Many patients with severe sleep apnea (OSA) often ask me, "Dr. Hsieh, can orthognathic surgery really improve breathing?"
Today's photos are the most authentic answer from inside the operating room.
This patient had long suffered from "receding mandible." Structurally, when the mandible recedes excessively, it directly compresses the airway space behind, causing the tongue to fall back and the airway to narrow severely when lying down to sleep, eventually developing into severe sleep apnea. This not only affects sleep quality but is also a hidden killer of cardiovascular health.
To address this fundamental structural problem, we employed MMA (Maxillomandibular Advancement, orthognathic surgery).

By comparing the before-and-after images of a patient in the operating room with a breathing tube still in place, the structural changes can be clearly seen:
- 1. The chin moves forward immediately: The previously retracted jawbone is precisely brought to the ideal skeletal position.
- 2. Changes in neck lines: As the bones move forward, the previously loose or compressed soft tissues of the neck change with the movement of the bones, making the profile lines tighter and smoother.
The change in appearance is just an "added value" of orthognathic surgery; our core purpose is to "improve airway space".
Along with the "3D digital surgical plan" in the post, we precisely simulated the angle at which the upper and lower jaws needed to be moved forward and the position of the bone screws before the operation. And for the most crucial evidence, please see the final comparison of the "postoperative CT computed tomography scan":
- Preoperative (red area): The airway is severely "narrowed" and airflow is obstructed.
- Postoperative (blue area): The entire upper airway space "increased" compared to before the operation.


With the change in structure and the creation of space, patients can immediately feel the ease of "breathing deeply" the moment they wake up from anesthesia and are extubated.
This is the most fascinating and medically valuable core of craniofacial orthognathic surgery—improving airway space through adjustments to the position of the jawbone.

