How to Pick an Orthognathic Surgeon

Jaw Surgery | MMA Advancement

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Orthognathic surgery has been performed since the 1970s, and over the years the procedure continues to be refined and improved. Its adaptation to correct airway disorders has advanced significantly.

Although every oral and maxillofacial surgeon is trained to perform orthognathic surgery, a vast difference exists in their skill level, experience, and attention to detail.

An experienced and high-level surgeon will provide:

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1. Surgical Skill and Craftsmanship

A critical factor in minimizing post-operative numbness, swelling, and recovery time.

Dr. Loetscher has performed thousands of orthognathic procedures over more than 30 years, consistently delivering a high level of surgical precision and craftsmanship. He has operated with the same experienced surgical team for many years, allowing for efficient procedures and predictable outcomes.

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2. Ideal Diagnostic Skills

A surgeon experienced in orthognathic surgery and airway disorders must evaluate the patient carefully to determine:

• Which jaw requires movement
• How far the movement should occur
• Whether orthodontics will be required
• Whether airway or sleep-related issues are present

An experienced surgeon can often identify airway and sleep concerns caused by improper facial development. In these cases, orthognathic surgery may significantly improve breathing and sleep quality.

Additional testing such as sleep studies may be ordered to confirm the diagnosis.

Dr. Loetscher carefully reviews each patient’s bite concerns, airway symptoms, radiographs, and CT scans. Many skeletal and airway abnormalities can be recognized through detailed examination of the face, mouth, and imaging.

By combining the patient’s symptoms, clinical examination, and radiographic analysis, a diagnosis can be made in over 90% of cases, with sleep studies used when necessary for confirmation.

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3. Precise Treatment Planning

Treatment planning is one of the most critical — yet often overlooked — aspects of orthognathic surgery.

Today, orthognathic surgery is digitally planned, allowing precise surgical movements to be determined before surgery even begins.

Dr. Loetscher works closely with an experienced design engineer during the planning process. Together they analyze:

• Facial measurements
• CT scans and radiographs
• Enlarged facial photographs

During this virtual planning session, the exact movements of the facial bones are determined.

The goal is to achieve the proper balance between:

• Maximizing facial esthetics
• Maximizing airway improvement
• Maintaining predictable healing and recovery

These factors must also support long-term skeletal and orthodontic stability, helping prevent relapse of the jaws or dentition.

This is particularly important when performing the larger skeletal movements often required for airway disorders and sleep apnea.

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Key Planning Considerations

1. Ideal Upper Tooth Display

Upper teeth should be positioned so the correct amount of tooth shows when smiling — not too much and not too little. Too little tooth display can make a face appear prematurely aged.

2. Forward Jaw Advancement for Airway

Advancing the jaws forward improves airway space and breathing. The goal is to maximize airway improvement while maintaining balanced facial aesthetics.

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What Patients Want to Avoid

One common mistake is insufficient jaw advancement, which can limit both airway improvement and facial balance.

For example, a surgeon may advance the jaw 7 mm instead of 11 mm because the procedure becomes quicker and technically easier. However, this smaller movement may fail to provide the optimal airway improvement or facial outcome that was possible.

Patients may never realize this difference — but the improvement in both breathing and facial profile could have been significantly greater.

This highlights the importance of choosing a surgeon who fully understands sleep-disordered breathing, airway function, and facial aesthetics.

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4. An Experienced Team Treating You

Orthognathic surgery is a team-based procedure involving collaboration between:

• Orthodontists
• General dentists
• Sleep dentists
• Sleep physicians
• The surgical team

Working together ensures accurate diagnosis and the best treatment outcome.

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Surgical Team

The surgical team includes the surgeon, anesthesiologist, surgical technicians, nurses, and assistants.

A highly experienced team allows procedures to proceed smoothly and efficiently, helping minimize complications and support a predictable recovery.

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Surgical Facility

The surgical facility also plays an important role.

Orthognathic surgery requires highly specialized instruments and equipment, and some facilities are better designed to support these procedures.

Dr. Loetscher designed and built a state-of-the-art outpatient surgical center specifically for orthognathic surgery. This facility allows his team to deliver optimal surgical care in an environment designed for efficiency, safety, and patient comfort.

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Post-Operative Support

Dr. Loetscher’s experienced nursing team will:

• Assist during your pre-operative visit
• Support the surgical procedure
• Help guide you and your family through the early recovery process

This level of support ensures a smoother recovery and excellent continuity of care.

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Summary

Dr. Loetscher and Atlanta Oral & Maxillofacial Surgery are uniquely equipped to provide advanced orthognathic surgery.

From diagnosis and digital planning to surgery and post-operative care, every step of the process is carefully designed to achieve the best possible results.

Dr. Loetscher believes the care provided in this practice is truly among the best available anywhere in the country.

There is a difference.

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