All incisions are made inside the mouth, except perhaps for small incisions on the cheeks. The upper and lower jaws are freed with the use of thin saws and chisels, and they are advanced together, with placement of titanium plates and screws to hold the jaws in position. The surgery involves placement of large braces (arch bars) on the teeth that remain in place for 6 weeks; typically the jaws are not wired together, although rubber bands are usually placed to assist in maintaining a stable bite during the healing process. Patients are on a soft diet and avoid chewing for 4-6 weeks. Some patients may benefit from placement of a temporary tracheostomy to avoid problems that can occur with swelling after surgery.
This procedure can be performed in patients who have abnormal jaw positions but who do not have OSA; in OSA patients, jaw advancement surgery is different, involving greater movements of the jaws, being technically more difficult for the surgeon, and having more risks and a more difficult recovery for patients.
