Sleep apnoea jaw surgery
A major jaw operation that moves the upper and lower jaws forward to open up the airway, used for selected people with obstructive sleep apnoea when other treatments have not worked or are not tolerated.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- It is a major jaw operation reserved for selected people with obstructive sleep apnoea, usually after treatments like CPAP have failed or been poorly tolerated.
- It can substantially reduce the number of breathing pauses for many people, but it does not always cure sleep apnoea completely and is not suitable for everyone.
- It changes the appearance of the face and the bite, so orthodontic treatment and a structured recovery are usually part of the plan.
- It needs thorough assessment, including a sleep study, by a sleep team and a specialist jaw surgeon, and a frank discussion of risks and realistic benefit.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Can substantially reduce the number of breathing pauses during sleep for many people
People who have not yet tried or properly considered first-line treatments such as CPAP or a mandibular advancement device.
You are monitored closely, sometimes in a high-dependency area, because of swelling and airway care. Pain relief is given and you start on fluids.
Close early monitoring of the airway, sometimes in a high-dependency setting.
You are monitored closely, sometimes in a high-dependency area, because of swelling and airway care. Pain relief...
Swelling and bruising peak then begin to ease. You manage a soft or liquid diet, keep the mouth clean, and may use...
Swelling continues to settle, eating gradually improves towards softer normal foods, and many people return to...
Bone healing progresses, the bite is fine-tuned with orthodontics, and most facial swelling resolves. A repeat...
What is sleep apnoea jaw surgery?
Obstructive sleep apnoea (OSA) is when the airway repeatedly narrows or closes during sleep, causing pauses in breathing, broken sleep and daytime tiredness. Sleep apnoea jaw surgery, known as maxillomandibular advancement (MMA) or bimaxillary advancement, moves both the upper jaw (maxilla) and lower jaw (mandible) forward.
Moving the jaws forward pulls the soft tissues and tongue base forward too, which enlarges the space behind them and helps keep the airway open during sleep. It is a major operation on the facial skeleton and also changes the shape of the face and the bite.
It is not a first treatment. It is considered for selected people, usually adults with moderate to severe OSA, when treatments such as CPAP (a mask that holds the airway open) or a mandibular advancement device cannot be tolerated or have not worked well enough. Suitability depends on a careful assessment of the sleep study, the airway, the jaws and the bite, often involving a sleep team and an oral and maxillofacial or orthognathic surgeon.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Maxillomandibular advancement (MMA)
The standard approach for sleep apnoea: both the upper and lower jaws are moved forward together to enlarge the airway behind the tongue and soft palate.
MMA with counter-clockwise rotation
The jaws are advanced and rotated to maximise airway opening while trying to preserve a natural facial profile and a workable bite.
Combined with other airway surgery
In some patients, jaw surgery is planned alongside or after other procedures (such as nasal or soft-palate surgery), guided by where the airway narrows.
Genioglossus advancement (tongue-muscle attachment)
A smaller bony procedure that pulls the main tongue muscle forward, sometimes done with or instead of full jaw advancement in selected cases.
Preparing for your surgery
- Have a full assessment, including an up-to-date sleep study, airway and jaw assessment, and discussion with a sleep team and specialist surgeon.
- Expect a period of orthodontic treatment (braces) before and after surgery to align the teeth and bite.
- Tell the team about all medical conditions and medicines, as untreated severe OSA raises anaesthetic risk.
- Stop smoking, as it impairs bone and wound healing.
- Plan for several weeks off work and for a soft or liquid diet in the early weeks.
- Discuss how your face and bite may change, and ask to see realistic expected outcomes.
- Arrange help at home, as eating, talking and swelling will affect you in the first weeks.
What happens
The operation is done under general anaesthetic, so you are fully asleep. The surgeon makes cuts inside the mouth, so there are usually no external facial scars, and carefully divides and repositions the upper and lower jaw bones, moving them forward. The bones are held in their new position with small titanium plates and screws.
The operation often takes around two to four hours. Afterwards you are monitored closely, sometimes in a high-dependency area at first, because the airway and swelling need careful attention. Most people stay in hospital for a few nights.
Eating starts as fluids and soft foods, and the bite is supported as it settles, sometimes with elastic bands between the teeth. Orthodontic treatment continues afterwards to fine-tune the bite, and the airway response is reassessed with a repeat sleep study once healing is complete.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- People who have not yet tried or properly considered first-line treatments such as CPAP or a mandibular advancement device.
- People whose airway narrowing is not at a level that jaw advancement would help, based on assessment.
- Those whose general health makes major surgery and general anaesthesia too risky.
- People seeking surgery mainly for snoring alone without confirmed significant obstructive sleep apnoea.
Delay surgery if…
- Sleep apnoea is severe and untreated, raising anaesthetic risk, until it is optimised (for example with CPAP) beforehand.
- There is active dental or gum disease or infection needing treatment first.
- Orthodontic preparation of the bite is not yet complete.
