Posted by sleepsurgeon on May 03, 2009 at 13:31:55:All patients are concerned about recovery from their surgery, and rightly so. There are many factors that influence the recovery course. Some may be controlled but most may not. I will make some general comments in terms of influencing factors. Some of the factors for MMA are age, health status, anatomy of the jaw, distance of advancement, attitude of the patient, and last but not least, the skill and attitude of the surgeon. In regards to the age of the patient, obviously, the young the patient, the easier the recovery course. Patients in their late teens just bounce back quicker than patients in the early sixties (having said that, a couple of my patients in their sixties went home after one night and did not take any pain medications after they were discharged!). Patients in good physical shape can withstand the trauma of surgery better than frail patients. The anatomy of the jaw also influences the recovery. Some patient’s jaw can be very thin and small. The mouth opening may be limited as well. The course of the nerve may be aberrant. Blood loss is greater for some. All these factors can make the procedure more difficult for the surgeon and lengthens the operative time. The distance of advancement clearly can influence the recovery. There is some natural laxity of the muscle. The initial few millimeters of advancement is easy and requires little effort. However, in order to achieve larger advancements, the surgeon has to slowly work on the jaws by stretching the muscles and tissue attachments. It results in greater stress to the muscles and jaws and will take longer to achieve. Greater trauma and longer anesthesia time certainly affects recovery. WHY do it? IT IS NECESSARY TO ACHIEVE THE HIGHEST SHORT TERM AND LONG TERM IMPROVEMENT OF THE AIRWAY AND OSA. I can’t emphasize the importance of the patient’s attitude. A healthy attitude is essential and patients that are motivated just do better. Finally, the skill of the surgeon is obviously an important factor but the attitude of the surgeon is equally important. Is the surgeon trying his/her best for you? This is a question only the surgeon can answer but I think it is vitally important. It is something that patients have to feel for while developing a relationship with the surgeon.