin4713 Certain palate expanders are more bulky than others. Also, the location on the palate where the expander is placed matters in regards to speech and eating. When you first get them placed, they are very difficult to speak with, but within 1-2 weeks you will quickly learn how to compensate and you will notice your speech changes MUCH more than others will.
Have you or are you having MMA yourself?
Yes, I'm having an MMA procedure in 2.5 weeks.
@@allsleepashley Exciting. Good luck! I hope to get MMA too, but I'm doubting myself now because I have read it will make TMD worse... Do you think it's worth the risk? (I'm pretty recessed)
What bi jaw surgery is safe
What is your definition of safe and what surgical goals do you have in mind?
@@allsleepashley double jaw surgery
@@royalrajasthan8654 There is an inherent risk to all surgeries. I know most about maxillomandibular advancement surgery and common risks for this include infection, resorption of the temporomandibular joint overtime, losing teeth, excessive bleeding, excessive vomiting, a mismatched bite, no being satisfied with one's appearance afterward, instability of the surgery (moves over time), among others. The question is always whether the potential reward is worth the risks.
@@allsleepashley mem i feel uncomfortable in this situation what I do
@@royalrajasthan8654 It is often not an easy decision. I suggest using surgery as a last resort in most cases. I’d be happy to discuss your case over a zoom consultation with you to offer any advice I may have. If that sounds useful you can reserve time on my website.