MQ (male 31) - San Francisco, California
Date of maxillomandibular advancement - October 14, 2009
The Bottom Line, First:
Undergoing Maxillomandibular advancement (MMA) surgery with Dr. Li was one of the best decisions I've made in my life. Only seven weeks removed from the operating room and I'm sleeping extremely well. I feel rested for the first time in ages; as a result, I'm thinking much more clearly, I have more energy and my mood has improved dramatically. Of course, now that I have a bit of perspective, it's tempting to bemoan all that time and opportunity lost to unhealthy sleep through the years. With my severe sleep apnea a thing of the past, though, I'm just too excited about what lies ahead to worry about what could have been.
I was diagnosed with sleep apnea in 2005. I struggled with CPAP for years before being re-evaluated by the Stanford Sleep Disorders Clinic in 2009. There, sleep studies revealed a Respiratory Disturbance Index (RDI) of 46.4, meriting a diagnosis of severe sleep apnea. My prescribed treatment was CPAP at a pressure of 15 cm of water. Unfortunately, my anatomy once again conspired against CPAP narrow breathing passages made it a struggle to exhale against the high air pressure coming in from the machine. When, and if, I fell asleep, I would wake up shortly with air streaming out of my mouth or abdominal cramping from swallowing too much air. Given my profile and inability to tolerate CPAP, the Stanford Sleep Disorders Clinic referred me to Dr. Li.
Dr. Li's reputation as a world class surgeon is matched by his bedside manner. He took the time to thoroughly evaluate my condition and familiarize me with all available options. Any question my wife and I may have had regarding the various procedures was answered with detail and consideration. Given my history and profile, it made sense to proceed with MMA surgery (in addition to correcting a deviated septum in my nose).
Day of the Surgery:
The morning of the surgery I was both nervous and excited, as was to be expected. The staff at Stanford Hospital, as well as the anesthesiologist and Dr. Li, ensured that everything progressed smoothly from checking in to recording my vital signs to wheeling me into the operating room. Once I was moved to the operating room, it wasn't long until I was under anesthesia. After that, my first solid memories are of the intensive care unit (ICU), where I spent the night after surgery.
The staff at Stanford is fantastic. I don't imagine it's ever fun to stay at a hospital, but the staff's attentiveness and familiarity with the procedure made my two days as pleasant as one could hope. The first night I spent at the ICU, where they made sure I was comfortable and recovering well from the surgery. For the most part, it was a blur of waking, sleeping and something in between. The second day I was moved to the general hospital, where I stretched my legs for the first time and began familiarizing myself with a liquid diet. There was some pain, as well as a little discomfort (my mouth was banded together), but overall it wasn't bad. Mostly, I felt tired, thankful the operation had gone well and eager to continue the recovery process at home. Dr. Li visited each day to check on my progress and I was cleared to return home my third morning in the hospital.
The First Week:
The first week after the operation wasn't a whole lot of fun. The minutes and hours seemed to crawl by, and I imagined that the coming few weeks would be some of the longest I could remember since childhood (I'm happy to say that wasn't the case: after the sixth or seventh day, routine took over and time seemed to accelerate). Pain was not a major issue for me; however, post-surgery nasal congestion made my first few days home less than pleasant. Combine a closed mouth, a prohibition on sneezing and post-surgery nasal discharge (blood and mucus drain from the sinuses during the first days post-operation) and you have yourself an uncomfortable time. Even though I stopped by Dr. Li's office immediately after leaving the hospital to have my nose drained, I found myself very congested the next morning, which happened to be a Saturday. My wife called Dr. Li, and he very kindly met us at his office just to clear my nose.
Fatigue and a bit of malaise set in after a few days. As Dr. Li noted, I had, after all, just undergone surgery. Neither condition lasted long, however. Looking back, I'm pretty amazed at how quickly I recovered the first couple days I pictured an eternity sleeping in a easy chair with my mouth banded shut and suddenly it's seven weeks later, I'm eating soft foods and sleeping like I never thought possible.
Random Tips and Observations on Recovery:
It's particularly important in the first week or so to remember that you will be feeling much better soon.
I did not experience a great deal of jaw or facial pain some discomfort and a little pressure from time-to-time, but it was not bad. Aside from the nasal congestion of the first few days, the most uncomfortable thing I experienced was an inflamed Eustachian tube on the right side of my face. Brushing my teeth or drinking occasionally triggered a sensation similar to descending (or diving) quickly and being unable to equalize pressure in my ear. This was painful, but I soon learned to mitigate the unpleasantness by clearing my ears, swallowing or gently repositioning my teeth. As Dr. Li foretold, the inflammation decreased and the incidents became fewer and farther in between; finally disappearing altogether.
Keep breathing passages moist. Showering a couple times a day early on and sleeping near a cool-air humidifier really helped with my nasal congestion.
It helps to read about other people's experiences with MMA surgery there are a lot of blogs out there with interesting insight on what to expect.
Get outside and walk around, if only down the block. It really makes you feel better.
Aesthetics think giant chipmunk for the first 7-10 days. As the swelling began to recede, I got a sense of my post-surgery appearance. With a stronger jaw and chin, I do look a little different I'll give all the credit to Dr. Li'as my wife even thinks it's an improvement. You can definitely tell Dr. Li is a skilled cosmetic surgeon.
You're not alone. Dr. Li and his incredible staff were always available if my wife or I had a question.
Life changing. I'd go through the process ten times over to be where I am today, and I'm only seven weeks out. Thank you, Dr. Li, for giving me a new lease on life.
JBC (male 46) East Lansing, Michigan
Date of maxillomandibular advancement
November 24, 2009
I suffered from OSA for more than 25 years and during my last year, due to a need for higher air pressure, CPAP was no longer an option for me. What I needed was a stable-definitive solution.
I make my living as a scientist so I did my research using my tools i.e. original peer reviewed manuscripts. All the information I gathered pointed to Stanford. So I made my appointment with Dr Kasey Li for September 17th. After careful physical examination and looking at my sleep studies and X-rays Dr Li concluded that an MMA was the best option. He was never pushy; he encouraged me to look at other surgeons and to consult with my family.
My surgery took place 2 days before Thanksgiving, on November 24. I had some uneasiness thinking that I would not be properly taken care of due to the holiday. Defying expectations, Dr Li was there every single day, including Thanksgiving. After I was release from the hospital, and for each subsequent appointment, I would show up with a long list of questions (some of them quite technical actually) and after he examined me he would listen and respond patiently. He also attended to my caregiver's (wife) concerns as if both were his patients.
The procedure to remove arch bars (not trivial) was done on December 28th, between Christmas and New Year's. Not only was Dr Li waiting for my-late-arrival from Michigan, the whole staff was there with the most delightful disposition (his office was full of patients too).
Since day 5 after the surgery I have been able to sleep like a normal person. I get out of bed rested, no body pain, no morning fogginess, no need for coffee. I sleep one hour less than before (7 hrs) and have no mid-afternoon sleepiness. I am currently dreaming in my sleep as I never had before, an added bonus. The question is, is this just pure coincidence? Was I lucky enough to have all the stars aligned for the surgery and the recovery? Not really, what made the difference is that I found a gifted physician and surgeon, Dr Kasey Li, assisted by a team of dedicated individuals like Daisy, Juanita and Linda.
Dr Li is not, I repeat is not, a typical surgeon. Besides having performed close to 1,000 MMAs and finding time to write dozens of seminal peer review articles in this subject, he is a human being that listen, does not hurry you, is reachable at all times of the day and responds to emails and calls (yes calls) personally. A steady hand, a bright mind, a driven individual that empathizes with each patient; what else one could ask?
For those suffering from a correctly diagnosed OSA, do not take my word for it, just go and visit with Dr Li once and you will get what you are looking for, the solution for a problem that not long ago was deemed incurable. Be prepare, you will also get the truth from him and if surgery is not the solution you will find out that as well.
DSS (male 34) New York, New York
Date of maxillomandibular advancement - July 28, 2009
Experience: Before I had my MMA surgery with Dr. Li, I was sleeping with a CPAP, but was not feeling rested even after a full night's sleep. Subjectively, I personally felt as if the sleep I was getting was "low quality." The process of preparing for the surgery, having the surgery and recovery were difficult of course, but more comfortable than expected due to a standard of care so good that I previously did not think it possible. The first few weeks were challenging, and my jaw did not feel "back to normal" for a few months. From the third or fourth day after the surgery, my subjective experience was of a quality of sleep many times better than my experience with CPAP. The amazing improvement in sleep made the recovery much easier, as I knew from very early in the process that the surgery had been worthwhile.
Thank you for the amazing, even miraculous, differences you have made in my life. I am forever grateful.
HB (female 19) Sacramento, California
Date of maxillomandibular advancement - April 15, 2009
I just wanted to thank you soooo much for giving me my life back! That might sound like hyperbole, but it's really how I feel. Everything has changed for me; I'm not depressed, I actually go to class, I think about things (I'm less impulsive), my memory is much better, and I've even been running two miles a day! This surgery has radically altered my lifestyle for the better and I am so appreciative!
TN (female 62) - San Francisco, California
Date of maxillomandibular advancement - June 13, 2007
Not a day goes by since June 13, 2007 in which I don't thank my lucky stars for having found Dr. Kasey Li after having been so ill advised about my severe sleep apnea. I am another MMA success story. Before surgery, I had an RDI in the '60's which has now been reduced to a mere 13. I went from working @ 8 hours per week to a very fulfilling 30+. Dread symptoms--an exhaustion so profound I did not think I could go on another day, frequent and frightening apneic episodes, distressing heart palpitations, an unremitting 4 year headache--have been
eliminated. I am a better and newer, older woman!
I recommend Dr.Li unconditionally. Please feel free to contact me via e-mail with any questions. I and other MMA victors hold an annual MMA get together, usually in September, for those who are considering such surgery and want to spend time with others who have undergone MMAs. We'd welcomed the opportunity to meet with you.
PF (male 51) - Oakdale, California
Date of maxillomandibular advancement - April 8, 2009
If you are reading this, you probably understand how debilitating apnea is. It robs you of sleep, health and the basic ability to participate in life.
Dr Li performed my MMA 9 months ago, and I recall knowing that my problem was resolved within a day or so of waking up from the anesthesia. It remains that way today. Now, I fall asleep normally, wake up normally, have abundant wakefullness and energy during the day... In other words - no more apnea. I enjoy life like a normal person again.
Regarding the recovery process, it takes time and has its trying moments. But the benefits far outweigh the inconvenience and minor discomfort. Over time, it heals. Each day is better than the day before, but it takes time.
As far as Dr Li, this is a truly exceptional Doctor. Gifted hands and mind, caring, and refreshingly straightforward.
Bottom line, Dr Li cured my apnea and gave me my life back. He told me he could fix me, and that is exactly what he did. I cannot give him enough kudos. I, and my family, are forever grateful.
Thank You Dr. Li.