- Weight, smoking or another medical problem should be addressed first to improve safety and results.
Alternatives to discuss
- CPAP, which is the usual first-line treatment for moderate to severe OSA.
- A mandibular advancement device (a custom dental splint) for milder cases or where preferred.
- Weight loss and lifestyle changes, alcohol and sedative reduction, and positional therapy.
- Other airway operations (nasal or soft-palate surgery) where the narrowing is at those levels.
- Hypoglossal nerve stimulation in selected patients where available.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Can substantially reduce the number of breathing pauses during sleep for many people
- Often improves sleep quality, daytime sleepiness and quality of life
- May reduce or remove the need for CPAP in some people
- Treats the airway at the level of the jaws and tongue base, which other treatments do not
- Uses cuts inside the mouth, so there are usually no external facial scars
Risks & complications
- Significant facial swelling and bruising for the first weeks
- Numbness or altered sensation of the lips, cheeks, chin or gums, which can be prolonged
- Difficulty eating, with a soft or liquid diet needed early on
- A change in the appearance of the face and the feel of the bite
- Lasting numbness in part of the lip or chin
- Infection, or problems with the plates and screws sometimes needing removal
- Bleeding needing review
- The bite not settling as planned, needing further orthodontic work or adjustment
- A piece of bone not healing well or a need for further surgery
- Damage to teeth or tooth roots near the cuts
- Sleep apnoea not improving enough, so other treatment is still needed
- Serious anaesthetic or airway complications, which is why monitoring is close
This is major surgery with a meaningful recovery and a real chance of altered sensation, particularly numbness of the lip and chin, which can be long-lasting. The biggest uncertainties are how much your sleep apnoea will improve and how your face and bite will change. Benefit depends heavily on careful selection. Ask your surgeon and sleep team how much improvement is realistic for you, how your appearance and bite may change, and what the plan is if the apnoea does not improve enough.
Published figures to discuss
Outcomes from jaw advancement for sleep apnoea are generally good in carefully selected patients, but they depend on how OSA is defined, the severity, the level of airway narrowing and individual anatomy. Published series report substantial reductions in the apnoea-hypopnoea index (a measure of breathing pauses per hour), but 'success' and 'cure' are defined differently across studies, so figures should be read as guidance, not promises.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Surgical success (large reduction in breathing pauses) | Around 85% in a pooled meta-analysis | 'Success' is usually defined as a major fall in the apnoea-hypopnoea index, not complete resolution; results vary with selection. | Maxillomandibular advancement for OSA: meta-analysis — PubMedpubmed.ncbi.nlm.nih.govPublished figure |
| Surgical cure (near-normal breathing on sleep study) | Around 40% in the same meta-analysis | A meaningful minority achieve near-normal results; many improve greatly but still have some residual apnoea. | Maxillomandibular advancement for OSA: meta-analysis — PubMedpubmed.ncbi.nlm.nih.govPublished figure |
| Altered sensation of the lip, cheek or chin | Common early; can be long-lasting in a minority | Numbness from handling the nerves in the lower jaw often improves over months but may be partly permanent. | Maxillomandibular advancement for OSA: meta-analysis — PubMedpubmed.ncbi.nlm.nih.govSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery from jaw surgery is gradual and takes weeks. Swelling and difficulty eating are greatest early on, and the final result for breathing, the bite and the face appears over the following months.
- Marked facial swelling and bruising that improves over several weeks
- Numbness of the lips, cheeks or chin that often improves slowly but can last
- A soft or liquid diet and gradual return to normal eating
- A different feel to the bite while it settles and is adjusted
- Tiredness as your body recovers from a major operation
Aftercare
- Follow the soft or liquid diet advised and build back up to normal foods gradually.
- Keep your mouth clean with gentle rinses and any prescribed mouthwash to prevent infection.
- Take pain relief and any antibiotics as prescribed.
- Use elastic bands or follow bite instructions exactly as the team directs.
- Avoid strenuous activity and contact sports while the bones heal.
- Attend all surgical, orthodontic and sleep follow-up appointments, including the repeat sleep study.
- Do not stop using CPAP unless your sleep team confirms it is safe to do so.
- Soft and liquid foods stocked for the first weeks
- Prescribed pain relief, antibiotics and mouthwash collected
- Help arranged at home for the early recovery
- Several weeks off work booked
- Surgical, orthodontic and sleep follow-up appointments noted
- A clear plan for whether and when to keep using CPAP
Scars and how they heal
Because the cuts are made inside the mouth, there are usually no visible scars on the face. There are small healing sites inside the mouth, and the plates and screws holding the bones are under the gum and not normally visible. The main visible change is to the shape of the face from moving the jaws forward, which your surgeon should discuss in detail beforehand.
