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Maxillomandibular Advancement Surgery Cured my Obstructive Sleep Apnea and Fixed my Weak Jaw/Chin - New York, NY

ORIGINAL POST

After years of poor sleep, lack of concentration...

StealthNYC
WORTH IT$100,000
After years of poor sleep, lack of concentration and depression, I had a sleep study done and finally discovered my problem - Obstructive Sleep Apnea (OSA).

OSA means that, during the night, my lower jaw would relax and fall back into my throat, blocking my airway and causing me to stop breathing. After a period of time, I would wake up gasping for air, as if someone had been choking me and had finally released their grip. This would happen several times per night. Needless to say, I spent many years without a good night's sleep. This lack of sleep caused all sorts of problems such as sleeping during conversations, while driving, etc. It also caused depression. I learned that eventually, it could cause contribute to heart failure. I didn’t realize that I was dealing with such a serious issue. I began to read about the causes of sleep apnea and wondered what was causing mine. I wasn't overweight, didn't drink or smoke, and was in otherwise good health. So the culprit had to be my receding chin and jaw.

I did some research and learned that I would need to consult with an oral & maxillofacial surgeon to find out more about my options. I searched in New York City (where I live) and found Dr. Majid Jamali, who was fantastic (I wrote in more detail about him in his review).

I met with him, he took photos and 360 degree x-rays, he evaluated my sleep study results and determined that I would benefit from a lower Bilateral Sagittal Splint Osteotomy (BSSO) as well as sliding genioplasty. This meant that my lower law and chin would be cut, moved forward, and then screwed back in place. This was no small operation, but I was ready to have my life back.

We moved forward fairly quickly. Once the procedure was approved by my insurance (that took a bit of effort), we scheduled the surgery for the following month.

The day before the operation, Dr. Jamali attached the surgical braces, which were metal bars on my upper and lower teeth, just below my gums, so they were actually barely visible. I wore these for about 3 months.

The following day, I went in to New York Eye and Ear (an excellent hospital, by the way), and had the surgery. I am told it took a total of about 5-6 hours (Dr. Jamali also removed an impacted wisdom tooth). When I woke up, I didn't really feel much pain and I was swollen but not nearly as much as I would have expected. The hospital staff was great, facilities were modern and clean. I stayed in the hospital overnight.

I had scheduled my vacation to coincide with my recovery so I was able to relax and recover for about three weeks, which was just the right amount of time.

The pain was surprisingly mild during the first couple of days immediately after surgery. I started to really feel the pain about the third or fourth day. It was never unbearable though. At its worst, it was just very uncomfortable. I was alternating between Tylenol 3 and 800mg of ibuprofen. The pain started to taper off during the second week. By about the third week, I was taking 400 mg of ibuprofen usually in the morning when I would wake up (I seemed to be most sore at the time), and then another 400 right before bed.

My diet consisted of liquids for about a month and a half - two months. I actually ate everything that I had been eating before the surgery, except in smoothie form. It was kind of fun! I would have my egg and whole wheat toast sandwich smoothie or protein powder smoothie in the morning. Then for lunch, I might have a tuna and pasta smoothie. And for dinner, it could be a steak, quinoa, and raw spinach smoothie! I didn't snack as much during this period, so I lost a little weight (maybe 5-10 lbs). I couldn’t open my mouth for the first couple of weeks, so I had to use a huge syringe to drink my smoothie. That was a bit of a pain. Not long after that, I would just drink it out of a thermos or put it in a bowl and eat it like soup. It took about two months before I was able to have soft foods. By about four months, I was back to my normal diet.

Since I couldn’t open my mouth (and had stitches on the inside of it) I couldn't brush my teeth, so had to gently swish with a special medicated mouth rinse for the first couple of weeks. I also wore rubber bands on my braces, which I had to replace twice daily. Eventually, after about two weeks or so, I was able to gently brush and floss (though I couldn't open my mouth much).

After about two months, the doctor told me to start trying to open my mouth. By this point, my jaw had stiffened a bit from lack of use so I had to literally pry it open and practice opening it wide several times a day. It took a couple of months of this to get it back to normal. Now, 6 months later, there's no pain, and there is only a little stiffness when I try to stretch my jaw muscles by opening my mouth as far as it can go (which is much farther than you would normally ever have to open it).

As for numbness - at first, much of the chin, nose, and cheeks were numb. Feeling began to return after a couple of weeks. Now 6 months later, I have about 85 - 90% of the feeling back. There’s still some numbness but I barely notice it. It can take several months and sometimes all of the feeling doesn’t come back, but that's one of the risks you take.