RF (male 50) - Maitland, Florida
Date of maxillomandibular advancement - December 7, 2007
Dr. Li, My experience with both you and your entire staff and surgical team was nothing less than extraordinary. The preop prep including the financial arrangements, the surgery itself and the postop recovery all went better than I had expected. The worst of the experience was the difficult nasal breathing during the first few days, but you did a super job in getting me through that even after office hours! It was most reassuring to be able to call you when needed after the surgery and always reaching you quickly. Your "bedside manner" was great even when you met me at your office after hours as needed. I am very thankful that I do not need CPAP any more and can get back to a normal life. I no longer dread bedtime! I hope you are able to help many more like I was who felt like a walking Zombie with CPAP. Thanks again and best wishes!
SS (male 58) - Menlo Park, California
Date of maxillomandibular advancement - March 3, 2010
Experience: As a practicing physician myself, I have been in a unique position to observe Dr. Li and his work. I have been overjoyed at the expertise that he brings to this field. Quite literally, he has saved my life. I was on a not-so-slow descent into physical demise and my quality of life was abysmal.
Dr. Li quickly sized up a complicated problem and pushed forward expeditiously (along with his very caring office staff) in getting me a surgical solution where all else had failed.
I have the utmost confidence in his surgical skills, but I am equally impressed with his kindness and advocacy for the patient. He is a compassionate man who brings all the virtues of medicine into plain view. He has a very reassuring bedside manner, and has gone the extra mile for me in all matters relating to this challenging surgical intervention.
It is the rare individual who brings his impeccable surgical and clinical skills to the table, yet retains the compassion that is so essential to weathering this difficult operation.
I wish all doctors (including myself) could be so wonderfully gifted and have such a kindness. He is without peer in my humble opinion. It was a blessing that I came under his care, and I shall be forever grateful.
SMAC (female 36) - Belmont, California
Date of maxillomandibular advancement - December 26, 2006
First of all, I actually had all four procedures. In 2006 I had an MMA, GA and Nasal Surgery (Deviated septum) at the same time, and in 2008 I had a UPPP, all with Dr. Kasey Li.
From the moment I met Dr. Li my life has changed for the better. Dr. Li was frank and honest with his recommendations for which I am grateful. After years chasing my tail trying to find out what was wrong with me, to get the RIGHT diagnosis and start working towards my ultimate cure was in itself a huge weight off my back. I also never felt like I didn't have enough information. For every question I asked, Dr. Li had a direct and informative answer.
Dr. Li's staff is friendly and helpful, and always makes me feel welcome. When I am concerned about something, I never have to wait long for a response after calling.
I have to say that Dr. Li is my favorite doctor of all time (and that's saying a lot since my OSA was undiagnosed until 2005 and have been under doctors' care for as long as I can remember). He is a master of his specialty, and has improved my quality of life in such a way words cannot possible describe. The MMA, etc. didn't just change my life, I think I got a new one...in a different world. A world where I'm not sick every day, where I dream instead of fight for my life inside nightmares every night. A world where I actually heal, and where I do not dread the embarrassment and danger of inappropriately falling asleep at work, during meetings,
in waiting rooms, and most importantly while driving.
I am a new person thanks to Dr. Li.
If you want to know more (with fun pictures) feel free to go to my blog: http://shelby.idstrom.com/category/sleep-apnea/ My first OSA entry was on February 4, 2005 and my surgery was December 26, 2006.
If you're reading this, you're most likely considering Dr. Li. In my opinion, you're on the right track.
GV (male 32) - Mountain View, California
Date of maxillomandibular advancement - July 7, 2009
Bottom line: I was diagnosed with sleep apnea, CPAP didn't work out always for me, neither did UPPP. I underwent MMA surgery in July 2009. The surgery went extremely well, so did the recovery. Dr. Li did an amazing job. It is 7 months since the surgery, and I'm pretty much fully recovered. I still have a bit of jaw tiredness if I eat things I shouldn't be eating, but it'll go away too. I sleep now and I dream and I feel a lot better after the surgery. From the follow-up sleep study it seems that that my sleep apnea is not completely cured - but that said, I have had a huge improvement, and the MMA went really well. I'm going to continue seeking further
treatment with Dr. Li.
I had very bad sleep issues starting sometime in 2004. I would wake up at 2AM or so, and would not be able to get back to sleep. I went thru behavioral therapy etc in the beginning, which didn't work out. Later, I was diagnosed with sleep apnea in 2006 with an RDI of 23. Although the RDI doesn't seem too high, I felt really horrible through the day. I was very rigorous with CPAP, but it worked out only 2 days a week for me. Those two days, I would feel like I can do absolutely anything and bounce off the walls, but the rest of the days, despite CPAP, I felt absolutely miserable. I underwent UPPP, Genioglossus, and Tonsillectomy in 2008 (in another clinic), but it didn't help much.
Subsequently, I decided to do an MMA with Dr. Li. Dr. Li described the procedure and talked about it at great length to me, and answered all sorts of questions (and I had many). MMA has a success rate of 95%, and I was hoping for the best.
Despite preparation, the thought of an MMA was terrifying on the day of surgery. Right befor the surgery, I almost ran out of the operating room:) But the surgery itself was not too bad. My jaw was advanced by a whopping 16 mm IIRC, and the surgery lasted only 3.30 hours! I don't think I look very different after the surgery, maybe just a bit. The recovery takes a long time - it takes about 8 weeks before you can eat solid food without a blender. The whole process is just longwinded rather than painful if you ask me.
Advice that I can think of:
- Do not panic before the surgery (which I kinda did). You are lucky to be cared for by Dr. Li.
- Feel free to ask questions to Dr. Li. I have never had a doctor who was as friendly and prompt as Dr. Li.
- Ice your face as soon as possible after the surgery. Dr. Li will tell you to do this, and take the advice very seriously. I kept icing my face for at least 2-3 weeks after the surgery, and the sooner you start icing the better off you are. It made a tremendous difference in my case.
- Have a good humidifier at home. It eases the nasal congestion you might have after surgery.
- Have a good blender at home. You are going to live on blended stuff for 6 weeks or so.
- Exercise. In my case, Dr. Li allowed me to walk about after 4-5 days or so. IIRC, in about 10 days I was walking round the block with my wife to help me just in case. It makes a difference in healing (not the wife, the walking:)).
- It took about 4 weeks for me to feel completely normal and to get off pain meds, but YMMV.
It has been 7 months since the surgery now. I have almost completely recovered, the only issue I have is that my left jaw becomes tired or hurts if I eat say, a steak. I don't have loss of feeling anywhere. Dr. Li did a wonderful job with the surgery and with the post-op care. I sleep better now and I have dreams. I still have some sleep apnea according to the latest sleep study I did, and I still have some difficulties with sleep. I guess I belong to the other 5% for whom an MMA doesn't completely fix the issue. But I have certainly had a huge improvement after the surgery and I'm glad I did it. I would recommend an MMA with Dr. Li to anyone with
sleep apnea. It really isn't as bad as it is made out to be (particularly on the web), nor was it as big a deal as I expected it to be - thanks to the care I
DL (male 40) - Oakland, California
Date of maxillomandibular advancement - April 24, 2001
It was the snoring. I'm not sure how long I had snored as loud as people said I did...but definitely in college...I was a major snorer. My roommates told me so. Classmates in the architecture studio told me so...whenever I fell asleep on the lounge couch we stole from the administration floor...I was doing some major wood sawing. One night when my friend was using my drafting table in my room, I went to sleep while she worked and she awakened me because she claimed I stopped breathing (around 1982). Years later, my wife claimed that my snoring was getting worse. She also noticed the lapses in breathing during sleep. I apparently snored more loudly if I drank alcohol. I would get very strong nauseous headaches some mornings and for some strange reason and coincidence, I associated these headaches with consumption of foods with MSG. My solution was to take aspirin before going to bed if I ate foods with MSG that day. I would feel drowsy at the end of the day and often had problems staying awake on the BART or bus rides home in the evening. It also seems that once I hit 30, I had trouble maintaining a healthy weight.
Dr. Kasey Li who eventually performed my surgery was actually someone I went to for a second opinion. In keeping with insurance procedure, I originally went to a specialist who was both referred to by General Practitioner Doctor and who was on the prescribed list. This doctor initial prognosis was that I had a large tongue and gave me a brief description about snoring and breathing patterns during sleep. He talked about cures such as burning off some of the palate and levels of operations. He also scheduled me for an overnight sleep test.
Anyway, I had no problem going to sleep even though it was a strange environment with stuff taped all over me. It was never uncomfortable. I think about 3 hours later, I was awakened by the technician who wanted to hook me up with a CPAP mask. Once he had this thing on...I was immediately uncomfortable. It changed what I felt to be a normal breathing pattern as it seemed to keep me inhaling but never allowing me to exhale. It was sort of a claustrophobic gagging. I removed it right away and asked the technician about the importance of this part of the test...I did not want to compromise it nor waste the time, effort, and money...but at the same time, I could not imagine myself tolerating this mask much less falling asleep with it. I was told that many people reject it but that also many people end up wearing this mask for sleep apnea every night. However in my case, other data was going to be achieved without it. So I wimped out and rejected the thing. In summary, I have a severe case of sleep apnea and the test showed I was getting about 67% oxygen during the night and had breathing incidents about 1.5 times a minute. My doctor does not feel that anything less than the jaw/mouth surgery will reverse the sleep apnea problem. He tells me to think it over...even suggests getting a second opinion.
I got online and made an appointment with Dr. Li and I have an X-Ray of my profile done and I showed him a copy of my sleep study. Dr. Li agrees with my doctor's recommendation for the surgery (formally called Maxillomandibular Advancement). When I asked my doctor how many times he had performed this procedure, his answer was 50. When I asked Dr. Li...he has done it hundreds of times specifically for sleep apnea. Well to me, if I was going to go through with this...it was pretty clear that Dr. Li held somewhat of an edge in experience. He advised me to think it over and maybe come back with my wife.
My wife and I went back together one week later with our list of questions; how long is the procedure, what is the recovery period, how and what do I eat, etc. This day, Dr. Li also sends a camera down my nose. My wife and I start to feel very confident in Dr. Li and feel that having this operation is probably the best thing for me considering the long term benefits to my health and Sharon's ability to sleep. The next day, I call Dr. Li's office to schedule my surgery.
Afterthoughts / 20-20 hindsight.
Wish I went to the dentist before my surgery and had a checkup and cleaning. While I had my mouth kept shut after the surgery...I kept feeling that my mouth was unclean and that I might have a cavity. I kept worrying about a pain that never happened. The thought of having a cavity was worse.
Have a notepad for right after the surgery.
Buy the water-pic before the surgery so I would have had it.
Best food during this: Has to be the mashed potatoes. Also liked mixing one bag of Instant Cream of Wheat with one instant bag of Quaker Oats Oatmeal for breakfast.
Food I bought that I thought I would like but did not: Jello pudding snacks. Too sweet.
After returning to work, it still took a few months of eating soft foods. Which was fine...I like having lost the weight. I have Jamba Juices or soups for lunch. I move up to ordering Tuna sandwiches but even then I eat it with a knife and fork.
This was a life altering surgery for the better for me. I feel that I have lowered my risk of a stroke or heart attack. I have much more energy during my day and am no longer drowsy in the afternoons. I no longer fall asleep on the commute home and had to get a new walkman radio so I could at least listen to the news on the way home (can't read on the bus...motion sickness). I owe so much to my wife who just could not stand my snoring to the point where I had to sleep in the guest room on some nights. And to the medical people involved in my diagnosis, my blood extraction, my hospital care, etc. Most of all, Dr. Li for his experience, his professionalism, his confidence, and his sincere concern for my welfare. I never doubted that I was in good hands from the moment I met him.
