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Surgery to Help You Sleep? Sounds Like a Snoozer

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Jeff Weinzweig, MD

Board-certified plastic and reconstructive surgeon who offers advice and information on all aspects of this specialty.


Dear Dr. Jeff, 

I have severe sleep apnea and use a CPAP machine at night to help me breathe.   I also have a very short thick neck with fat below my chin and at the bottom of my neck.  Would any type of cosmetic surgery on my neck/face to remove the extra fat around my neck help with the sleep apnea ?  Or will the procedure just make me look fabulous on the outside, like I told my husband ...

LM

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Dear LM,

There is a definite correlation between excess neck fat and a predisposition to sleep apnea. A study out of Scotland (Mortimore, et al.) has demonstrated this in both nonobese patients and obese patients with sleep apnea.  In particular, they found that excess fat specifically localized in the areas anterolateral to the upper airway (i.e., in the front and the sides of the neck) was associated with sleep apnea in 52% of nonobese patients and 88% of obese patients. A short neck can further accentuate the volume of fat present and potentially add to the problem.

When CPAP machines don't solve the problem or patients become tired of using them, several surgical options exist.  With a neck similar to what you describe, liposuction can certainly reduce the excess fat and possibly improve symptoms as a result.  Not only would you look fabulous but you might also feel better.  But there is no guarantee as to how much your symptoms would improve, if at all.

2-jaw Image.JPG

Two-jaw advancement and genioplasty surgery for the treatment of severe obstructive sleep apnea.


Other surgical interventions, of course, would all be based on a thorough assessment of structures that include the length and size of your soft palate as well as the position of your upper and lower jaws.  Base on such an evaluation, recommendations might include a UPPP (uvulopalatopharynoplasty) in which a portion of the soft palate and associated tissue in the back of the throat that may be contributing to the obstructive sleep apnea is removed, or movement of the jaws and chin forward to permit expansion of the airway and alleviation of apnea symptoms.

Such procedures are not simple undertakings and the degree of improvement is not predictable although as many as 75% of patients do experience significant improvement of their symptoms.

Thanks for your question! 

Dr. Jeff

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Please note that unless you are actually my patient, in which case I have seen you at The Chicago Center for Plastic & Reconstructive Surgery, then I am technically not your doctor. These posts and responses to inquiries are provided for educational and entertainment purposes but cannot apply to any individual patient who has not been directly evaluated by myself or another board-certified plastic surgeon.  


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3 Comments

Eliza Siep said:

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Great post! I always wondered about that.

Kelly Baron, PhD said:

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Good review of surgical sleep apnea options Dr. Jeff!

Most sleep centers will work with patients to figure out what's the best option for them (whether it's surgery or CPAP, or more conservative treatment like a dental device).

For some, surgery is the right option because they have an anatomical issue that is directly causing their apnea, have mild apnea, or they have failed other treatments.

I also want to add that weight loss (either through diet and exercise or through bariatric surgery) is a very effective treatment for sleep apnea.

In fact, some of the success of apnea surgeries can be attributed to weight loss- because they experience discomfort in their throat and therefore people eat less while they are healing.

Dr. Jeff said:

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Thanks so much for your comments, Dr. Baron. I agree completely.

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