What questions should I ask the OMFS at the consult? In order to both (1) determine that his skillset and experience are a good fit; and (2) steer towards the optimal surgical plan for both function and aesthetics?
I am being referred by my ENT for MMA for severe sleep apnea (CPAP not working, not a candidate for soft-tissue OSA surgeries). The surgeon is on the young side, about a decade out of OMFS residency/board certification, and seems to mostly do wisdom teeth extractions plus the odd trauma repair case. I’m concerned that he may just default to linear MMA for sleep apnea since it’s the most straightforward. If so, how can I bring up the possibility of CCW, sliding genioplasty, nose & lip effects, etc. considering he’s not a bread-and-butter jaw surgery specialist? The ENT says he’s referring me to this surgeon because he may be able to do surgery-first, otherwise braces will be a lot more expensive.
While I'm doing this for the OSA, I’d also like a good aesthetic result. I am female with recessive jaws, okay bite except for mild residual overjet/overbite after headgear and braces, normal upper tooth show, flat chin, convex profile, mild asymmetry, jaws too small for tongue, bruxism, occasional TMJ issues on right side (possibly due to jutting lower jaw forward during sleep in attempt to make more room for my tongue). Wary of philtrum lengthening and chimp-profile from straight advancement - would CCW and/or SG mitigate this? How is it determined if I'm a good candidate? Is posterior downgrafting something most OMFS are capable of? I don’t think I have the maxillary length to accommodate anterior impaction. Of course I want the optimal plan for my case, but how do you balance this with the limitation of what movements the surgeon is capable of/comfortable with?
I’d be thankful for any advice, I really appreciate the depth of knowledge on this forum. I want to maximize the value of the consult by having a good list of questions to ask before going in. I'll have a cbct done on the day, and will update afterwards.
(Note: I realize going to someone more experienced may be the obvious recommendation, but realistically speaking that may not be possible for me. There aren’t many I know of in my area since the go-to jaw surgeon retired, and I have limited funds so going to the US for surgery is probably out of reach financially. If this surgeon doesn’t seem right I’m open to other recommendations in Canada.)