JM (male 46)- San Francisco, California
Date of maxillomandibular advancement - June 4, 2008
Dr. Li is a great, great man. Both, as a surgeon and a human being. His level of experience and care make him second to none.
15 years ago, I was diagnosed with sleep apnea, (although I had it for many, many years prior to that) and had a radical UPPP surgery (by a different doctor) which seemed to help for several years. Unfortunately, it did not last and by 2007 my OSA was back at a "moderately severe" level. Even after sleeping for 8 hours, I would wake up feeling tired, and struggle to stay alert during the day. I once even fell asleep while driving (at 3 in the afternoon!) My quality of life was not good and I needed help.
That is when (after getting 3 of the same opinions) I chose Dr. Li to perform my MMA and GA surgeries. It was an easy choice for me and definitely one of the very best choices I have ever made. Leading up to my surgery, he answered every question I had, and helped me understand *exactly* what was going to happen.
Only 3 months after my surgery, a new sleep study revealed that I had an RDI of 4.8, so I feel it was all a huge success. Dr Li has also performed 2 turbinate reductions to help "fine tune" my breathing at night and that has helped as well.
I am still in awe at the level of care that Dr Li gave me, before, during and after my procedures, and as you can see by all of these other testaments, there are many others who agree with me. I must also add that along with this amazing surgeon, comes an amazing support staff who *all* really know what they are doing.....and they are all SO NICE to-boot! What a truly great crew!
So, if you are suffering from OSA, I highly suggest you contact Dr Li because I am very confident that he will have the right solution to your problem.
I also blogged about my whole experience, so feel free to have a look at:
Thanks, Dr Li! You're the best! ~JM
SL (male 43)- Key Largo, Florida
Date of maxillomandibular advancement - May 22, 2007
Experience: I was first diagnosed with OSA in 1994, but I am certain that I was suffering from it since the late 1980's. Prior to Doctor Li performing the MMA/GA (he also fixed my deviated septum ) I had undergone many other procedures: LAUP, Hyoid Suspension, etc. over the course of 10+ years. I was first told about the MMA procedure by my doctor in the late 1990's. When I learned of that procedure, I said to myself that I would never do it!
Many years later, things had deteriorated to the point that I started to rethink that decision. I had reached a point where my quality of life was so severely impacted by the OSA that I was now willing to do it. I looked for the best surgeon in the world and found Doctor Li.
The result of the procedures was immediate and dramatic. I was at once dreaming again and sleeping better....even in the ICU. I didn't even realize that I had stopped dreaming! I wished that I had found Doctor Li 10 years earlier.
Everyone I encountered at Stanford was first rate. The nurses and the technicians were always prompt, cheerful and were sensitive to my needs.
Recovery from the surgery requires patience and preparation. I was unable to talk and used a memo pad to communicate. Also, I had provisioned myself for a liquid diet. Suprisingly, there was very little pain after the surgery. Instead, there was numbness which, while not pleasant, is still better than being in severe pain. I did not have a great deal of energy the first week, but I was not exhausted either. I was able to function but certainly could not have been able to do a full days work.
The archbars in my mouth were causing me to drool a great deal during the first 2 weeks. It diminished each day, but I had to sleep with a towel under my head to absorb it. I also recall that during the first week, I was somewhat sensitive to changes in temperature. One moment I would be cold, the next hot. Slowly, but steadily, the numbness in my lower jaw and lip was going away. In about 3-4 months the numbness was barely noticeable but it was about one year before all of the feeling returned.
Recovery is a slow process. In approximately 4 weeks after the surgery, Doctor Li removed the arch bars. I was still on a liquid diet as I recall, although I may have started with extremely soft food such as pudding after the arch bars were removed. I started to eat things such as eggs and fish after 8 weeks of recovery. It was about 6 months before I was able to eat a tender steak. It was about a year before I was able to eat steak without difficulty. I lost approximately 15 pounds and have not gained it back!
The surgery performed by Doctor Li has changed my life. I now sleep like a baby and have dreams and wake up feeling refreshed. Yes, it's a big step, but Doctor Li would tell you if he felt that the procedure was not for you. As I said, I wish I had done this with him 10 years earlier.
Throughout the entire process, from initial consultation to post surgical care, Doctor Li was phenomenal. In addition to the fact that he is an amazingly skilled surgeon, he was always available and extremely accessible. He demonstrates genuine caring, concern and empathy for his patients; and his skill as a surgeon is second to no one. He is the best of the best.
Thank you Doctor Li.
PJO (male 46) - Cincinnati, Ohio
Date of maxillomandibular advancement - September 2, 2008
Experience: I had my surgery in September of 2008. The surgery is not easy but Dr. Li is the best in the world and it was a great success. I have almost zero sleep apnea today and my life has changed dramatically for the better.
Thank you Dr. Li
MC (female 45) - Mountain View, California
Date of maxillomandibular advancement - May 7, 2007
The surgery changed my life! Before I was falling asleep when I was reading, watching TV, at the theater, at the traffic light and started to fall asleep driving, even though I was using a CPAP machine. I was very tired all the time. I had jaw surgery and now my life is completely different. I can get up in the morning, I am not falling asleep during the day, I have energy, I can watch an entire movie in the evening and read a book. I feel so much better and I am able to work again.
The pain after the surgery was not so bad. I only felt pain in the evening at the joints of the jaws because I was talking through my teeth during the day, when my mouth was held be rubber bands. I did feel some numbness in my upper front teeth and below my lower lip, but it gradually went away after several months, and it is all gone now. Eating with a syringe after surgery was frustrating and challenging. The syringe kept getting stock, while pumping the food or pushing it out, so it was taking a long time. I received great care from Dr. Li, and his staff. The surgery went very well and Dr. Li was very caring and attentive to my needs. I had many follow-ups to make sure things were progressing well, until I was completely healed. The surgery was a success for me, if I had to, I would do it again, I got all the care I needed, and I would recommend Dr. Li and the jaw surgery if needed.
Mother of NF (female - 25) - Seattle, Washington
Date of maxillomandibular advancement - March 29, 2006
Dr. Li - The results of my daughter's surgery have been miraculous! We are blessed to have the resources financially to provide the best care possible for her. She is now breathing easily and pursuing her dreams - She looks great! Thank you.
LD (female 44) - Livermore, California
Date of maxillomandibular advancement - March 21, 2006
My experience with Dr. Li and his staff was superb and very professional. Dr. Li was referred to me based on his knowledge and expertise so I knew I was in good hands. The level of care and communication was comforting. The results of my surgery have been flawless. I have no numbing or tingling or visible scarring.
Dr. Li is an expert in his field and I would highly recommend him.
WC (male 41) - Seattle, Washington
Date of maxillomandibular advancement - January 18, 2005
My experience was fantastic. An odd thing to say about a major procedure. However, things couldn't have gone better! Dr Li's service was exemplary and his staff were and are fantastic!!
I have documented my positive experience on numerous patient support groups online and will continue to refer complex (sorry Dr Li) patients to your practice.
MU (Male 42) - San Francisco, California
Date of maxillomandibular advancement - March 11, 2008
My surgery was a huge success. It changed my life. I wish I had done this sooner. Sure it's inconvenient and not fun but it's not painful and it can have a positive impact on other aspects of your life to like diet not to mention finally feeling rested and not tired all day. Dr. Li and his staff are amazing and will explain everything to you in detail.
JT (male 60) - Phoenix, Arizona
Date of maxillomandibular advancement - January 5, 2010
Experience Equals a Miracle
Some people speak of being reborn after experiencing a life changing event in their lives. Often it is a near death experience or a new found religion or just the realization/awareness of the blessings that surround them.
I have no problem stating emphatically that on January 5, 2010 I experienced a rebirth, a life changing event, which will dramatically change my daily life for the rest of my life (not to mention a likely extended life). I have been reminded daily, over the course of the past ten weeks of recovery, what a miracle and blessing occurred when Dr. Li successfully completed my Maxillomandibular advancement surgery at Stanford Medical Center.
I must first give credit to God and for all the people that prayed for me and Dr. Li. I then must give credit to Dr. Li. His expert surgical skills and extensive experience is without a doubt tops in the country. The most important thing that I could ever say to anyone contemplating this surgery is that you must, I will repeat this, you must utilize a surgeon with extensive Maxillomandibular advancement surgery experience; And, one that performs this surgery specifically for the correction of obstructive sleep apnea.
Background and Symptoms
I struggled for over 20 years with low energy, irritability, mental & physical exhaustion, fragmented sleep, lack of focus & concentration, lost memory, low testosterone, low antibodies, continuous sinus infections and other depression like symptoms. As many know, your family also suffers right along with you. These symptoms are very similar to symptoms of persons suffering from depression and in fact, I was misdiagnosed with chemical depression and treated with various and multiple anti-depressant medications for over ten years. I tried over 8 different anti-depressant medicines and at one time I was on 3-4 meds to combat what the doctors thought was depression. I consistently informed the doctors that the medicines were not working.
For 15 years I believed I had some form of depression that was untreatable by meds and therapy. Fortunately for me I tried a new psyche doctor every three years and the last one said to me after 3 months of unsuccessful treatment, John you do not fit the profile of a sleep apnea patient, but I think we should have you tested at a sleep lab. This is a very important point to understand and a major reason why many sleep apnea patients go undiagnosed. I did not fit the profile of a sleep apnea patient in that I was not over weight, did not have a large neck and did not snore much. I also did not fall asleep during the daytime.
For more detailed background you may visit my MMA surgery blog at: http://sleeplessinphoenix.blogspot.com/
In March 2006, after a diagnostic sleep study, I was diagnosed with severe obstructive sleep apnea and had an AHI of 47.7. That means I stopped breathing 47.7 times per hour. That's 3 out of every 4 minutes throughout the night.
Unsuccessful Sleep Apnea Treatment
For the next four years I tried CPAP, BiPAP, APAP and several other positive airway pressure machines (with total compliance I only missed 3 days during this entire period) along with at least 6-8 sleep medications. All of my symptoms continued and I had no positive results. I also had four sleep apnea surgeries (all at one time) which included Septoplasty and a Limited UPPP. This surgery reduced my obstructive apneas, however it did not improve my symptoms. I continued with the APAP (a $5,000+ automatic BPAP) without any corrective effects>
Stanford Medical Center Dr. Guilleminault
I researched, researched and did some more research (I am a retired Federal Investigator and currently conduct forensic criminal and civil investigations) and determined that the number one sleep center in the country is located at Stanford Medical Center where the founder and leader of Sleep Apnea diagnosis and treatment lives, breaths and practices. I set up an appointment for an evaluation by Dr. Christian Guilleminault, the top doctor at the sleep clinic and a diagnostic sleep study. The results from the sleep study and Dr. Guilleminault's examination were that my obstructive apneas were not being treated by the BiPAP; my sleep apnea was genetic; my airway opening is very small; and I likely have suffered from this all my life. Dr. Guilleminault brought in Dr. Li the next day and they both reexamined my airway. I was advised to consider MMA surgery and to be evaluated for being a viable candidate.
