Bimaxillary Advancement Overview
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.
"I had some plastic surgery done to correct my a creator on head after a traumatic event. Dr Schendel gave me a few options to consider, which resulted with excellent results."- A.K. / Google / May 09, 2018
"I am taking the time to share the positive experiences I have had of Dr. Schendel because it is important that any public information is accurate. Firstly, the doctor went out of his way and..."- A.T. / Yahoo / Dec 03, 2017
"I am taking the time to share the positive experiences I have had of Dr. Schendel because it is important that any public information is accurate. Firstly, the doctor went out of his way and made room in his schedule to consult regarding my 8 year-old daughter's needs when we had no prior relationship with him and oral surgery was imminent. He was gentle with her and honest with me about our choices. His expertise and care allowed me to make the best choice for my child.Secondly, he has cared for more than one individual I hold dear. This family has faced over 20 years of medical intervention and combined, upward of 30 surgeries. Dr. Schendel has been steadfast, consistent, and brilliant in his care of my dear one and her child. As her friend, each time they have faced yet another intense physical challenge or surgery, I have rest assured that she was getting the absolute best treatment because she was in Dr. Schendel's care. The bottom line is I trust him, both to care for my family and those I cherish.Aneea Toomajian PPS, LMFTEducational and Behavioral Consultant"- A.T. / Yelp / Dec 03, 2017
"Dr. Schendel has been my surgeon since I was 15 years old, I am now 44. I have been incredibly grateful for his work and dedication to his field. He has performed several procedures on me to correct a severe unilateral cleft lip and palate. I was referred to him because my clefting was so unusual and other surgeons had been unsuccessful with my case. My cheekbones were non-existent, eye sockets sucken in, jaw extremely recessed, palate permanently open and I had existing scar tissue from previous cosmetic surgery attempts by another surgeon. These are ALL the things Dr. Schendel has fixed with expertise, compassion and dedication. californiacraniofacialin…Over the years, Dr. Schendel has carefully and compassionately rebuilt my face from the inside out. Giving me the bone structure that I was not born with due to the severity of my cranial facial anomalies.When I first met him(I was 14) he excused his entire team of fellows who were there to observe him. He gave me the privacy I needed, handed me a mirror and asked me, "What don't you like about your face?". As a teenager, I was given the space to communicate the things that were great sources of pain. I explained the various things about my cleft lip that caused other kids teased me about. From that moment Dr. Schendel set out to give me a normal face with nothing but determination, dedication and true compassion.Over the years, I have faced other complications with my bone structure and degeneration from my severe cleft. Dr. Schendel has fiercely, carefully and methodically worked to fix the constant erosion and instability in my face. He has striveded to continually find the newest, best techniques available. I have been able to have implants along with bone grafts to retabalize my eroding palate, stem cell procedures to improve the tissue and blood flow to my face and cosmetic revisions-- I have been incredibly grateful and happy with the results.Dr. Schendel's ability to listen and connect with me has been amazing. As a youth, I felt safe, validated and listened too as a patient. As an adult, he has heard my worries and validated the pain I have felt in my face and palate. He has worked tirelessly to fix my cranial facial anomalies. I believe that his ability to be so compassionate and careful with his patients comes from YEARS of working with cleft affected children here and in third world countries. A few years ago, I learned that Dr. Schendel has also volunteered countless hours of surgery in third world countries to operate on children. He has insisted that the surgeries are learning sessions for local doctors in those countries. He has created a learning environment to teach the newest techniques to other physicians in these countries. He also spends months of his own time collecting supplies to take to these countries to donate for the surgeries. Dr. Schendel's passion for rebuilding faces generates from a desire to truly want to help rebuild lives--physically...and emotionally.Our son is also bilaterally cleft affected, he is now 13. Dr. Schendel has revised his soft palate and his lip. It is with tremendous gratitude that we have Dr. Schendel as our son's doctor. His revision is beautiful and his cleft is a non-issue. His speech has also VASTLY improved due to the titrated listening of Dr. Schendel in knowing how to revise our sons palate so skillfully so he can now make sounds like "J" "P" "K". I have referred Dr. Schendel to several family friends for various things that are not cleft related. Not because Dr. Schendel is an incredible oral maxillary and plastic surgeon. But because of his ability to connect with his patients, to hear them, to see them and then to use his dedication to medicine to help them."- V.L. / Yelp / Dec 03, 2017
"Dr. Schendel has been my surgeon since I was 15 years old, I am now 44. I have been incredibly grateful for his work and dedication to his field. He has performed several procedures on me to..."- V.L. / Yahoo / Dec 03, 2017
Bimaxillary Advancement Surgical Technique
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 During/After 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.
Bimaxillary Advancement Expected Cost
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.