lahari
- Joined
- Sep 8, 2025
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I've been looking into how much insurance would cover a bimax + marpe procedure, If gone well I would have nothing else to change about my features. So I have written a case to cut down costs as much as possible, some points true and some exaggerated but easily fakeable
Pwease give critique and improvements if anyone is willing to read
MY CASE
ORTHODONTIC HISTORY
• Severe dental crowding and narrow palate since childhood.
• Long-term mouth breathing, drooling, airway issues during growth.
• Braces for 1.5+ years → teeth straightened, skeletal issues remain.
• Orthodontist confirms: Maxilla sits downward and backward. Skeletal discrepancies cannot be fixed with braces alone.
SKELETAL / BITE FINDINGS
• Overbite with subtle crossbite.
• Very narrow maxilla and palate.
• Recessed maxilla → long midface look.
• Bite unstable; skeletal origin, not just teeth.
FUNCTIONAL IMPAIRMENTS
• Chewing: Cannot chew with front teeth. Chew only with molars. Fatiguing and inefficient.
• Speech: Tongue very crowded; hard to enunciate. Others report mumbling and unclear speech.
• Airway / Breathing: Chronic mouth breathing esp at night. Dry mouth at wake. Nighttime awakenings. Unease breathing. Childhood asthma + immune issues.
• Jaw / Muscle Strain: Jaw strained from skeletal restriction. Tuck mandible under the upper teeth to look ideal; habitually push forward for comfort when alone.
WHY PROCEDURE IS MEDICALLY NECESSARY
• Braces alone cannot fix skeletal malocclusion.
• Narrow maxilla and retrusive jaw cause:
• Chewing problems
• Speech problems
• Airway compromise
• Issues are structural, not cosmetic.
• Surgery needed to:
• Fix bite
• Improve airway
• Restore normal chewing and speech
IDEAL PROCEDURE
• MARPE
• Le Fort I maxillary advancement (± vertical adjustment)
• Bilateral sagittal split osteotomy (BSSO) for bite stability
• CCW rotation to increase airway space
• Cosmetic improvements (genio, midface implants) are secondary; can get later
INSURANCE JUSTIFICATION SUMMARY
• Documented skeletal malocclusion
• Failed orthodontics
• Functional problems: chewing, speech, airway
• History of airway symptoms
• Surgery is medically necessary, not cosmetic
→ Strong candidate for insurance-covered MARPE and Double Jaw Surgery
⸻
SLEEP STUDY SETUP
• Legs elevated, head lowered, chin tucked, sleep on back.
• Nostrils pinched and blocked with cotton. Mouth taped with small breathe slit.
• Fan near mouth
• Intense 1hr exercise and large meal before sleep
• Set loud alarms every 60–90 minutes
• Sleep deprived 3–4 days before study
HYPOTHETICAL OBSERVED FINDINGS:
• Frequent nighttime awakenings.
• Snoring and/or abnormal breathing during sleep.
• Mouth breathing necessary due to limited airway space.
• Oxygen saturation drops during sleep.
FINAL INTERPRETATION:
• Obstructive sleep events indicate airway restriction.
• Skeletal structure contributes to airway collapse.
• Functional issues confirm need for surgical intervention.
• Procedure would: Widen maxilla, Advance both jaws, Improve airway volume and sleep quality.
• Diagnosis: structural airway compromise with high risk for sleep-disordered breathing / obstructive sleep apnea (OSA).
AND NOW I HAVE (virtually) FREE MARPE AND JAW SURGERY
If anyone has had an insurance covered MARPE and/or DJS PLEASE share your experience or tag someone who has
Pwease give critique and improvements if anyone is willing to read
MY CASE
ORTHODONTIC HISTORY
• Severe dental crowding and narrow palate since childhood.
• Long-term mouth breathing, drooling, airway issues during growth.
• Braces for 1.5+ years → teeth straightened, skeletal issues remain.
• Orthodontist confirms: Maxilla sits downward and backward. Skeletal discrepancies cannot be fixed with braces alone.
SKELETAL / BITE FINDINGS
• Overbite with subtle crossbite.
• Very narrow maxilla and palate.
• Recessed maxilla → long midface look.
• Bite unstable; skeletal origin, not just teeth.
FUNCTIONAL IMPAIRMENTS
• Chewing: Cannot chew with front teeth. Chew only with molars. Fatiguing and inefficient.
• Speech: Tongue very crowded; hard to enunciate. Others report mumbling and unclear speech.
• Airway / Breathing: Chronic mouth breathing esp at night. Dry mouth at wake. Nighttime awakenings. Unease breathing. Childhood asthma + immune issues.
• Jaw / Muscle Strain: Jaw strained from skeletal restriction. Tuck mandible under the upper teeth to look ideal; habitually push forward for comfort when alone.
WHY PROCEDURE IS MEDICALLY NECESSARY
• Braces alone cannot fix skeletal malocclusion.
• Narrow maxilla and retrusive jaw cause:
• Chewing problems
• Speech problems
• Airway compromise
• Issues are structural, not cosmetic.
• Surgery needed to:
• Fix bite
• Improve airway
• Restore normal chewing and speech
IDEAL PROCEDURE
• MARPE
• Le Fort I maxillary advancement (± vertical adjustment)
• Bilateral sagittal split osteotomy (BSSO) for bite stability
• CCW rotation to increase airway space
• Cosmetic improvements (genio, midface implants) are secondary; can get later
INSURANCE JUSTIFICATION SUMMARY
• Documented skeletal malocclusion
• Failed orthodontics
• Functional problems: chewing, speech, airway
• History of airway symptoms
• Surgery is medically necessary, not cosmetic
→ Strong candidate for insurance-covered MARPE and Double Jaw Surgery
⸻
SLEEP STUDY SETUP
• Legs elevated, head lowered, chin tucked, sleep on back.
• Nostrils pinched and blocked with cotton. Mouth taped with small breathe slit.
• Fan near mouth
• Intense 1hr exercise and large meal before sleep
• Set loud alarms every 60–90 minutes
• Sleep deprived 3–4 days before study
HYPOTHETICAL OBSERVED FINDINGS:
• Frequent nighttime awakenings.
• Snoring and/or abnormal breathing during sleep.
• Mouth breathing necessary due to limited airway space.
• Oxygen saturation drops during sleep.
FINAL INTERPRETATION:
• Obstructive sleep events indicate airway restriction.
• Skeletal structure contributes to airway collapse.
• Functional issues confirm need for surgical intervention.
• Procedure would: Widen maxilla, Advance both jaws, Improve airway volume and sleep quality.
• Diagnosis: structural airway compromise with high risk for sleep-disordered breathing / obstructive sleep apnea (OSA).
AND NOW I HAVE (virtually) FREE MARPE AND JAW SURGERY
If anyone has had an insurance covered MARPE and/or DJS PLEASE share your experience or tag someone who has
