Can A Maxillomandibular Advancement Done For Sleep Apnea Be Reversed?

Q: Dr. Eppley, I previously had a BSSO/Lefort I to open up my severely restricted airway and address sleep apnea. While I did receive some relief from the apnea (about 50% improvement in nighttime breathing), the aesthetic result has been a huge problem for me. I had delicate features going into the surgery and the effect of advancing both the upper and lower jaws threw my overall facial balance and harmony out of whack. I have never become accustomed to my new look. This has upset me greatly since the surgery – especially the look of the upper jaw. I look odd and unnatural. A year after the surgery I had cheekbone implants to create greater balance by addressing my midface deficiency. I also had a genioplasty to address my concerns with the chin and jaw that I felt were too strong for my delicate features. But obviously neither one of those procedures are going to address the impact on my appearance caused by the maxillary advancement – and my chin and mandibular still remain too strong in appearance, overwhelming my other features. I fear this imbalance is only going to get worse with age. Can a BSSO/Lefort I ever be set back a bit, or essentially reversed? Does it involve major surgery and a long recovery like the original BSSO/Lefort I? Can you help me? Thank you for your time.

A: Thank you for your inquiry and detailing your history. A maxillomandibular advancement can be reversed in most cases of which the surgery and the recovery would be identical to the first time as it is the same operation just a different direction of movement. As a result this gives one some serious consideration between balancing the aesthetic tradeoffs and the functional improvements gained from the first procedure. Whether are other alternatives to that approach I can say without comparing your before and after surgery pictures.

Dr. Barry Eppley

Indianapolis, Indiana