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Sleep Surgeon Question 16

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Question 16 - How about MMA Revisions?

From: F.G.

Dear Dr. Li: I am strongly considering MMA surgery, but a some MMA surgeons do not want to do me because I had a lower jaw advancement with the lower front tooth segement moved back about 25 years ago and they say that would make the MMA surgery more complicated.

So I guess I need to find a surgeon well experienced in revisions. The way they did the surgery on me back then was different and I just have two wires in the back of my jaw. I would like to ask you 3 questions: !.How many revisions of past surgeries like mine have you done.

Additionally, I was told the counter clock wise rotation is more difficult and it is very important to get a MMA surgeon that has done a lot of them. 2.How many counter clock wise rotations have you done? 3.

Some MMA surgeon do not want to do MMA surgery on me because my upper and lower jaw are okay now and would not recommend to much advancement because it would really hurt my appearance. However, a very well respected sleep apnea ENT surgeon who was rated one of the best doctors in the united states and writes lots of articles about sleep apnea surgery, said if I have my tongue base cut off and maybe the bone behind my palate cut off I would not have to be moved as far for MMA surgery.

Would you agree with that....because the same movement should not be for everyone. Could you work with this nationally know doctor who has done a total airway exam on me and says my tongue blocks my airway so much that he has only seen two other patients where the airway was blocked by the tongue so much. Gratefully yours,

F. G.

Answer Provided by Dr. Kasey Li
Aug 10, 2007

Revision surgery is always more difficult and most surgeons don’t have any experience in this type of operation. I have treated about a dozen patients over the years with revision maxillofacial surgery.

They are more complex, but certainly not impossible. The results have been good.

Counter-rotation of the occlusal plane/jaw is routine in my practice and I would estimate that well over a 100 cases.

Lastly, many patients ask me about different types of operation and whether they would be a candidate for them. Since I have not examined you, I can not tell you either way. My usual answer for all patients is that if a surgeon feels that he can help you significantly with a certain type of operation, he/she should be able to provide 3 patients who have had such operation(s) for you to talk to.
Good luck.

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