Jaw surgery Case # 101: Kendrick - Sleep Apnea, Maxillomandibular Retrusion

Kendrick visited us from Canada because he was suffering from sleep apnea problems that greatly affected his quality of life. As he presented a correct bite, Prof. Hernandez Alfaro proceeded with the "Surgery Last" protocol where no orthodontic treatment is needed before or after surgery.
Thanks to a bimaxillary advancement surgery, he simultaneously increased his airway by 400%, and obtained adequate facial projection, more definition of the jawline and neck, and better soft tissue support.

[@lincolnuland5443]

Absolutely absurd what a handful of millimeters here and there can do. Amazing.

[@RS54321]

He looked absolutely exhausted before surgery!! Now he looks very handsome, and his facial profile is beautiful! Nice to see a fellow Canuck having gone to this clinic for treatment!

[@FwJT_]

How lucky, he got the personality plus(+) package!

[@Daniel456324]

The animated VSP actually shows the CCW rotation actually made the patient's facial height increase. Not saying this patients facial profile is bad, but there are other ways of maintaining the facial height or reducing it, such as Inverted-L osteo, CCW rotation with posterior downgrafting, maxillary impaction, all while increasing the windpipe and giving the patient a more "ante-face" which is customarily a signature of frontal midface development.

[@johenkay1129]

He needed orthodontic treatment for the most optimal aesthetic result. He needed extractions and braces to retract the proclined teeth. Then forward jaw movement. I think they cut corners on this one. Even if his bite is "correct", his teeth became compensated and his incisors are proclined.

[@no89lan3]

His face looks too long, I agree

[@deepblack2193]

@@johenkay1129extractions?? Really??

[@deepblack2193]

Idn to me he’s more handsome after

[@r.b.6977]

its just inane. he looked like a guy you would not look at again for a second time to a handsome young man!

[@armywithluv55]

One day i will have enough money to go to Spain and get that surgery 🥰

[@vidan004]

How long post-op was this filmed? Great result

[@InstitutoMaxilofacialBarcelona]

Many thanks. That's 3 weeks post-op.

[@smedmark1]

Thank you, I had the same exact question

[@shuikai272]

I'm all for skipping premolar extractions, but I think in this case maybe would have been a wise choice. Especially in asians they have a lot more bimaxillary protrusion. Observe how far the incisors are from the A/B points. Could have simultaneously achieved more advancement (for sleep apnea), less genioplasty, and reduced lip projection.

[@RS54321]

Healthy teeth should never be extracted b/c it changes the face shape and reduces biting surface area. Please look at more primitive Asian groups where they have beautifully wide faces, no extractions. Diet and tongue posture are everything in regard to widening the palate to make room for all the teeth, regardless of genetic heritage.

[@user-vm9oj4fd1p]

amazing work..

[@dex6892]

What were the specific maxilla and mandible movements and degree of CCW for this? Great result

[@InstitutoMaxilofacialBarcelona]

as per company policy, we do not discuss specifics of our patient's surgeries.

[@Megan66666]

Thanks for sharing !

[@evanzhang9286]

guy seemed nervous during this vid lmao

[@juanvi3979]

It's not his first language cmon

[@leochan3050]

@@juanvi3979 hes from toronto...

[@RS54321]

@@juanvi3979 English is his first language. Not everyone is comfortable speaking in front of a camera.

[@juanvi3979]

@@RS54321 yep he was nervous

[@marquisstrongchild7535]

And why are you making fun of him?

[@spriggan93]

This is me apart from the surgery is so expensive for me 😢 im suffering so much 😭

[@jdoe5873]

That's a huge maxilla gap!!! Did you use bone graft (from his hip or something) to fill the gap?

[@InstitutoMaxilofacialBarcelona]

We use hydroxyapatite to fill the gaps.

[@jheritage7492]

​@@InstitutoMaxilofacialBarcelona Can nerves be restored if the space is filled with artificial bones in between?

[@InstitutoMaxilofacialBarcelona]

@@jheritage7492 Nerves cannot be restored, but they shouldn't be touched during surgery.

[@jheritage7492]

@@InstitutoMaxilofacialBarcelona Do you mean permanent nerve damage? I have no sense of taste in the tongue itself due to tongue surgery, but I feel the taste through the palate, mouth mucosa, and throat. If I operate in the same way as Kendrick, will I permanently lose sense of taste through palate and the mucous mouth?

[@InstitutoMaxilofacialBarcelona]

@@jheritage7492 Nerve damage is a possibility, but it remains very very low, and we haven't had any serious case of nerve damage in our center.

