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Maxillomandibular Advancement Care

Expert maxillomandibular advancement (MMA) surgery at PristynCare for severe obstructive sleep apnea and jaw deformities. Advanced orthognathic technique for lasting airway relief.

Expert maxillomandibular advancement (MMA) surgery at PristynCare for severe obstructive sleep apnea and ... Read More

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    Dr. Abhijit Mantri  - A ent-specialist for Stapedectomy

    Dr. Abhijit Mantri

    MBBS, MS-ENT
    33 Yrs.Exp.

    4.5/5

    33 Years Experience

    location icon Pristyn Care LOC Hospital, Vijayanagar Colony, Pune
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    080-6542-3035
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    Dr. Ashutosh Nangia - A ent-specialist for Stapedectomy

    Dr. Ashutosh Nangia

    MBBS, MS-Oto Rhino Larynology
    21 Yrs.Exp.

    4.5/5

    21 Years Experience

    location icon Pristyn Care Sheetla, New Railway Rd, Gurugram
    Call Us
    080-6542-3711
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    Dr. Asha M S - A ent-specialist for Stapedectomy

    Dr. Asha M S

    MBBS, DNB-ENT
    15 Yrs.Exp.

    5.0/5

    15 Years Experience

    location icon Kochi, Ernakulam, Kerala 682025
    Call Us
    080-6962-5909
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    Dr. Richa Mina - A ent-specialist for Stapedectomy

    Dr. Richa Mina

    MBBS, DLO | Otorhinolaryngologist
    21 Yrs.Exp.

    4.8/5

    21 Years Experience

    location icon Pristyn Care La Midas, Main, Nathupur Rd, nr. 38, DLF Phase 3, Sector 24, Gurugram, Haryana 122002
    Call Us
    080-6541-4451

Jaw Advancement Surgery

Maxillomandibular advancement (MMA) is an orthognathic surgical procedure that moves both the upper jaw (maxilla) and lower jaw (mandible) forward to enlarge the upper airway and correct jaw deformities. It is the most effective surgical treatment for severe obstructive sleep apnea and skeletal jaw abnormalities.

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Symptoms

Conditions treated with MMA include:

  • Severe obstructive sleep apnea unresponsive to CPAP
  • Jaw misalignment causing bite or chewing difficulty
  • Facial profile abnormalities from jaw deficiency
  • Snoring and upper airway obstruction
  • Daytime fatigue and poor sleep quality
  • Temporomandibular joint dysfunction from jaw imbalance

Are you going through any of these symptoms?

Causes

Indications for MMA surgery include:

  • Skeletal jaw deficiency (retrognathia) causing airway narrowing
  • Failed CPAP therapy or non-compliance
  • Hypopharyngeal or multilevel obstruction in sleep apnea
  • Class II or III malocclusion from jaw size mismatch
  • Craniofacial anomalies affecting airway and bite

Types of MMA Surgery

Surgical variations include:

  • Standard MMA – advancement of maxilla and mandible equally
  • MMA with genioglossus advancement for tongue base support
  • MMA combined with uvulopalatopharyngoplasty (UPPP)
  • Asymmetric MMA for facial asymmetry correction

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Risk Factors

Candidates for MMA surgery typically have:

  • Severe OSA with AHI above 30 events per hour
  • Skeletal mandibular or maxillary deficiency
  • Failed or intolerable CPAP therapy
  • Normal body weight and no surgical contraindications

Who is at Risk

Adults with severe obstructive sleep apnea who cannot tolerate CPAP, those with jaw skeletal deformities, and patients with documented multilevel airway obstruction are candidates for maxillomandibular advancement surgery.

Diagnosis

Pre-operative assessment includes:

  • Polysomnography (sleep study) for AHI determination
  • Cephalometric X-rays for jaw anatomy assessment
  • 3D CT scan for surgical planning and simulation
  • Orthodontic evaluation for dental alignment
  • Awake endoscopy for obstruction level identification
  • Multidisciplinary team review

Treatment Options

MMA is performed in combination with pre-operative orthodontic treatment. The jaw bones are cut and repositioned with titanium plates and screws. Expected advancement is 10 to 14 mm for maximum airway gain. Post-operative orthodontic finishing completes the treatment.

The Procedure

MMA surgery involves:

  • General anesthesia with nasal intubation
  • Le Fort I osteotomy to advance the maxilla
  • Bilateral sagittal split osteotomy (BSSO) to advance the mandible
  • Genioglossus advancement for tongue base support if required
  • Fixation with titanium plates and screws
  • Intermaxillary fixation or elastic bands post-operatively
  • Hospital stay of 2 to 3 days

After the Surgery

Post-operative recovery includes:

  • Soft diet for 6 to 8 weeks post-operatively
  • Jaw exercise and physiotherapy from week 4
  • Swelling and bruising reducing over 3 to 6 weeks
  • Post-operative sleep study at 3 to 6 months
  • Orthodontic follow-up to complete bite finishing
  • Numbness in lips or chin may persist for several months

Possible Complications of MMA Surgery

Potential complications include:

  • Temporary or permanent numbness of lips, chin, or teeth
  • Skeletal relapse requiring revision surgery
  • Malocclusion requiring orthodontic correction
  • Infection at plate fixation site
  • Temporomandibular joint changes
  • Airway swelling requiring monitoring in the first 24 hours

Frequently Asked Questions

What is maxillomandibular advancement?

MMA is an orthognathic surgery that moves the upper and lower jaw forward to enlarge the upper airway and is the most effective surgical treatment for severe obstructive sleep apnea.

How effective is MMA for sleep apnea?

MMA achieves significant AHI reduction in 85 to 90 percent of patients, with many achieving complete surgical cure of obstructive sleep apnea.

How long does recovery take after MMA surgery?

Full recovery takes 6 to 8 weeks. Soft diet restrictions last 6 weeks. Final sleep study results and aesthetic outcomes are assessed at 3 to 6 months.

Is MMA surgery painful?

Discomfort and facial swelling are expected for 2 to 4 weeks. Pain is managed with prescribed medication. Most patients are comfortable within 1 to 2 weeks post-surgery.

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Medically Reviewed By
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Dr. Abhijit Mantri
MBBS, MS-ENT
33 Years Experience Overall
Last Updated : April 4, 2026

What Our Patients Say

  • VM

    Vikas Mehra, 41 Yrs

    verified
    5/5

    My hearing was dull for years. After the stapedectomy at Pristyn Care, there's clear difference. The procedure went smooth and succesfull. Also want to thank Pristyn Sheetla Hispital staff, they kept good care of me.

    City : Gurgaon