Does Maxillomandibular Advancements For Sleep Apnea Improve One’s Appearance?
Q: Dr. Eppley, Wondering if you do maxillomandibular advancements surgery for sleep apnea or know of any other plastic surgeons that are also dentists/oral surgeons that might do this procedure. Would prefer to have a oral surgeon that is also skilled as a plastic surgeon in hopes of having not only a successful surgery, but also a better cosmetic outcome. Thank you.
A: I do perform bimaxillary (maxillomandibular) advancements for obstructive sleep apnea. You are correct in that there can be a delicate balance between how much to move the face below the eyes forward and not so much that it creates facial disharmony. (resultant infraorbital-malar hypoplasia) As a general rule it is recommended to move the maxilla and mandible as far forward as possible. (usually about 10mms) But in some patients that may well create a ‘protruding lower face’ that is disproportionate to the natural facial appearance above it. This requires insightful planning beforehand based on the patient’s facial shape. Using computer imaging and VSP (virtual surgery planning) for the facial bones from the patient’s 3D CT scan, more thoughtful surgical planning can be done that takes into account both the functional and aesthetic needs of the patient.
Dr. Barry Eppley