[@yyitttty]

I have sleep apnea and tmj disorder I want to have a bimax surgery advancement with Prof. Hernandez-Alfaro I want to know how much it cost I m live in Thailand after surgery how long I have to stay in Spain before go back to my country I just have my wisdom tooth removed Yesterday how long I m have to wait to have a bimax surgery

[@InstitutoMaxilofacialBarcelona]

Hello, this article might help you to get a better idea of the whole process: www.institutomaxilofacial.com/en/2020/01/08/orthognathic-surgery-in-spain-hows-the-process-like/

[@necronecrow1826]

i need that treatment too. Maybe along with MARPE

[@InstitutoMaxilofacialBarcelona]

Contact us at [e-mail]

[@no89lan3]

Hola, cómo puedo saber el costo de la cirugía si estoy en otro país? Personalmente no necesitaría ortodoncia como el caso de este video.

[@InstitutoMaxilofacialBarcelona]

Buenos días, para solicitar una primera consulta y obtener un presupuesto, puedes escribir a [e-mail]. El cirujano te dirá si hay o no necesidad de hacer un tratamiento ortodóncico previo o posterior a la cirugía.

[@sardar_gurjot]

Can the Ramus bone be lengthen in case of posterior mandibular deficiency?

[@Krish-pl6kd]

Yes

[@joshuanorrish3354]

Nice work, did Kendrick require orthadontics prior to surgery?

[@InstitutoMaxilofacialBarcelona]

No, he didn't

[@recalibrate4180]

How is his sleep apnea now? Is he cured?

[@InstitutoMaxilofacialBarcelona]

Yes, can sleep perfectly well now.

[@based6950]

Was this a high lefort? Cannot tell if this was subspinal or not.

[@InstitutoMaxilofacialBarcelona]

You can see the 3D planning at the beginning of the video.

[@based6950]

@@InstitutoMaxilofacialBarcelona I did but am still unsure. The cut looks higher than normal?

[@InstitutoMaxilofacialBarcelona]

@@based6950 No, as usual.

[@based6950]

@@InstitutoMaxilofacialBarcelona Thank you. Does Dr Alfaro ever do high leforts?

[@InstitutoMaxilofacialBarcelona]

@@based6950 not usually, but it can be considered if the case requires so.

[@britneylopez226]

Can MSDO be used on the chin to get comparable mandibular movement and facial profile improvement like this?

[@InstitutoMaxilofacialBarcelona]

Hello, MSDO is used to widen the chin. The movements donde in Kendrick's case were advancement and counterclockwise rotation of both mandible and maxilla, so it's a completely different outcome.

[@hyeminchun3777]

Do patients with class 1 bite (not fixing their bite) have to wear wafer after getting double jaw surgery? If so, for how long?

[@InstitutoMaxilofacialBarcelona]

Hello, our patients do not wear a splint after surgery, only some elastics to help them exercise.

[@yourbrain8700]

How long post op was the video?

[@InstitutoMaxilofacialBarcelona]

3 weeks.

[@bhavanit56]

Can the plates be removed after 1 yearrrr

[@InstitutoMaxilofacialBarcelona]

Yes, it can be done, altough it is not recommended: www.institutomaxilofacial.com/en/2020/03/12/should-plates-be-removed-after-orthognathic-surgery/

[@TheTinyOrc]

Could this be covered by health insurance

[@InstitutoMaxilofacialBarcelona]

We are a completely private center.

[@user-un6pr7uq4n]

Hello, Kendrick! Did you wear braces?

[@InstitutoMaxilofacialBarcelona]

Good morning, Kendrick had worn braces previously, so he didn't wear them before of after his surgery.

[@RS54321]

@@InstitutoMaxilofacialBarcelona It looked like he had braces in during the video.

[@InstitutoMaxilofacialBarcelona]

@@RS54321 He had some post-surgical elastics on

[@lesptitsoiseaux]

How much was it?

[@InstitutoMaxilofacialBarcelona]

Hello, in this link you can find a price range for orthognathic surgery: www.institutomaxilofacial.com/en/2019/06/28/cuanto-cuesta-una-cirugia-ortognatica/

[@hell0kitje]

can u post one example of post op peek gonial angle?

[@InstitutoMaxilofacialBarcelona]

Working on it ;)

[@hell0kitje]

@@InstitutoMaxilofacialBarcelona ❤

[@ahmadmaravia5419]

How much it cost these jaw surgery's?

[@InstitutoMaxilofacialBarcelona]

www.institutomaxilofacial.com/en/2019/06/28/cuanto-cuesta-una-cirugia-ortognatica/

[@user-kk6bm3no4d]

patient looks abit strange postop. not sure what exactly though

[@707vv]

nah bro messed him up

[@ravenoushydra7948]

he went from 2/10 face to 5/10 or average looking, maybe its impossible to make him look perfect, but its huge positive change imo

[@rl3045]

How ? He looks so much better and his sleep apnea is cured, I think that’s the most important thing.

[@based666]

he also needs maxilla surgery

[@RS54321]

Seriously? He looks so handsome afterward...look at his jawline and facial profile!

[@neel8554]

Want to have this surgery, how to contact u regarding cost and type of surgery

[@InstitutoMaxilofacialBarcelona]

Please write to [e-mail]

[@neel8554]

Only genioplasty sufficient

[@Avielalex]

He had sleep apnea