Stanford and Sleep Apnea Surgery Center - Dr. Kasey Li
I saw Dr. Li on December 7th 2009 for my initial evaluation and consultation for surgery. You can be assured that surgery will only be recommended if there is a very good chance of success. I was advised that my sleep apnea could be improved 80-85%. Surgery was scheduled.
Surgery and Recovery
Surgery went as expected. My expectations were high. My pain was little to non-existent. Eating was difficult but that was expected. Everything went well and my recovery has progressed as expected. The only thing that has not gone well and was unexpected was how my insurance company has paid or reimbursed the medical costs. This is the patient's responsibility and not Dr. Li's.
Dr. Kasey Li
Thank you so much. I am so blessed and fortunate that you were my surgeon. There is no one out there that could have done a better job. Your expertise and your remarkable results surpass even the top sleep apnea surgeons.
Good Luck. By reviewing Dr. Li's website and reading these reviews, you have started out in the right direction.
AL (Male 30) - San Jose, California
Date of maxillomandibular advancement - January 3, 2007
My treatment was awesome. I didn't have much pain and yet the surgery changed my health and life a lot! Thank Dr. Li's amazing skills!
PS (Female 45) - Denver, Colorado
Date of maxillomandibular advancement - January 26, 2010
I cannot say enough about doctor Li in helping me through this, and being entirely accessible and wonderful doctor. I couldn't have picked a better person to rearrange my face!
Did it work? Well, at almost six weeks postop-I can say I am sleeping more deeply and dreaming than I have in years.
LB (Male 60) - New York, New York
Date of maxillomandibular advancement - October 13, 2010
I suspected that I've had sleep apnea for at least the past 31 years. My initial experiences with what I believed to have been sleep apnea, occurred at the end of November, 1979, in New York, the first day after my wife and I returned from our honeymoon. After 30 to 45 minutes after I work up, as I was on my way to work, after feeling reasonably alert, my head suddenly went into the fog, noticing that I was inexplicably felt less conscious, with my short term memory feeling impaired. This persisted every day thereafter, and seemed to occur every day shortly after I woke up. I seemed to sleep okay, but noticed that I didn't seem to be going into the normal deeper sleep that I had been accustomed to during most of my earlier life. I attempted to have a sleep study conducted in 1980, but abandoned it after I had been unable to fall asleep for about 3 hours.
At this point, a sense of hopelessness pervaded me, given the limited knowledge and treatment options that were available. My only recourse was the taking of power naps during the day when I was able to find some time to take them, which provided some temporary periods of greater daytime alertness after I'd take them.
In 1993, I had a sleep study, which resulted in a formal diagnosis of mild sleep apnea. As a result, in August, 1993, I elected to undergo a nasal-septoplasty, uvula pharyngoplasty by an ENT surgeon. However, it wasn't effective and as a second treatment option, I obtained and unsuccessfully attempted to utilize a dental mandibular advancement device in early 1994, which I obtained from a dentist. Shortly thereafter, I then attempted to use a CPAP machine, but was unable to to so because it felt like I was suffocating when I used a face mask with it.
In 1995, I made another unsuccessful attempt at having a sleep study, but I abandoned it after about 5 hours after being unable to fall asleep because of all of the wires and devices that had been hooked up to me.
Finally, after being notified of a work-related demotion in 2008, I had two sleep studies. The first one was conducted without CPAP, and resulted in the diagnosis of severe sleep apnea when laying in a supine position and mild apnea when laying on my sides. The second one used CPAP to titrate the appropriate level of pressure needed to effectively treat it which was at the 8 level.
As a result, I obtained a CPAP machine and was fitted with a nasal pillow. However, I only received very limited benefits with the nasal pillow because of my nasal allergy, so I 2009, I switched over to using a full face mask instead, but again, only noticed a slight improvement as I was continuing to experence extensive daytime drowsiness
In May, 2009, I had another sleep study conducted, and I think the results indicated that my condition actually deteriorated. The head of the sleep clinic, advised me that there was little that he could do except prescribed a stimulant to alleviate the daytime drowsiness. However, he hesitated in doing so because of the concern that it could stress out my liver with the addition of this medication, since I was already taking Lipitor for cholesterol reduction and Diovan for high blood pressure. He advised me that he didn't think raising the CPAP pressure level would benefit me.
In May, 2010, I went back to the sleep clinic and consulted with a new doctor who advised me that I wasn't obtaining the maximum benefits of CPAP becasue I wasn't wearing the face mask tightly enough because I wasn't placing the mask's velcro main support strap on the back of my head, resulting in the leakage of air from the mask and corresponding reduction in the pressure levels. After making this adjustment, I noticed a significant improvement in my overall situation with a reduction in the level of my daytime drowsiness, but I still needed to take an average of about 2 naps each day in order to function at a minimally effective level.
Finally, after receiving another work-related setback at the end of May, 2010, I did some online research and learned of the availability of the surgical procedure that was conducted by Dr. Li.
The surgery, and follow-up difficulties, to put it mildly, has been quite a challenge. However, so far, the quality of my sleep has been dramatically improved and I've noticed significant improvement in the quality of my level of daytime alertness which on a subjective level, almost seems like it's unprecedented with a dramatic improvement from the pre-surgical situation. Although I feel I still need to take occasional naps, I've noticed that I'm alert during almost all of my waking hours, even right up to the point that I take any nap, unlike my pre-surgical situation.
Dr. Li, thank you from the bottom of my heart.
MG (Female 30) - Orange, California
Date of maxillomandibular advancement - January 12, 2010
Experience: I had the mma (maxillomandibular advancement) surgery on 1/12/2010 which advanced my lower jaw 12 mm. I don't know how much my upper jaw was advanced. This surgery has been THE dream of mine for several years now and was my last hope from escaping the nightmare that is sleep apnea/sleep-breathing disorders. When I first heard about the surgery several years ago, I thought it seemed quite drastic but now that I've experienced it first hand, I would have it done every year for the rest of my life if it meant not having to live with this disorder. First let me tell you a bit about myself:
Race: Asian specifically Filipino/Chinese
Family history: Father has severe obstructive sleep apnea
I previously had 2 sleep studies at accredited sleep clinics that showed nothing but an AHI of 2 and unexplained spontaneous arousals. The sleep clinic tech let me try out a cpap machine even though I was not diagnosed with severe enough OSA/UARS. I immediately felt better after a few nights so I knew I had a sleep breathing disorders. I also tried the TAP 1 and Somnodent oral appliances but they gave me jaw problems. I needed a definitive diagnosis and was having difficulty self-treating myself so I faxed a letter to Dr. Li in spring 2009 explaining my situation. He was kind enough to call me the next day. He suggested that I do the sleep study at Stanford Sleep Disorders Clinic. I had it done in 7/2009 and was relieved to be diagnosed with an AHI of 14, all hypopneas and many, many flow limitations. I stopped by his office and within 2 minutes of examining me, he knew the mma surgery would help me. It was like visiting the Wizard of Oz.
Of course, surgery is a last resort but I had exhausted all options at this point including two oral appliances and the cpap/apap at the max pressure of 20 cm.
As many of you know, it is difficult to articulate how cruel and debilitating OSA/UARS can be. I felt like I had Alzheimers/narcolepsy/fibromyaglia/chronic fatigue syndrome all in the same body. I remember being almost bed-ridden and was ready to quit my job. In desperation, my family and I (thank God for my family) made the decision to do the mma surgery even if it meant paying for it out of pocket. I could not wait any longer for my insurance to approve it and with my low AHI it would be a fight.
Dr. Li said my case was unusual given my low AHI but the fact that I had many flow limitations probably was the cause of the sleep disruption. My pre-surgery x-ray revealed a narrow airway which was probably caused by my small, narrow, recessive jaws. Dr. Li agreed to do my surgery on me even with a low AHI (which I am grateful for). He said AHI does not reflect the severity of OSA/UARS symptoms. January 12, 2010 was my surgery date. I arrived 5 days earlier with my mom for the pre-surgical appointment and to prepare for the surgery. We stayed at the Homestead Studio Suites Hotel in Mountain View which had a mini-kitchen - great for cooking.
I was pretty nervous on my surgery day but Dr. Li, his staff and anesthesiologist were informative, professional and competent so was unafraid. I don't remember anything about the surgery day other than Dr. Li telling me that everything went perfectly. No nerves were cut so he did not expect too many problems. Dr. Li even threw in extra surgeries - my impacted wisdom teeth were pulled and my deviated septum was fixed. I didn't even know I had one.
The staff at the hospital were wonderful. They gave me good pain meds and on a regular schedule so that the pain was minimized. I basically slept a lot. My face was really swollen - like a giant chipmunk. They put ice packs over my cheeks and I took small sips of liquid through a big syringe. Pain was the worse during these first few days as expected. Sleeping at an angle and on your side is a must. Dr. Li stopped by my hospital room several times each day to check up on me which I greatly appreciated.
I was discharged from the hospital to my hotel room. I slept more and watched a lot of TV. Make sure you keep your pain meds on a regular schedule and don't get behind. Sometimes I took Oxycodone if the pain was real bad. I slept with a foam wedge pillow and drank liquids blended in a Magic Bullet blender then strained. The pain was still bad but not unbearable and highly controlled with pain meds. I felt a squeezing pressure in my jaws like it was in a vise (it was tolerable). DO NOT talk at all don't even moan. Buy a dry erase board and marker to communicate. I bought a water pik to clean my teeth between meals. I stopped by Dr. Li s office every few days for nose cleaning and progress checks.
Ten days after being discharged from the hospital, I was allowed to go back to Southern California. The day before leaving for home Dr. Li, loosened my arch bar rubber bands a bit. I would come back 3 weeks later to have the arch bars removed.
Recuperated at home. Continued not to talk at all. Did light walking and deep breathing as suggested by Dr. Li. Also try to get out for fresh air and sunshine. Do not engage in seemingly harmless exercises like Yoga I would unconsciously clench my teeth causing jaw pain. Drinking liquids constantly got really boring but fortunately I lost 15 pounds. Sleep was much better than pre-surgery sleep but still felt fatigued on many days. Slept noticeably better on sides than on back/stomach. At first I would wake up after 5 hours and then it took me 2 hours to fall back asleep. I think my body has been so sleep deprived it thinks 5 hours is adequate enough. I would have vivid, memorable dreams most occurring in the last 2 hours of sleep (last stages of REM). Later my sleep changed - I would sleep 9-10 hours and still be tired throughout the day but definitely not as bad as pre-surgery sleep. Try not to think about your sleep too much or you'll start to over think your recovery. I continued to communicate with Dr. Li via e-mail. He always gets back to me promptly which I find quite amazing. I researched other people's mma blogs and experiences. Many people said significant sleep improvements do not show until 8 + weeks so I tried to be patient.
