The technical question would be “does orthognathic surgery affect the upper airways?” There is a favorable effect of orthognathic surgery in the upper airways regardless of the surgical approach. Bimaxillary (upper and lower jaws together) advancement and counterclockwise rotation of the mandibular occlusal plane are the most significant contributors. (J Oral Maxillofac Surg 79:450-462, 2021). From the time that I (Dr. Wagner) trained in the 1980s, I have found that orthognathic surgery essentially always results in improved airways and breathing. Many times, this is a significant improvement. A big part of this is that the design of the procedures and workup toward surgery is logically oriented toward returning the individual to as normal an anatomy as possible. Putting “things” in correct place is usually in line with improved mechanics. In places where it is not, a skilled surgeon recognizes this in the treatment planning stages and modifies the procedures to give the best results.

I often talk about the “art of surgery” and this is certainly true of this type of treatment planning. The art of it is being able to see the result of it in your minds eye ahead of time. This is a big part of the “fun”, “joy” and satisfaction of providing life-changing care such as this.

There are also adjunctive procedures that can be done at the same time as orthognathic surgery such as improvement of nasal mechanics (turbinates, septoplasty, etc.) which we build into our procedures where possible – which contribute significantly to improved breathing as well.