Roger is in his early fifth decade. Years before he had a serious work accident. His upper jaw was crushed and his front teeth pushed up and ankylosed. Now, years later Roger developed a very serious sleep apnea, that was eating all his daily live-energy. He extremely suffered from this, was in therapy with a CPAP for over a year. The device was bothering him a lot for several reasons, but he could not function without. We had several long-taking consultations, and finally came out with a comprehensive treatment plan. We wanted to solve his sleep apnea, to solve the problem of his dislocated upper jaw. He also dreamed to have his teeth normally aligned, and dreamed to expose showing teeth when laughing. Proposed and agreed was on the following: Lower jaw: major advancement of nearly 8mm on one side with some rotation to the left. Upper jaw: major extrusion in a vertical way with building up his . For this we included a posterior hip graft to graft it in the extruded upper jaw (8mm down).The midface deficiency was further solved with adding bone vestibularly and circumferentially. The upper jaw was advanced at the same time to fit the bite of the lower jaw (5-6mm). It was proposed to Roger to eliminate the upper teeth and to restore them with implants, and to perform a wrap around dental implant suprastructure. For aesthetic reasons I convinced him to built up his high cheekbones with Bioss ( what is essentially non resorbable hydroxy apatite) and tisseel (a human glue). We agreed to built up the teeth within a week after surgery, with a supra structure  in chrome cobalt fit directly on the implants. All the surgeries were performed in one time during a one shot surgery. Here you see Roger  postoperatively, one year after the surgery.He was a reborn man, and kept telling f the surgery was an absolute live changer. His quality of live had a major boost, his sleep apnea was disappeared, he was fit and sporting a lot, and was extremely happy with his enhanced appearance .