⚠ Get urgent help if…
- Difficulty breathing or noisy, obstructed breathing — seek emergency help
- Heavy bleeding from the mouth or nose that does not settle
- Spreading swelling, redness, heat or pus, or a high temperature (signs of infection)
- Severe pain not controlled by the prescribed pain relief
- Inability to swallow your own saliva or take fluids
- A sudden change in the bite or a feeling that the jaw has shifted
- Calf pain, swelling, chest pain or breathlessness (possible clot) — seek urgent help
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result is a noticeably more open airway, fewer breathing pauses on a repeat sleep study, better sleep and less daytime sleepiness, with a face and bite the person is comfortable with. For many carefully selected people, jaw advancement markedly reduces the severity of obstructive sleep apnoea.
It cannot be promised to cure sleep apnoea for everyone. Some people have a big improvement but still have mild residual apnoea, and a minority need ongoing treatment such as CPAP. Weight, the pattern of airway narrowing and individual anatomy all affect the outcome. Success is best judged by a repeat sleep study and how you feel, not by the operation alone.
Jaw advancement produces a structural change to the airway that tends to last, and many people maintain improvement over the long term. However, sleep apnoea can be influenced by weight gain and ageing, so it can return or worsen over time. Long-term follow-up, healthy weight management and, where needed, repeat sleep studies help keep the condition in check.
Combining with other procedures
Jaw surgery is usually combined with orthodontic treatment before and after the operation to align the bite. Depending on where the airway narrows, it may be planned alongside or after nasal or soft-palate procedures. Care is coordinated between the sleep team, the surgeon and the orthodontist, and weight management and CPAP may continue around the surgery.
Follow-up & long-term care
You will be followed up by the surgical team to check bone healing and the bite, by the orthodontist to fine-tune the teeth, and by the sleep team, usually with a repeat sleep study once you have healed, to measure how much your apnoea has improved. Long-term review checks that the benefit is maintained and that any residual apnoea is managed.
- A repeat sleep study after recovery to confirm the airway response
- Ongoing orthodontic care until the bite is settled
- Long-term monitoring of sleep apnoea, especially if weight changes
- Healthy weight management to help maintain the benefit
- Continued CPAP if the sleep team advises it for residual apnoea
Revision and secondary surgery reality
- Some people improve greatly but still have residual apnoea needing ongoing treatment such as CPAP.
- Plates and screws occasionally need removal if they cause problems.
- Further surgery or orthodontic adjustment is sometimes needed if the bite does not settle as planned.
- Sleep apnoea can return over years, particularly with weight gain, and may need re-treatment.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- Close early monitoring of the airway, sometimes in a high-dependency setting.
- A clear pain-relief, diet and oral-hygiene plan, with a named contact for problems.
- Coordinated surgical, orthodontic and sleep follow-up, including a repeat sleep study.
- An explicit plan for residual apnoea, including whether to continue CPAP.
- Long-term review to check the benefit is maintained over time.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The surgeon's fee for major jaw surgery, which varies with complexity
- General anaesthetic and theatre fees, plus a hospital stay of several nights
- Orthodontic treatment before and after the operation
- Sleep studies before and after surgery
- Plates, screws and any specialist planning or imaging
- Follow-up across the surgical, orthodontic and sleep teams
- Any further surgery or treatment if the apnoea does not improve enough
- The surgeon's fee and what the operation includes
- The hospital stay, theatre and anaesthetic fees
- The cost of orthodontic treatment before and after surgery
- The cost of the pre- and post-operative sleep studies
- Follow-up across the surgical, orthodontic and sleep teams
- What happens, and what it costs, if the apnoea does not improve enough or further surgery is needed
- The cancellation policy
On the NHS? Jaw surgery for obstructive sleep apnoea is available on the NHS for selected patients who meet clinical criteria, usually after CPAP or a dental device has been tried; private care is mainly chosen for speed or choice of surgeon.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Promising a cure rather than a likely reduction in breathing pauses.
- Not explaining the real chance of long-lasting numbness of the lip and chin.
- Glossing over how much the face and bite will change.
- Not setting out the need for orthodontics and a repeat sleep study to judge success.
- Recommending surgery before first-line treatments have been properly considered.
Marketing red flags
- Claims that jaw surgery is a guaranteed cure for sleep apnoea or snoring.
- Downplaying the major nature of the surgery and its recovery.
- Not mentioning the risk of permanent numbness or facial and bite changes.
- Offering surgery without a confirmed diagnosis from a proper sleep study and team assessment.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- How much improvement in my sleep apnoea is realistic for me?
- How will my face and bite change, and can I see expected outcomes?
- What orthodontic treatment will I need before and after surgery?
- How likely is lasting numbness of my lip or chin?
- What happens if my sleep apnoea does not improve enough?
- Will I still need CPAP, and how will you measure the result?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Will this cure my sleep apnoea?
Will it change how my face looks?
Why can't I just stay on CPAP?
Is it available on the NHS?
How long will the numbness last?
Are there scars on my face?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Obstructive sleep apnoea NICE — OSAHS guidance (NG202) Maxillomandibular advancement for OSA: meta-analysis — PubMed Bimaxillary advancement and OSA: meta-analysis — Scientific Reports
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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