Getting the arch bars removed was a milestone in the recovery period. I began to talk too much immediately which caused jaw pain. My voice did not change at all and I found it best to speak with a modulated voice. I ate soft foods like mashed potatos/yams, soft noodles, soft fish etc. It is good to research soft foods you can eat and different kinds of recipes. My sleep slowly improved and I had my fair share of bad days. I would still be tired/fatigued throughout the day but did not have any deep urges to nap. I noticed the perpetual dark circles under my eyes and skin bruises went away. My ability to read/focus and articulate words/language also improved. I felt less irritable and anxious. However, I did experience depressive symptoms which gradually went away. If you experience these symptoms which are common after surgeries please contact Dr. Li for guidance.
Currently 8.5 weeks post-surgery:
It really does take 8+ weeks for noticeable sleep improvements. Dr. Li and former mma patients said that sleep improves continuously over several months. I'm back at work full-time and while I m not at 100% (more like 75% - 80%) I do feel improvements with each passing week. It's best to focus on the progress you've made.
This surgery is truly life-changing. Just the other day I was thinking how nice it is to feel normal again I was willing to do anything just to feel this way. I can't express enough gratitude to Dr. Li and everyone involved in my surgery. I could not have asked for a better surgery.
WB (Female 39) - Helena, Montana
Date of maxillomandibular advancement surgery - October 13, 2009
Dr. Li and Staff,
Thank you all so much for your excellent care and service. You helped a very miserable situation have a positive outcome. Everyone involved was so caring and helpful. Dr. Li, I especially appreciated being able to communicate with you directly and you always responded so promptly. I also can't thank you enough for your generosity and making the surgery within my financial reach.
I can finally say that I am feeling much better. What a difference a little sleep can make! The world is a very different place for me now - much brighter. But, don't take my word for it - the proof is in the report (RDI 4). Thanks so much for helping me out! - with your incredible skill and compassion.
TP (Female 54) - San Carlos, California
Date of maxillomandibular advancement Surgery - March 10. 2009
It has been one year since my MMA surgery. I now know what a good night sleep feels like!!!! Thank you Dr. Li!
Dr. Li has given me my life back. I was diagnosed with SEVERE sleep apnea. It was so bad that the last 6 months before surgery I had to sleep sitting up in a chair. Before seeing Dr. Li, I had two other consultations with doctors from UCSF. One very disturbing! A friend of mine referred me to Dr. Kasey Li and that was the beginning of my new life. I knew what needed to be done and who was going to do it after my examine with Dr. Li. I took my girlfriend with me to my examine. She was looking for every excuse not to do this very invasive surgery. She was convinced after my consultation with Dr. Li. He has state of the art, high tech equipment
that showed the blockage of my breathing path on a screen and what needed to be done to open my airway. Dr. Li thoroughly explained my diagnosis and what needed to be done. I was ready.
My surgery went well and with full attention and follow up care from Dr. Li. The kindness and extra attention was available at all hours after the operation including weekends via cell phone. Dr Li is a dedicated, wonderful, caring doctor. I now sleep much better, have more energy and I am loving life. I must also add that Dr. Li's staff are exceptional! Very professional, caring and friendly. Thank you Ladies!
LA (male 47) Kernersville, North Carolina
Date of maxillomandibular advancement - June 21, 2011
9 days after surgery: Dr. Li, I just wanted to make a little personal note to say thinks for the treatment and care for my surgical procedure. After a long search, I chose to see you for my treatment due to your skills and follow-up care. I am glad you accepted me as a patient.
Your post-surgical care met and exceeded your reputation. Coming into your office on Friday and Saturday for an unscheduled visit was exceptional. But, when you personally called on Sunday to check on my status, your went above what I expected. I really appreciated that. So far, you have greatly eased my concerns and fears.
AKP (Female 53) - Palo Alto, California
Date of maxillomandibular advancement - March 31, 2010
I'm 7 weeks out from my MMA, still a bit numb and with limited mobility, but thrilled to have done it. My airway (exemplified by x-ray) is huge!!! Next month Dr Li will remove my son's adenoids and tonsils.
As I started to embark on this MMA journey a friend, whose son has had multiple surgeries due to an exceptionally rare disease, advised me that the difference between a very good surgeon and the best surgeon can be life altering. But just how does one know which is the "best"? Luckily we live in Palo Alto and over the months of this process I've run into many people that had heard of Li, used Li, consulted with Li, or had their children see Li. They all said the same thing (unprovoked): Oh, he's the best. But my favorite comment came from a professional in an associated field (who sees many post-MMA patients): All of Dr. Li's patients look and feel great following their surgeries. That's not true for some of the other surgeons .
Aside from that, I don't have much to add to the plethora of patient stories. Here are just a few things that surprised me:
- I had a nasal septoplasty in conjunction with the MMA and was really concerned that I would not be able to breathe, given the multiple on-line descriptions of dripping mucus and noses being suctioned out. It turned out to not be a problem, breathing was always easy and I hardly noticed the septoplasty (except for the advantages of it).
- For the first few days don't lean forward or your reward is a bloody nose.
- In the hospital your family, and even the nurses, may encourage you to talk. Don't do it.
- Miso soup and baby food (with some salt) are great options for the first week.
- I really didn't like the arch bars. If you can, opt for braces instead.
Good luck. Dr. Li, I hope you're still in business in 9 years when my son will be old enough for his MMA!
SF (male 34) - Enebyberg, Sweden
Date of maxillomandibular advancement - February 2002
Dear Dr. Kasey Li, I had sleep apnea surgery done by you almost 10 years ago, back in February of 2002. It radically changed my life as it eliminated my apnea problems completely as well as virtually reduced snoring to zero. The only problem I had was some loss of external skin sensitivity (which has persisted), but this was a very low price to pay compared to what I gained. So, almost 10 years later I'm still extremely happy with the surgery and would consider it the single best investment in my own health and quality of life that I have ever done. So please accept my sincere thanks for the expert surgery that you performed and the results!
If at any time you need a recommendation from someone in Sweden (or in Swedish), then please do not hesitate to contact me.
AKP (Female 53) - Palo Alto, California
Date of maxillomandibular advancement - March 31, 2010
Update: It's been one year, one wonderful year since my MMA. Choosing Dr. Li for my MMA surgery was one of the best things I ever did. I feel and look younger, but more importantly, I feel smarter. Getting oxygen to the brain is a good thing. To me, sleep apnea is a misnomer - having a limited airway seemed to have affected me even when awake. At any rate, life is one heck of a lot better when you feel good! My son, who had his tonsils and adenoids removed by Dr. Li, is also doing extremely well. At the beginning of the school year we were told he was headed for the special day class (as soon as they had room), now they tell me there is no way he'll go there, he's fully participating in the regular classroom. What a fantastic change and it's because of the surgery (and orthodontic jaw expanders); the change has been drastic.
Here's another statement on Dr. Li being the 'best': I've recently seen another dental professional, someone who has often been in the surgery room with Dr Li. He told me Dr. Li is the most gifted surgeon he's ever seen, that he raises surgery to the level of an art. He said Dr. Li is focused, fast, and steady. Even when his patients are under anesthesia, he's careful with them, gently cradles and lifts their head, etc.' What more could you ask for?
Lastly, a couple more tips I learned over the yea: Magnesium supplements helped with digestive issues as a result of a soft diet and seem to help me, and my son, sleep better. Before surgery (and after) it might help to do some breathing exercises, mediation and/or yoga.
KT (Male 53) - Seattle, Washington
Date of surgery - December 17, 2009
My journey to Dr. Kasey Li began differently than most I believe. In the spring of 2009 I was referred to Dr. Li by my sleep apnea physician. My primary physician and sleep apnea physician submitted pre-authorization requests to insurance to have Dr. Li perform my maxillomandibular advancement surgery. Dr. Li and I exchanged numerous e-mails about my situation and the impending surgery. His response to any inquiry was always extremely prompt and I felt complete confidence in him. My wife and I purchased airline tickets for a consultation, but the day before we were to leave we received notice from our insurance carrier that they would not cover Dr. Li because of being out-of-network ... and gave us names of physicians in-network in our area. I didn't feel at peace having another surgeon perform this surgery ... but felt I had no choice.
The maxillomandibular advancement was performed on 9/21/09 in Seattle ... metal bar removal approx. three weeks later ... a "redo" of the left jaw (screws having become dislodged) on 10/26/09 ... and the metal bars reapplied around 11/03/09. Pain was a constant companion from 9/21 on. Friday, 12/11/09, my teeth were not lining up and the left jaw that had been redone was sagging ... so I called my surgeon and was told to call on Monday for an appt. After relaying this info to my wife she immediately called Dr. Li and he returned her call within five minutes. We booked tickets for Monday, 12/14, and arrived at Dr. Li's office around 10 a.m. that day.
Dr. Li and his outstanding staff (Juanita, Daisy, & Linda) took us in for six hours that day and could not have been more professional and kind to us and the situation we were facing. Both jaws had a non-union, missing areas of bone, and major bone infection. This was devastating news; along with hearing that at this point depending how much bone was missing and how much may have to be removed due to infection (now or in the future if things didn't go well) Dr. Li couldn't be sure of a complete healing. Worse case scenario would leave me as a cancer patient who would need reconstructive surgery ... with being able to ever chew again or not in
We left Dr. Li's office that day emotionally drained but with complete confidence in him to do his utmost to save my jaws. If anyone could do it, he would be the one and having him as my surgeon gave us "great" hope.
I was admitted to Stanford Hospital the next morning to begin i.v. antibiotics. Surgery was done on 12/17/09 to repair my now fractured jaws and deal with the extensive infection. Additional infection was found in the chin and sinus areas. A bone graft was also needed. Three days after surgery I could literally go without pain medication; especially during the day. After three months of ongoing pain this in itself was a miracle.
I was released from Stanford a week later and stayed in Palo Alto an additional week. Because of the extensive infection I needed to continue i.v. antibiotics. We returned home on 12/28/09 and are still doing i.v. antibiotics from home at this time (2/8/2010). Blood tests are done weekly to monitor the infection & the numbers are improving.
Dr. Li manages my care and is in close contact with the physicians near my home to monitor and advise ... and doesn't hesitate to call me at home to reiterate instructions and what my limits are and are not at a given time. My Infectious Disease doctor at home stated on my first visit that no physician in our area could have handled this case of a surgery gone wrong.
Dr. Li is always upfront, thorough, and kind in all the care he gives. At the point I came to him, the situation for having a healed and workable jaw was grave. I firmly believe that no one else could have gotten me to this point of healing, and cannot imagine what life would have been like without Dr. Li accepting me as his patient. He stands out above all others in his expertise and experience, thought-process, communication, care management, and his all-around treatment of the patient and the patient's family. I can never thank him adequately for taking on this more than challenging task.
Although I would never wish to have gone through this ordeal, meeting Dr. Kasey Li will always stand out in my mind and my wife's mind as a quality experience with an outstanding individual. We are so thankful for him and all he does. In closing I would say to be very informed and follow your instincts because many doctors claim to have this surgery down, but Dr. Li is the only one I could and would ever recommend. My experience and health would have been so much the better if he had done my original surgery.
YMA (male 42) - Doha, Qatar
Date of maxillomandibular advancement - February 18, 2010
My doctor send me from Qatar to see Dr. Li because he told me there is only 1 doctor in the world can help me! My oxygen goes to 65% when I sleep and I wake up all the time from choking. Now I sleep very well and no more waking with apnea! Dr. Li changed my life.