There have been no unexpected complications during my recovery. I had a couple of nosebleeds at one point early on and learned that it was normal. Other than that, it was relatively easy.

So the whole experience was well worth the trouble. It has been like night and day. I am sleeping so much better now. My disposition has improved tremendously, I have more energy, and I feel rested. And I am happy with the way my jaw and chin look. What more could I want?

If you suspect that you have sleep apnea, have a sleep study done. If it turns out that you do have it, your surgeon will need the results of that sleep study in order for your insurance company to pay for the surgery.

Make sure you find a reputable oral and maxillofacial surgeon who is experienced and who understands the needs of someone who suffers from sleep apnea. Do your research. Read reviews. Get a referral from another doctor you trust. Dr. Jamali was a Godsend for me, so I hope that you may find someone like him and have as good an experience as I have had.

StealthNYC's provider

Majid Jamali, DMD

Majid Jamali, DMD

Board Certified Oral & Maxillofacial Surgeon

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Replies (19)

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April 14, 2014
Fantastic review!  Thank you so much for taking the time to do this.  I know you will help others with all of this information!  Would you please consider adding anonymous before/after pictures?  People who are doing this for non-cosmetic reasons may not understand what a large impact this can have on the look of the jaw (those doing it cosmetically have a much better idea, I'd wager, though it'd still be helpful for them!)
April 15, 2014
My pleasure. Thank you. That's a good idea. I will check with Dr. Jamali's office since they have my before and after pics.
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April 16, 2014
Cool!  And wow, I just looked at the cost.  Insurance hopefully covered all of that?
April 16, 2014
That's a good question. I'm not entirely sure. I put the total amount that my insurance was billed, from the hospital costs, to the anesthesiologist, to the doctor himself. Since my deductible had been paid by that point and I didn't have any co-pays, I didn't have to pay anything out of pocket, so everything was covered (as far as I know). I'm not sure what the insurance company ended up paying. They have a cap on how much they will pay for certain procedures, so I'm sure they payed much less than what was billed. I don't know what the national average is for this type of surgery but in a good Manhattan hospital with a top-notch doctor, I imagine this is about right.
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April 17, 2014
I'm sure you're right.  I just wanted to know if you had to pay $100k out of pocket!  Glad to know your insurance did cover it :D
March 5, 2015
Hi, thinking of having a sliding genioplasty. Dr Jamali is on my list. Would love to see some pictures!
June 4, 2015
Pics are here: http://www.realself.com/photos/sleep-apnea-treatment
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June 4, 2015
Your pic looks like me!! I can see you're having trouble keeping your mouth closed in the before pics.
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June 4, 2015
Stealth how old are you if I might ask? I have OSA and I am at my wits end feeling tired and miserable. I am also in NY about 10 minutes from Dr. Jamali's office. You definately recommend him out of all the other surgeons in NYC? PM me if you dont want your age and stuff on display. Thanks
June 4, 2015
No problem! 43. Definitely see what Dr. J has to say. I wish you the best.
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June 4, 2015
43? Im 40. Would you say that it took you longer to recover than if you were 20 or is 40ish still young enough to heal normally?
October 4, 2015
I'm sorry I just saw this. It's hard to say. I'm petty healthy. I don't smoke and lead a pretty healthy lifestyle and don't have any other health issues, so that helps in the healing process. Generally, I think it does take a little longer for an older person to heal but if you're healthy, you'll probably have roughly the same recovery time that I did, barring any unforeseen complications.
March 28, 2016
Can u meet?
June 4, 2015
Pics are here: http://www.realself.com/photos/sleep-apnea-treatment
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June 5, 2015

Thanks for the update.  I was diagnosed with severe OSA in September 2014 and am seriously considering this procedure.

October 4, 2015
I'm sorry I just saw this. I know how difficult it is. I hope you have taken the steps towards having the surgery. It is well worth the initial discomfort.
October 3, 2015
Great results. So you did not require any formal orthodontics? Just the surgical braces?

Any idea how much your maxilla & mandible were advanced, as well as the genioplasty? Thanks!
October 4, 2015
Thanks! Dr. Jamali is amazing. He changed my life. I had had my teeth straightened with Invisalign a couple of years prior to surgery and that issue was largely cosmetic anyway so there was no need for anything more. I'm sorry I don't know the precise measurements of the advancement(s).