Maxillo-mandibular Advancement (MMA) or double jaw advancement is a procedure whereby the upper and lower jaws are surgically moved forward (Lefort 1 osteotomy of the maxilla and saggital split advancement of the mandible). The concept is that as the bones are surgically advanced the soft tissues of the tongue and palate are also moved forward, again opening the upper airway. The usual movement is about a half an inch. Since the upper and lower teeth are moved the same amount, the bite would be similar before and after operation.
The MMA will always alter and often enhance appearance, but is not disfiguring. The operation is accomplished through the mouth. The jaws may be briefly wired closed following the operation. The procedure is technically involved with the potential for complications as in any surgical procedure, but most patients recover remarkably well from this surgery.
For some individuals, the MMA is the only technique that can adequately create the necessary air passageway that can resolve the OSA condition with finality.