EJY (male 38)- San Mateo, California
Date of Maxillomandibular advancement - January 27, 2010
Experience: A wife's side of sleep apnea.
Thank you so much for taking such exceptional care of my husband following his surgery (not to mention the surgery itself, which he has benefited immensely from). We've so appreciated your very generous time and meticulous attention to our many questions throughout the process! Thank you from the bottom of our hearts, for sharing your expertise and your kindness.
CM (male 55) - Ashburn, Virginia
Date of maxillomandibular advancement - August 3, 2010
Maxillomandibular advancement is "as advertised." My brother stayed with me the night before the surgery. He was astonished at how I thrashed around in bed, gasping for air. After the surgery the constant tiredness of the sleep apnea was gone. Completely, totally gone. I tried CPAP. I tried three different airway -pressurizing machines- CPAP, BiPAP, and ASV. Only MMA is the cure. I feel like I have been given my life back.
I'm sleeping very well. I feel good every day. I have been waking up at six o'clock and getting into the office by nine.
Little things are so easy - mopping the kitchen floor, the laundry, emptying the dishwasher, washing pots and pans, making the bed, much livelier in conversations.
It is serious surgery, but by the end of the first week I was on my own safely. After a few days getting liquid food- juice, soup, protein shakes, milk shakes, etc. -through a large syringe is easy. The pain was not very serious. After discharge from the hospital I mostly only took medicine for pain at night just to sleep more easily.
I recommend MMA to everyone with serious effects of sleep apnea like I felt. If sleep apnea is dragging you down, leaving you tired 24 hours a day, seven days a week, give MMA a chance to restore you to a normal life.
Thank you, Dr Li.
DVS (male 61) - Bend, Oregon
Date of maxillomandibular advancement - October 12, 2010
I suffered from a very severe case of sleep apnea. On CPAP level 16, I was still extremely fatigued every day. I was in bed 10 hour per night on average, and would still have to nap one to three times per day, sometimes for an hour and a half for a single nap. My athlectic performance had deteriorated to the point that I didn't even maintain my health club membership for periods of time.
After surgery by Dr. Kasey Li at Stanford Medical, and a brief hospital stay, I noticed that on the 7-9th days after surgery that my breathing at night had improved remarkably, and that I was getting the first decent sleep at night in many, many years, incredibly enough, without any CPAP assistance at all.
On my daily walks I also already notice that the shortness of breath just walking up a flight of stairs that I experienced previously is gone.
Tomorrow is day 10 and I look forward to more improvements in my life as my recovery continues. I heartily recommend this surgery for individuals with the severity of sleep apnea that I experienced.
RM (male 45) - Castle Rock, Colorado
Date of maxillomandibular advancement - August 25, 2009
In 2006, I was diagnosed here in Colorado with Severe Obstructive Sleep Apnea. I had two tongue base reductions, a Pharyngoplasty, tonsillectomy, Nasal Surgery alone with a few other procedures that I just do not remember off hand. To date, I had a total of ten procedures! Most of them were here in Colorado. I found Dr. Li in 2009. He performed a Bi-Maxillomandibular Advancement on me. This procedure cured all of my remaining sleep apnea problems. This included Snoring, Bruxism (teeth grinding), and all remaining airway problems. The pain was way less than expected. The healing was quite fast (in my opinion). Stanford Hospital was fabulous! This was definitely my best experience regarding any surgical procedure (and I had many) I strongly recommend Dr. Li and Stanford Hospital for an overall better quality of life, and longevity.
DCS (female 57) - New Smyrna Beach, Florida
Date of maxillomandibular advancement - July 21, 2010
I have had sleep apnea since I was in high school. I was finally officially diagnosed with sleep apnea in 2000. Over the next 20 years I had UPPP surgery, CPAP and Bi-Pap therapy and the oral appliance. Even though I was fully compliant with the CPAP and Bi-Pap therapy I still had severe sleep apnea (verified through sleep study). I tried using oral appliances and the tongue appliance. The oral appliances worked somewhat, unfortunately my jaws could not be moved forward enough. I was referred to Dr. Li only after our last Doctor on a long list Florida doctors who specializes in Maxillomandibular advancement (MMA) surgery.
Dr. Li and his staff are wonderful people. They worked with my husband and me throughout the whole process. Always at the forefront was my care and comfort. This surgery has changed my life. Before the surgery I woke up every day with a headache. Sometimes the headache would be gone within two hours, sometimes not. I was tired all the time and would take 1 to 3 naps per day. To go out to lunch with friends required that I take a nap first. I had no life. Additionally no matter how hard I tried, I was always tired and others could hear that tiredness (sometimes sharpness) in my voice. I was not pleasant to be around. The sad thing is, I didn't know it. I didn t laugh or listen to the radio anymore. I had my MMA surgery in July, 2010. Now most days, I can stay awake. When I do feel tired sometimes just resting my eyes for 30 minutes or taking and one hour nap is enough to refresh me. I have not had a 2 4 hour nap since my surgery and I no longer wakeup with headaches.
I whole heartedly recommend the MMA surgery with Dr. Li. In my case I had no choice as I had no life. Dr. Li has given me back my life. My husband and I took our first trip in 10 years. There is too much life has to offer to put off having the surgery. I kept telling myself I had to try and I am glad I did.
I would recommend to anyone about to have the surgery to do some exercise prior to the surgery, even if it is only one minute a day. I could hardly leave the house before the surgery so I thought exercise was too much. Anything is better than nothing because after the surgery you will want to do it all. I had to start and minus zero so be smarter than I was. Also I would recommend practicing breathing properly. I was a very shallow breather and am now taking yoga classes to help me with my breathing. Additionally, I would recommend go off caffeine after surgery. It should be easiest then.
Lastly I would recommend contacting Stanford Hospital s Department of Social Work and Case Management at (650) 723-5091. We found the social worker to be great to work with and very helpful. She helped guide us to the perfect place for us to stay. The social worker can help you find a place to stay in your price range, whatever that range may happen to be.
You life is waiting for you. Dr. Li and his wonderful staff will be with you all the way to help you.
JWS (husband of DCS)- New Smyrna Beach, Florida
Date of Maxillomandibular advancement - July 21, 2010
Experience: Husband side of sleep apnea.
My wife was always falling asleep when we drove more than 20 minutes. Took lots of naps, stayed up late, got up late, and just was tired and very irritable all the time. In 2000 she had a sleep study and was officially diagnosed with SLEEP APNEA. The cure was to be a C-PAP machine or surgery of the soft tissue (UPPP). She chose the surgery and when that failed, we advanced to the C-PAP machine and then the BI-PAP machine. All were confirmed failures by sleep study tests. Her Apnea doctor gave up and she went for the Oral Appliance ( moves the jaw forward). Worked for 6 months when she started to lose her teeth from the pushing of the Oral Appliance. We were down to the last option that was to move the jaw forward via surgery. We had done our home work and knew we would have a major fight with our insurance and we must seek some very special doctors who have the skills of a surgeon, dentist and extensive apnea training. We spent hours on the internet and determined that we had some Doctors in Florida who specialize in the surgery. We made appointments, were examined, took test and then told we needed to go to a doctor who does only this type of surgery due to her being a very hard case. One of the Doctors recommended Doctor Li. We had come up in our 10 year searching with Dr. LI and new of his Palo Alto office. By this time my wife had lost her ability to express herself, was drinking coffee and cokes by the case, scared to sleep due to her fear of death, and was showing signs of sever confusion. I called on a Monday to find out about making an appointments and Dr. Li answered the telephone. We talk about her case and I asked if he would review her medical history ( I had scanned it into a pdf file) if we e-mailed it to him. He reviewed and called me that same day. He recommends that she have a new sleep study at STANFORD and then he would examine her and make recommendations. Dr. Li recommended the surgery and we set a tentative date. The next few months were spent working with the insurance advocate and providing a complete history of the steps we had gone through with dates and telephone numbers. WE FOUND our insurance company DO NOT READ ANYTHING IN LETTER FORMAT, do not have a doctor on staff, AND ONLY DETAILED SUMMERY FORMAT WORKED (1 PAGE).
My wife's breathing or lack of became normal and her migraine headaches were now gone. Her naps were reduced to 1 short nap per day and now at month 4 none, most of the confusion and lack of ability to express herself has also gone. She has become active by joining some yoga classes and long beach walking. We took our first trip in 10 years and just played for two days. she was just overwhelmed that she could enjoy life. We see new improvements each day even 4 months after the operation.
Month 5, and we went north 80 miles to ST. Augustine and played tourist. We left our home at 9:00 am and returned around 10:00 pm. NO NAPS, AND I HAD TO PUSH REAL HARD JUST TO KEEP UP WITH MY DURACELL BUNNY! THINGS JUST KEEP IMPROVING! I am the son of a doctor and after my years dealing with doctors, I can say the Dr. Li is the most outstanding and knowledgeable professional I have had the privilege to know. I just asked him to please do not change.
IB (male 21) - Chicago, IL
Date of maxillomandibular advancement - November 12, 2015
Dr. Li, Thank you for changing my life!
GR (male 50) - San Mateo, California
Date of maxillomandibular Advancement - January 27, 2015
Dr. Li, I want to thank you again. Feeling much better thanks to your work.
FM (female 20) - Palo Alto, California
Date of maxillomandibular advancement - June 29, 2009
Dr. Li-You are amazing! I appreciate every effort you made to make me feel comfortable. I am very grateful. Thank you!
AP (male 25) - Philadelphia, Pennsylvania
Date of maxillomandibular advancement - September 20, 2011
Four months after surgery...So far things have been going very well since I last saw you. I have regained most of the sensation in my lower lip and can now eat a lot more things (still have trouble with a few things, but assuming I continue to improve I have no doubt sooner or later I'll be able to eat just like before). Most importantly, I am sleeping well (I haven't had a sleep study yet but as far as I can tell I am sleeping at least as well as I used to with the CPAP - I haven't used it once since the surgery and don't intend to!). I'll have the sleep study some time this year and will be sure to have the results sent to your office. All in all, I'm very happy I chose to have this surgery and even happier that I chose you to perform it!
MM (female 22) - Los Altos, California
Date of maxillomandibular Advancement - September 22, 2010
The operation changed my life. Honestly I can say now I know what it feels like to get a full nights rest. I can now hold on to a job and operate in reality without going insane from sleep deprivation. I don't know how I survived before but my whole outlook on life has changed and it is because of Dr. Li. sleep apnea has many cures, symptoms, and misnomers but to be cured of it is the answer to all of my medical issues. I am so glad I found Dr. Li while I was young and have the rest of my life to get a full nights rest.
AT (female 25) - Salt Lake City, Utah
Date of maxillomandibular advancement - November 23, 2010
I had an incredible experience from the consultation through the operations to the follow ups. The operation helped me immensely starting days after the surgery. I noticed small differences at the beginning and now 10 weeks out I feel like a different person, sleeping better with a lot more energy. I wake up early on my own and stay alert with lots of energy throughout the day. I am able to do all that I want to. I feel like with time that I will feel better and better and be able to do things that I never thought I would do.
