Orthognathic surgery, commonly known as jaw surgery, is a specialized procedure that corrects abnormalities of the jaw bones and realigns the jaws and teeth to improve their function and appearance. This surgery is typically performed by oral and maxillofacial surgeons in collaboration with orthodontists to ensure proper bite alignment.
Many people suffer from jaw misalignment that can cause difficulties with chewing, speaking, breathing, or even sleeping. While orthodontics can address some dental alignment issues, skeletal problems often require surgical intervention. Modern orthognathic surgery techniques have made the procedure safer and more predictable than ever, with life-changing results for patients who have lived with jaw-related problems for years.
Orthognathic surgery becomes necessary when there's a significant discrepancy in jaw size or position that can't be corrected with orthodontics alone. Common reasons include difficulty chewing or biting food properly, chronic jaw or TMJ pain, excessive wear of teeth due to malocclusion, open bite (front teeth don't touch when closing mouth), or receding chin or protruding jaw.
Beyond functional issues, jaw misalignment can also cause breathing problems like sleep apnea, speech difficulties, and significant facial imbalance that affects self-esteem. Many patients don't realize how much their jaw position affects their overall facial harmony until they see their post-surgical results. The surgery not only improves oral function but often enhances facial aesthetics as well, creating a more balanced and proportional appearance.
This procedure corrects an upper jaw that's protruding, too small, or misaligned. The surgeon makes cuts in the bone above your teeth so the entire upper jaw can move as one unit. This is often used to correct open bites or crossbites.
This addresses a lower jaw that's too large (prognathism) or too small (retrognathia). The most common technique involves making a cut behind the molars and lengthwise down the jawbone so the front can be moved forward or backward.
While not technically jaw surgery, this often accompanies orthognathic procedures to improve chin projection. The chin bone is cut and repositioned to create better facial balance.
This comprehensive procedure involves both upper and lower jaws when both need significant repositioning. It's often the best solution for severe malocclusions or facial asymmetries.
Orthognathic surgery is typically performed under general anesthesia in a hospital setting and takes 2-6 hours depending on complexity. The surgeon makes incisions inside the mouth (avoiding visible scars) to access the jawbones. Using specialized instruments, they carefully cut and reposition the bones, securing them with small plates and screws that usually remain permanently.
Before surgery, patients undergo extensive preparation including orthodontic treatment (usually 12-18 months), dental impressions, photographs, and advanced imaging like CT scans. Surgical planning often involves computer simulations to predict outcomes. After surgery, most patients stay 1-2 nights in the hospital for monitoring. Swelling and discomfort are normal but manageable with medication. Initial healing takes about 6 weeks, with complete recovery taking up to a year as the bones fully consolidate.
The first two weeks post-surgery are the most challenging, with significant swelling, difficulty speaking, and a liquid diet. Patients typically take 2-4 weeks off work or school. By week 3-4, swelling decreases substantially, and soft foods can be introduced. Most patients return to normal eating by 6-8 weeks.
Key aspects of recovery include:
Complete healing takes 9-12 months, with minor swelling continuing to resolve over this time. Most patients are thrilled with their results by 3-6 months when the majority of swelling has subsided.
As with any major surgery, orthognathic procedures carry some risks, though serious complications are rare with an experienced surgeon. Potential issues include infection, excessive bleeding, nerve injury causing temporary or permanent numbness in the lower lip/chin, jaw joint problems, relapse of jaw position, or need for additional surgery.
The most common temporary side effects include swelling, bruising, stiffness in jaw muscles, and changes in sensation. These typically resolve within weeks to months. Careful patient selection, thorough planning, and skilled surgical technique minimize risks significantly. Patients can further reduce complications by following all pre- and post-operative instructions precisely.
The benefits of properly performed orthognathic surgery can be life-changing. Patients often experience:
Many patients report not only physical improvements but significant psychological benefits from feeling more comfortable with their appearance and no longer being self-conscious about their jaw position.
Ideal candidates for jaw surgery are generally healthy individuals who have completed facial growth (usually late teens or older) and have significant jaw discrepancies that can't be resolved with orthodontics alone. Common indicators include chronic jaw pain, difficulty chewing or biting, excessive tooth wear, significant overbite or underbite, open bite, facial asymmetry, or breathing problems related to jaw position.
Good candidates must be committed to the process, which includes pre-surgical orthodontics (often making the bite temporarily worse), the surgery itself, and post-surgical recovery. Non-smokers have better outcomes, as smoking significantly impairs healing. Patients with unrealistic expectations or those unwilling to follow through with the complete treatment plan may not be ideal candidates.
How painful is orthognathic surgery?
While discomfort is expected, most patients report the pain is less severe than anticipated and well-controlled with prescribed medications. The first 3-5 days are typically the most uncomfortable, with steady improvement thereafter.
Will I have visible scars after jaw surgery?
No visible scars result from standard orthognathic procedures as all incisions are made inside the mouth. The only exception might be genioplasty (chin surgery), where a small external incision under the chin may be used in some cases.
How long until I see final results?
While initial results are visible once major swelling subsides (4-6 weeks), final soft tissue adaptation and subtle changes continue for up to a year as the bones fully heal and settle into their new position.
Is orthognathic surgery covered by insurance?
When performed for functional/medical reasons (not purely cosmetic), most health insurance plans cover a significant portion of the procedure. Coverage varies, so pre-authorization is recommended.
Can I have braces removed right after surgery?
No, orthodontic treatment typically continues for 6-12 months post-surgery to fine-tune your bite. Total treatment time averages 18-24 months from braces start to finish.
If you're considering orthognathic surgery, schedule a consultation with an experienced oral and maxillofacial surgeon to discuss your specific needs and develop a personalized treatment plan.