Diagnosing the Patient with Upper Airway Resistance and Treatment with Orthognathic Surgery (with Dr. Andy Loetscher)

2025-04-21

During this episode, Dr. Grant Stucki is joined by Dr. Andy Loetscher, an Oral Maxillofacial Surgeon practicing in Atlanta, Georgia to discuss Orthognathic surgery. The conversation centers around some of the nuances of Orthognathic surgery, and how to adapt it to improve airways. We start by discussing different approaches for disparate ages and concerns, before exploring how to find the ongoing balance between aesthetics and function. Next, we discuss why airway concerns must be dealt with urgently, unpack what a clinical examination can help to determine, and hear some success stories from Dr. Loetscher’s patients. This conversation also touches on how patients discover Dr. Loetscher, how he works to prevent complications, and how he prepares patients for the changes they may see in their facial structure after surgery. We touch on healing in older patients, post-op meds and anesthesia, maintaining the structures of the face, and much more. Thanks for listening!

Key Points From This Episode:

Welcome to Dr. Andy Loetscher and background on how his practice has evolved in the context of Orthognathic surgery.
How treatment differs between younger patients and older patients with disparate concerns.
Weighing aesthetics versus airway concerns.
An example of why it is so valuable to address airway issues sooner rather than later.
The role of a clinical examination and clinical history in diagnosing a problem.
Success stories from Dr. Loetscher’s patients and the incredible results they experience.
How most patients land up in Dr. Loetscher’s chair.
Avoiding complications during the healing process for older patients.
Preparing patients for changes in their facial structure.
Why sensation returns slower in older patients and how the blade can impact the process.
His approach to post-op meds and anesthesia.
Exploring different diagnostic options.
Role of the septum and other facial structures.
Opening up the bone to avoid structural changes in the face.
A case study with a 72-year-old patient.
What Dr. Loetscher is watching at the moment: Landman.
Book recommendations and more.