SPO (male 45) - Paso Robles, California
Date of maxillomandibular advancement - June 29, 2010
The MMA has changed my life profoundly for the better! I never realized how bad it was until after the operation. Now I sleep great, dream every night, feel rested when I wake up, and feel a lot healthier. It's amazing how much better I feel now. I finally can think clearly again. Thank you Dr. Li and staff for giving me my life back! It was worth every dime and all the pain! After almost 9 months I am healing nicely with just a little numbness on my top jaw line, but its going away slowly. I would be happy to talk to any of your patients who are not sure if this surgery works for those people that CPAP and other procedures have failed. Thanks again!
JH (male 46) - Akron, Ohio
Date of maxillomandibular advancement - March 15, 2011
I will try to do a quick before, during, after, with during be defined by me as the stay in Palo Alto / Stanford. The bottom line for me is that I knew while I was in the hospital this was a game changing, born again type event. I have been alert and awake since that time, in a way that I do not ever recall having been, at least for many many years.
I have fought with apnea for many years, as is the case with many here. It slowly robbed my life of energy and joy, posed an immediate threat to my career, and made me sick in ways that are not always directly attributed to Apnea.
I had my UPPP, nose work, etc (soft tissue or phase 1) done in 2006, when we found at a highly regarded Cleveland hospital that I could no longer be successfully titrated on my back, and was in what was described as a dangerous condition.
Following the surgery, I was very disappointed when it became clear that I needed CPAP again, but I was led to be very frightened of jaw surgery, which was always described to me as last resort. Over a period of three to four years, I progressed from a pressure of 6 CM to 12 to 19+, to AUTO BIPAP, all under the close supervision of doctors, some good, some not. Still, in 2010 it became necessary for me to begin taking Nuvigil at a low dose. I HAD to take it, or possibly face losing driving privileges after a daytime sleep study. The dose over the next year moved to the maximum, and I was told that people do develop a tolerance to it. Still, I was falling asleep in the afternoon, and as a professional salesperson I was in jeopardy again. I actually nodded off in a meeting in Europe with a colleague of mine and customers. They were very kind about it, but it was devastating to me. I had previously fell asleep in a meeting with vice presidents from my company, my second week on the job.
Each time I was titrated or medicated or some issue was addressed, I would get relief for a month or two. I have done serious amounts of caffeine for many years. I have used the CPAP 100 percent, traveling with it globally.
There was definitely an anxiety and some depression that kicked in, and nightly choking fits and nightmares drove me to research disability and see what my worst case might be in my mid 40's. I told my wife that we needed to fly to Palo Alto ASAP for consultation with someone. At the same time, I ranked three physicians and for my particular situation, chose to see Dr. KL. We corresponded via email, then that evening he called me at home. I have never had a potential physician call me up for consultation, but it was very helpful. I sent him all my records which I scan religiously. He replied that the trip to Palo Alto was warranted, and we set an appointment.
We are blessed to have a lot of travel points. I felt that my wife could use her own support person. I booked flights and hotels on points for us and her good friend to travel to Palo Alto for the surgery. We came in a day early and went up and down El Camino Real looking for small amounts of great food for the entire Monday after our presurgery visit.
The day of surgery went pretty fast for me. I recommend valet parking. Why hassle to save a few bucks at this point? My wife was able to have them get the car various times during the day so that she could put my clothes in it, etc. The only time I felt we didn't quite have the pain managed yet was waking in ICU to my wife, her friend and the nurse. That was quickly managed. ICU has multiple rooms with 2 patients, each one having one dedicated nurse in the room with them! I don't know about where you come from, but this was incredible to us. In fact, I will just say that neither I, nor my wife have ever experienced anything like the care and genuine caring that we received at Stanford.
By day 2, I had told my wife that something significant had happened. After years with Small fiber neuropathy which caused pain and spasms through my body, that pain was gone. I was not on the muscle relaxers or neurotin that I normally take daily. As crazy as it sounds, I also felt alert.
Day 3 I backed off of the morphine and went to liquid Vicodin. I had been walking around the hall quite a bit, but the Doctor would not let me out until I drank more liquid, so I concentrated on that, and we headed for the Residence Inn early afternoon.
I have seen many who felt pretty bad at this stage, so it is probably important to tell you that I signed a waiver and we WALKED to the other part of the hospital where the car pickup was. I never had the shortness of breath or severe fatigue issues, and ramped it up every day after this. My wife worried like crazy and I had to keep reassuring her that I felt great.
During the next week or so, I continued with NO CAFFEINE, and significant alertness that was almost scary. I could go all day without a nap, and was stir crazy, often having to convince my wife that I was well enough to get out and do something or feared I would go nuts. I fell in love with the friendly people in the Palo Alto area of California, who seemed to go just a bit slower, and were not all cranked up and angry like folks get here. They were just darn friendly, and I will always have a special place in my heart now for that area of the country. My only rough spot was one evening where I convinced myself that my mouth might be swelling. It was all anxiety, but my wife called the Dr who called right back (after midnight) on his cell, had her put me through the paces with drinking water, etc, and finally we all agreed that maybe I needed something for anxiety, which I had thanks to years of not being able to breathe at night panic.
When we flew home at a little less than two weeks, The doctor, at my request, cleared me to work from the home office, but without business travel and without talking. I stayed completely stir crazy until having my arch bars removed a bit over a week ago. I would ask my family to go shopping for an excuse to get out, and I finished some old projects that had been sitting for way too long due to fatigue.
I drink only a few cups of low caffeine tea per day, because I like to sip on something hot. I lost my taste for coffee and diet coke. I do not need the caffeine. I am wide awake every day until I decide to go to bed. The other day, we decided to take a quick trip to WV for slot machine night, a 1.5 hour drive. The day ended at 2 AM here. I had only had one cup of tea in the morning. I never felt tired.
I dropped from my list of medications, Nuvigil, Baclofen, Neurotin, and pain pills. I still occasionally take some pills for pain mostly having to do with sensitive nerves around my lower lip, mouth and chin, but am taking much less now than before the surgery.
My only anxiety is that history will repeat itself and the nightmare start again, but I am following the doctors orders on everything, and have been reassured that things should maintain.
AL (male 25) - Palo Alto, California
Date of maxillomandibular advancement - August 18, 2009
Experience: I can't thank Dr. Li enough. After the surgery the heavy curtain of constant fatigue had been lifted! I am now working at a startup, which would have been impossible without regular sleep.
KM (female 21) - Los Altos, California
Date of Maxillomandibular advancement - August 21, 2014
Experience (from dad): I want to thank you for your brilliant work on my daughter's jaw. She now says, "I used to think when can I get my next nap, all day long. Now I have the energy to stay awake all day!"
As her father and the man who has labored to pay for this treatment, I am extremely pleased with your work. She is prettier, with an enhanced profile-she is beautiful! Your correction to her airway will improve her life and the lives of those around her one-hundred-fold.
Thank you for your skills, you rkindness and for being our surgeon. I wish you the best with your practice and I am truly thankful to have found you to address my family's problem!
MW (male 56) - Mandeville, Louisiana
Date of maxillomandibular advancement - October 28, 2008
Experience: Since my surgery I have had so much energy that I started training with a personal trainer at the local gym and in March of 2010 I finished a half ironman event, 1.2 mile swim + 56 mile bike and a half marathon. Last month I took an hour and a half off that time to place 18th in a field of 70 atheletes in my age group in the half ironman in Augusta. All thanks to you and your MMA procedure!
MW (male 39) - Raleigh, North Carolina
Date of maxillomandibular advancement - October 11, 2011
Experience: First off, I want to share that deciding to have MMA Surgery was not an easy decision at all.
However, it was the best decision that I have ever made. Dr. Li is amazing! He is incredibly responsive, helpful, and compassionate.
I had the surgery 17 days ago and already feel much better. I no longer snore. I no longer have apneas. My energy level is coming back. I am still recovering and still have pain and discomfort, but, once, that goes away, I know my sleeping will be unbelievably great. It is already much better just 17 days post surgery.
If you have really bad OSA, seriously consider this surgery. I tried CPAP for 2 years but it never worked. I woke up 90 minutes after falling asleep with severe bloating--all the air from the CPAP was going into my stomach not my lungs. If you see Dr. Li and he says you need the surgery, get it. The first week or so after surgery really isnt plesant, but, you just have to keep reminding yourself that you are making a lifetime change. Also, dont try to do the recovery process alone. Make sure that once you get out of the hospital you have someone there who can help you and care for you. You will need help for the first 2 weeks.
It is a scary decision to make, but, I wish I had gotten the surgery 4 years ago. Dr. Li. totally knows what he is doing. He routinely does this surgery. I live in NC and went to a bunch of local surgeons who either wouldnt do this surgery or had only done it 2-3 times in their career. Go to an expert like Dr. Li even if it means you have to travel. This is a very complicated procedure and you need an expert. Hey, my wife even says I look younger--Dr. Li is also a plastic surgeon! :)
DCS (female 57) - New Smyrna Beach, Florida (2012)
Date of maxillomandibular advancement - July 21, 2010
Dear Dr. Li,
We continue to be amazed at the difference your jaw advancement surgery in July, 2010 has made in our lives. I am easily awake at 5:00 am for my mile walk in the morning, and then I get ready for morning mass, followed by a full day of activities. I do things in one day that I could not accomplish in a week before the surgery. The best gift is to be able to drive long distances. I have driven us from Houston, Texas to New Smyrna Beach, Florida (about 1 1/2 day drive). Before the surgery I couldn't drive more than 10 minutes away from my home. Thank you again for all you have done for us.
DGS (male 19)- Burlington, Vermont
Date of maxillomandibular advancement - May 24, 2010
Dear Dr. Li,Thank you so much for all you have done for me, and for your kindness and generosity throughout the process of my jaw correction. My life has been drastically improved simply by the ability to eat and sleep normally, and it would not be as great as it is today without your help. I have truly enjoyed my experience with you and your staff (to the extent possible with such things), and I have every confidence in your skills as a physician. I would recommend any patient to you in a heartbeat, and I hope that you continue to do such wonderful work.
DH (female 42) - Roseville, California
Date of maxillomandibular advancement - May 9, 2012
Experience: I have suffered from chronic fatigue and low blood pressure my entire life. I was diagnosed with sleep apnea at Stanford Sleep Clinic February of 2012. This started my journey to find Dr Kasey Li. I had MMA surgery May 2012. After for the surgery, I immediately noticed a difference. I feel like I am getting more REM sleep and breathing better. I have more energy and feel more focused. At this point, I am 10 weeks post operation and things are improving on a daily basis. Dr Li, Daisy, Linda and Juanita are very professional and kind. I am very glad I had the MMA surgery.
RK (male 34) - Sunnyvale, CA
Date of maxillomandibular advancement - February 13, 2013
I am pleased to have found and decided on Dr.Li.
Afterwards, another doctor said my septum was very straight (septoplasty
done during the procedure). I can breathe better through my nose.
My dentist said my teeth fit together better.
Dr.Li showed concern. During my time in the hospital, he visited in person
3 times. Later, after an odd result on a home sleep study, he called me to
talk about it.
He has answered my emails quickly. I appreciate his answering my questions
during my appointments as many patients have long lists.
