Palo Alto plastic and maxillofacial surgeon, Dr. Stephen Schendel, is a sleep disorder expert and performs bimaxillary advancement for patients with severe obstructed sleep apnea. Often times, congenital skeletal jaw disparities cause obstruction of the airway, and may cause difficulty eating and chewing, as well as lead to joint pain within the jaw. Also referred to as double jaw advancement, this surgery is generally recommended after more conservative measures have failed to work. During the procedure, Dr. Schendel moves the upper (maxilla) and lower (mandible) jaws forward, in order to enlarge the airway in both the palate and tongue regions. While this surgery is considered more invasive and does require a longer recovery, it has a 90% cure rate or greater.
"Dr. Schendel is helping me feel like myself again after a tumor changed my life. - I am 28F and was diagnosed with a rare pituitary tumor resulting in a condition called acromegaly in 2015. Because of this condition my brow grew, the soft tissue in my face increased and the right side of my jaw grew asymmetrically which resulted in a quickly developed underbite. After surgically controlling the tumor by an SF neurosurgeon to ensure no more growth would occur, my husband and..."- B. / RealSelf / Apr 28, 2017
"Best decision I ever made! - Best decision I ever made was to have a mid-face lift with Dr. Schendel. He listened to my concerns and came up with a strategy that I would be pleased with. Dr. Schendel has a great bedside manner and put my fears to rest pre-surgery. He and his staff were very attentive post surgery as well. I look renewed and refreshed not "done". I no longer cringe when I look in the mirror. Thank you for giving me a decade+ back."- C. / RealSelf / Mar 24, 2017
"Dr. Schendal is a consummate professional with a warm caring disposition. He is held in very high regard by everyone I spoke to at Stanford Hospital. I had absolute confidence in him and my surgery held no surprises due to the care he took in explaining everything and setting realistic expectations. His post op care was just as good."- L.G. / Healthgrades / Oct 23, 2016
"Dr. Schendel is a great doctor. My family and I have been fortunate enough to be under Dr. Schendel's care for many years. He has been helping me look and feel beautiful since my 50th bday... many years ago. He and his staff are wonderful in every way. His office manager, Carol Oderio, and everyone in his office treat you with the greatest care and make sure everything is perfect:) Dr. Schendel is able to enhance your beauty in an amazing way, all while looking very natural."- J.H. / Yelp / Mar 14, 2016
"I've been getting Botox from Dr. Schendel for several years - and I still look forward to my appointments because he always manages to make me smile and laugh. The office is clean, easily located by the freeway, and the staff is courteous and always prompt."- C.R. / Yelp / Nov 01, 2015
During this procedure, Dr. Schendel will place the incisions inside the mouth. Once he has access to the internal structures, he frees the lower and upper jaw by using surgical tools in the shape of small saws and chisels. Once the jaws are loose from their original position, he advances both of them (moves them forward) at the same time and secures them into place using titanium plates and screws. Patients will not have their mouths wired shut. Instead, rubber bands are used to assist in the healing process. This procedure, however, does involve the placement of arched braces on the teeth that patients will wear for 6-8 weeks. Because the incisions are located inside the mouth, there is limited to no scarring with this surgery.
Bimaxillary advancement is performed under general anesthesia as an outpatient surgery in our accredited surgical facility. The procedure takes between 1-3 hours. After surgery, patients will be prescribed pain medication to keep them comfortable in the first few days, and an antibiotic will be given to prevent infection. Patients will stay on a liquid, and then a soft chew diet for approximately 4-6 weeks. While the recovery is more prolonged than some of the other sleep apnea surgeries, it has a very high success rate. Post-surgery protocol information will be discussed in great detail before surgery.
The average cost for a bimaxillary advancement surgery ranges between $2,000-$20,000. The cost does vary depending on the severity of the case. In some situations, insurance may cover a portion of this procedure. Many times, it will need to be proven that a medical condition (such as an obstruction) is causing the sleep disorder. This can be accomplished during the initial consultation and testing phase.
Plan Your Procedure
- Average Cost
- $2,000 - $20,000
- Recovery Time
- 4-6 Weeks
- Average Procedure Time
- 1-3 Hours
- Procedure Recovery Location
Bimaxillary Advancement FAQs
The initial consultation and testing phase will help determine exactly what is going on inside of the mouth that is causing the sleep disorder. Airway X-rays are usually performed, as well as a 3D imaging. A sleep study test may also be performed. Based on the results of all of the testing, we will be able to determine if a conservative approach will cure the condition, or if a surgery such as bimaxillary advancement is necessary.
When Can I Eat?
In the days following surgery, patients will need to stick to a soft chew diet and slowly progress towards eating regular foods. The chin and jaw will be quite sore for a couple of weeks and chewing will be difficult at first. We provide patients with a strict diet and post-operative protocol to adhere to.
This surgery, while invasive, produces excellent outcomes for patients. On average, it has a 90% cure rate or greater. Not only does it help with the medical issues and sleep interruption, but it can also produce a nice aesthetic result for patients who wish to change the appearance of their chin or jaw.
Bimaxillary advancement is a specialized jaw surgery to correct severe sleep apnea. While some plastic surgeons are trained to perform complex chin and jaw surgery, it is recommended that patients do their research and find a qualified, experienced plastic and maxillofacial surgeon; a person that is trained and skilled in craniofacial disorders. This will ensure that the best possible outcome occurs.