25mm advancement seems high?

[sventory]

I don't know I don't analyze peoples side profile faces like that, I guess I would say it's at least moderate.

[kavan]

I don't know I don't analyze peoples side profile faces like that, I guess I would say it's at least moderate.

Well, the reason I asked for just a QUALITATIVE assessment from you was that your question asking if a NUMBER displacement was 'excessive' gave no information on what your analytic abilities were. Think about it. You're asking for QUALITATIVE assessments on a QUANTITATIVE value (a number).

The way to do it is to first make a qualitative assessment and then look at the numbers. My qualitative assessment is that the extent of your retrusion is SIGNIFICANT, ie. EXCESSIVE.
It's no surprise to me that the quantitative numbers the doctor gave are in the venue of the amount that would be needed to advance your jaws.

Although the numbers SOUND like a lot, the retrusion LOOKS like a lot too.

[Lazlo]

You will be fine. You need that kind of advancement as an OSA patient and it will be better for your health and aesthetics. Don't even fret.

[XXRyanXXL]

There are some dangers associated with a movement that large.
I had my bimax surgery 3 years ago, had 11mm mandibular advancement on one side, 9mm on the other (asymmetry). During the movement process, the mental nerve was damaged. This nerve feeds sensations to the lower lip and chin. He either cut it, or put significant stress on the nerve, because now, 3 years later, I am completely numb in that area. Not only that, but I had a genio, and he placed it too far foward and low (as in sliding genio with lengthening), that I cannot speak correctly.
If nobody believes this opinion, you can search for "numb chin" syndrome.

[kavan]

There are some dangers associated with a movement that large.
I had my bimax surgery 3 years ago, had 11mm mandibular advancement on one side, 9mm on the other (asymmetry). During the movement process, the mental nerve was damaged. This nerve feeds sensations to the lower lip and chin. He either cut it, or put significant stress on the nerve, because now, 3 years later, I am completely numb in that area. Not only that, but I had a genio, and he placed it too far foward and low (as in sliding genio with lengthening), that I cannot speak correctly.
If nobody believes this opinion, you can search for "numb chin" syndrome.

There are dangers associated with a lesser movement too. Nerve damage, possibility of, is listed as a risk associated with the surgery itself whether or not the surgery is for a modest or large advancement, the capacity of the doctor and the quality of diagnostics used to navigate a surgery.

Nerve damage is more directly attributable to the CUT than the extent of the movement itself. The main nerves to the mandible are found inside the bone. Just the cut ALONE to the mandible in order to do a BSSO, is a SAGITTAL one to SPLIT the bone vertically. So, it's the CUT where they have to be really careful not to damage the nerve so the nerve stays where it is behind the cut made to move out the mandible after it's split.

Risks and dangers are also going to differ among doctors. Just like risks and dangers differ among skiers. A bunny hill skier will have more risks going down a steep incline than a good skier will. Also, new high tech Virtual Surgery Planning programs that in no uncertain terms show where the nerves are help lower the risks of nerve damage. So, a doctor with a lot of experience using one will tend towards having lower risks than a lesser doctor not using one.

[sventory]

Right Kevan, the reason why I said that is I've not heard of other surgeons recommending movements that high, though Movahed seems to be one of the "better ones" in the country, my local doc only suggested 6mm top and 15mm bottom. I've also read some studies that show movements greater than 10mm to lower are more likely to leave permanent nerve damage.

XXRyanXXL's situation is what I am worried about. I've also read a story or two of people getting trigeminal neuralgia from this surgery, which sounds absolutely horrible. I'd rather take my current lack of sleep than that kind of pain. The numbness I can deal with, but that kind of constant pain? Man it's scary.