Hello everyone !
Hope you are doing alright in these troubled times.-- BACKGROUND So after a lot of fight with the medical world, I got diagnosed with mild OSA / UARS at 21yo. I am fit, and healthy (173cm for 62kgs). My father most likely has sleep apnea, because of lack of jaw and a lot of soft tissue genetic. (bulldog look).
I had braces when I was younger, because my teeth were really crowded / crooked, but my bite is okay. I do have TMJ a lot, when putting headset for example, or doing nothing special.
I had this sleep issue probably since primary school, I was dozing in class all the time and always felt absolutely awful. But due to poor parenting and my ADHD preventing me from napping, it was not seen. After getting Crohn, I got to 32kgs, with a look like model jawline, but sleep wasn't better at all.
My symptoms now are severe. I can't list everything but this thing is becoming life threatening. I also had to drop out because of the physical and psychological toll this is putting on me.
-- Lack of jaw -> sleep issueAnyway. I met with a maxillo facial surgeon who get me through all this process, sleep tests, etc. He told me right away that my issues were indeed coming from a narrow airway. My issues are not related to adenoids, nose, or anything.
My AHI was mild on the test (6), but it was not a normal night for me, and surgeon told me on the phone "do you want to do bimax, if you have severe symptoms, we can do it", which I was super excited, since I did not want to have a machine at 21yo.
Fast forward, I met with him, but he was looking stern.
---- Esthetic > function ?He told me that we couldn't do bimax / ccw, because I have already an "harmonious profile", which I don't think is true (IRL pics at the end).
Where I live, they are used to do bimax only on high/severe apnea case and on people with severe bite issues.
He told me that this would not be worth it, and that it could result in a chimp lip look. So he offered me a genioglossus advancement and rhinoplasty, which I am gonna refuse.
I immediately went to a second surgeon, who went more thoroughly through my scans, and told me that indeed there was an esthetic risk, but that I did have a lack of jaw, despite a normal bite, and that it was causing the airway issues, and that 1st surgeon proposition would not change anything. He offered me to do a PSG study, to detect UARS which I have.
He did told me that, again, I could end up with a "chimp lip" look. But both surgeons didn't seem to really have think this through, they only told me about bimax but not about CCW, for example. I trust the surgeons with their job. But if my issues come indeed from my "lack" of jaw, I have a hard time thinking that a jaw surgery wouldn't be worth it, and that esthetic wouldn't follow function.
Therefore I am looking for advices on how we could mitigate this esthetic issue while still getting the right airway. I think the issue is that I got already big lips, my chin is basically the only "forward" movement on my face, and my jaw is ridiculously steep / lack horizontality. I also believe that the orthodontic and braces done younger might have pushed my teeth forward, because of the lack of space inside my mouth. Though this also might be a s**tty theory. I am open to discussion !
Obviously, I trust surgeons about this issue. I just wonder if more could be done about it. They really didn't "try", either because didn't take sleep issues seriously (UARS barely recognized in France), or lack of time (second surgeon).
PS: this is not a post about whether or not I have OSA/UARS, and what could cause it, please do not suggest "try to lift" or "diet", as experienced on reddit . I also apologize for any orthographic mistakes, english isn't my first language, and writing with sleep issues and ADHD isn't easy IRL pics :
https://imgur.com/a/kPZidXX3D xrays :
https://imgur.com/a/t5W1nUS