Dr.Li took a call at dinner time when I was panicked about something in
Dr.Li helped me through a number of insurance problems. One time he called
them back the day he came back from vacation and got it straightened out.
Dr.Li steered me away from surgery when he didn't think it was a good idea
because he wasn't sure it would benefit me.
I write this at 9+ months. I still have a sleep problem, but I think it's
mostly psychological now. The most important thing is that I am back to
living life. Before, it was a crisis: "Nothing matters except fixing my
sleep." I am now having a decent number of days where I feel that life is
Dr.Li has my thanks for providing an honest service that benefited my life,
conducted in a conscientious way.
I also thank Daisy, Juanita, and Linda for their briskness in helping me
through this process.
DWJ (male 57) - Texas
Date of maxillomandibular advancement - October 23, 2012
Dear Dr. Li and Staff, There is probably nothing that we can say that has not already been expressed to you for the wonderful care you have given throughout this procedure. I don't think I have ever met a doctor who gave so much of himself to insure that the patient received the best care.
Daisy, Juanita and Linda, you each have also done a marvelous job helping us with a host of items. you could not have a better staffed office.
So may we just say thank-you from sincere and appreciative hearts. We wish the very best for each of you!
JF (male 31) - Monterrey, Mexico
Date of maxillomandibular advancement - January 21, 2015
Only I am writing to thank you for all your attentions with my husband's surgery. We thank you for all the support and help you provided in order to perform the surgery. We hope to see you someday and remember that if you ever come to Monterrey, please let us know, would give us great pleasure to have dinner with you anytime.
VL (male 55) - Irvine, California
Date of maxillomandibular advancement - April 10, 2012
Experience: I truly believe the apnea problem is solved, which I'm eternally grateful. I finally feel I can move on with my life again. Thank you for giving my life back!
SWS (male 36) - Gridley, CA
Date of maxillomandibular advancement - January 8, 2013
I am not sure where to start, there are so many things that I want to express to
those who are, one thinking of having the Maxillomandibular Advancement and two having Dr. Li do the procedure.
First let me start off by talking about just how bad I was and did not want to deal with it. I was at a point where I was only sleeping a few hours a night if that, even with the CPAP machine. I had no energy, was always getting sick, and was starting to become really depressed. I gained over 70lbs, weighing at a 320 (6'4).
My wife would count at night how long I would stop breathing, which she had up to 45 seconds at one time. This was just not safe.
Dr. Li was the one who suggested the Jaw Surgery. He was the one that said how bad I was and how I needed this. He expressed how it was going to make things better as long as I did my part as well. Dr. Li was right on. Now that I have had the surgery, I have lost 50lbs, I sleep great. I do not snore at all. I do not have to use any CPAP. My wife and I can actually sleep together. I am exercising everyday and feel like a new man. Dr. Li truly saved my life. I do not think I would have lived a long life if it would not have been for this surgery.
Now the Surgery itself was not easy, but it is well worth it. I would be sugar coating it if I said it was a hard six weeks, but Dr. Li and his staff made it so much easier to get through. Dr. Li is a very careing, understanding, educated, and thorough Dr. I live more than 4 hours from Dr Li but it was worth the travel. The hospital staff at Stanford were awesome. The entire experience was absolutely perfect.
TS (female 41) - San Jose, Ca
Date of maxillomandibular advancement - March 5, 2013
I have absolutely benefited. I have more energy and don't feel tired. Thank you Dr. Li!
LH (female 55) - Camano Island, WA
Date of maxillomandibular advancement - May 9, 2006
Experience: I came from a family whose business was practicing medicine. I've had the rare opportunity to know or have had work performed by some the world experts in their field. I feel fortunate that upon being diagnosed with severe OSA, I was referred to Dr.Kasey K Li.
Dr. Kasey K Li performed an MMA on me in May 2006 then subsequent septoplasty when removing the bracing 30 days later. There are so many informative posts here offering a patients experiences undergoing and recovering from a maxillamandibular advancement by Dr. Kasey K. Li. I too am thankful to have experienced the same passion for excellence by Dr. Li.
I feel the most important advise I can add is this an extremely elegant surgery requiring the combined expertise every credential achieved & perfected by Dr. Kasey K Li. Dr. Kasey Li's deep experience include doctoral degrees in the medical and dental sciences from Harvard Medical School and UCLA Dental School. He is certified by the American Board of Otolaryngology, American Board of Oral and Maxillofacial Surgery and American Board of Facial Plastic and Reconstructive Surgery. All of his credentials and the tremendous amount of experience in those disciplines are extremely important in insuring the best outcome possible. I must add, he has the best "bedside" manner and you become his patient for life.
TT (female 50) - Walnut Creek, CA
Date of maxillomandibular advancement - August 28, 2007
Experience: I just realized that today is the 5th anniversary of my surgery to correct my sleep apnea condition, and I wanted to take a moment to tell you how much I appreciate your positive impact on my life and health-I would do it all again. Thank you for your talent and good care throughout the years!
BFF (female 15) - Menlo Park, CA
Date of maxillomandibular advancement - June 12, 2013
Experience: Thank you sooo much for making me better. Even though my mouth was a "little" sore after it's changed my life for the better! Thank you!
Mother's perspective: Heart felt thank you for curing my daughter of her sleep apnea! She is truly a different person! Thank you for your expertise, caring and humor during the process. I an so grateful to you for all you have done to help her lead a normal, healthy life! You are wonderful!
GH (male 56) - Scottsdale, AZ
Date of maxillomandibular advancement - December 4, 2011
My experience from start to finish was great. The professionalism from all staff and especially Dr. Li is the greatest.
I feel my surgery was a success. I have just started the process to return to work as a pilot. Thank you.
CA (male 52) - Nashua, NH
Date of maxillomandibular advancement - December 10, 2015
The effort Dr. Li has made on my behalf has been amazing. I came to him and
explained that CPAP wasn't cutting it for me. The problem had dragged on for years with little in the way of relief. The Doctor was patient and thorough taking the time to explain the process with me and helping me to understand what hurdles I would face. I found his methods down to earth and honest and when it comes to having an operation as important as MMA, I cant think of better qualifications for the person to select.
I would also like to mention that Dr. Li has gone well beyond the extra mile for me. He has listened to my questions and worked hard to help me understand the process of healing. All in all, it has been a wonderful change for me and I would do it again tomorrow (Provided I am assured Dr. Li would be in command of the procedure).
To the good doctor and his talented staff, my eternal thanks for everything you have done on my behalf.
CDD (male 45) - Seattle, Washington
Date of maxillomandibular advancement - August 25, 2015
Quality of life
Before and after the surgery
For three years before the surgery:
1. I had constant pain on the top right side of my head. This was not a headache or a migraine, but a strong pain that would not change. Of the many medications I was taking, most had horrible side effects that would leave me with the same pain plus the problems of the side effects.
2. The pain did not let me sleep and I was taking Excedrin, supplements, and medication to help me sleep.
3. I would never sleep more than 5 hours at night and would never feel rested in the morning.
4. I was not able to continue running and working out.
5. I was without ability to concentrate and recall basic information.
Since the surgery:
1. The pain has diminished by at least eighty percent, and in some days, I don't even feel it at all.
2. I am taking Excedrin less than once a week and even less as my sleep patterns normalize.
3. I am now falling asleep naturally, sleeping soundly for up to six hours at a time and getting up rested in the morning. My sleep patterns improve by the day.
4. I am now walking a mile at least once a week and plan to start running and return to the gym soon.
5. My head is clearing up. I am again watching movies, reading and studying.
6. My quality of life is returning to what I had four years ago. It was pretty good.
DMG (male 42) - Conyers, Georgia
Date of maxillomandibular advancement - March 22, 2016
Dr. Li, You lived up to your reputation. I am so thankful + blessed that you were my surgeon. All of my initial fears were totally goundless. Thank you for the outstanding care. Words can't express my thanks, I wish they could.
KJM (female - 52) - Palo Alto, CA
Date of maxillomandibular advancement - March 11, 2015
I have been sleeping like a baby! Thank you for your expertise and surgical ability. I have recommended you to others!
DMK (male - 21) - San Carlos, CA
Date of maxillomandibular advancement - December 8, 2016
I had an amazing experience under the care of Dr. Kasey Li. At a young age, I was diagnosed with severe overbite. My dentist and orthodontist both agreed a surgery was in order. After meeting with Dr. Li, I was certain he would be the best surgeon to operate on me. His staff was incredibly kind, always on time, and consistently ready to help. Dr. Li was easy to talk to and answered all of my questions in a way that I could understand. It has now been a little over a year since my operation and I am extremely happy with the results. My breathing has definitely improved. Not only that, but my sleep is much better and I feel more energized in the morning. The operation absolutely helped me. There was an obvious improvement in my quality of life. I am, without a doubt, more confident in my appearance as well. Who knew a surgery could be so beneficial? My nights are much more relaxed, and I find it easier to fall asleep. Sleep, in general, has enhanced for me. I am beyond grateful for Dr. Li and his staff. I would do it again in a heartbeat. Thank you for everything.
DMG (male - 44) - Conyers, Georgia
Date of maxillomandibular advancement - March 22, 2016
Two years ago you changed my life for the better. Thank you for our skill, patience and commitment to improving a personís life!
JBW (male - 57) - Stamford, CT
Date of maxillomandibular advancement - July 27, 2016
Experience: It's been 18 months since I started the journey with Dr. Li,
undergoing two separate procedures about 9 months apart: first, the MMA
and then a SARPE procedure (rapid expansion of upper pallet). I am 57
years old, so this was a major decision to take on these surgeries at this
stage of my life. However, I was so desperate with severe sleep apnea.
After years of trying all traditional approaches (CPAP, jaw extender,
nasal surgery) my wife convinced me that my life and health would continue
to deteriorate unless I underwent a dramatic treatment, and the MMA was
the only solution left.
The last straw for me was yet another sleep study that recommended the
maximum airway pressure on a bi-pap machine - and even that max pressure
was not enough to remediate the apnea. My apnea was getting worse and
worse over time. Of course I was unable to tolerate the airway pressure,
leaving me very little choice of where to go next.
After doing some research, it was obvious that MMA was a potential
solution, and that Dr. Li was one of the best and most experienced in the
world. I had an initial consultation with Dr Li and then made the decision
to have the MMA surgery, knowing it was going to be a major disruption to
After all was said and done, I have to say I can't imagine what life would
have been like if I hadn't gone through with it. I have been sleeping
great since the MMA surgery, and the SARPE surgery improved my sleep even
more. My health, energy, zeal for life have all come back many times
over... I literally have a new lease on life!
Yes, the surgery is hard and it takes months to fully recover. I have some
nerve damage that may or may not recover in my lower lip and chin. But
honestly that is a very small price to pay for gaining back years of my
life. Every day I am thankful that I don't need a CPAP machine and I can
have deep, dreamy sleep rather than tortured suffering or bulky, noisy
CPAP equipment plastered over my face every night.
If you are considering the surgery, and if Dr Li has agreed you are a good
candidate for it, my advice would be to do it as soon as possible. There
is no point in postponing your health.
Dr. Li is the best, and I would not have trusted this surgery to anyone
else in the world. He knows how to handle these issues and will not steer