Jaw surgery is also known as Orthognathic surgery, Corrective Jaw surgery and Double Jaw surgery. The purpose of an Orthognathic surgery is to correct the irregularities of the jaw bones and realign the jaws (maxilla & mandible) and teeth so as to  improve the functionality of the Stomatognathic system and the facial aesthetics. Overall, an Orthognathic Surgery can improve your facial appearance and restore the smile on your face.

Usually, an Orthognathic surgery is the best corrective solution where Orthodontic treatment alone, cannot resolve  existing jaw problems. In most cases, patients need to have braces on their teeth not only before surgery and during recovery, but also after surgery until healing and alignment are achieved. Collaboration between an Orthodontist and a Maxillofacial surgeon is essential to determine the appropriate treatment plan that matches your needs.

This operation can be performed by an Oral and Maxillo-facial surgeon under general anesthesia. Depending on the case, the duration of an Orthognathic surgery ranges between three to six hours and patients are required to be hospitalized for at least one night. Ideally, jaw surgery is appropriate after growth stops. This usually applies around 14 to 16 years of age for females and 17 to 21 years of age for males.

There are many reasons why someone opts to undergo an Orthognathic surgery. Double Jaw surgery can help:

• Facilitate the chewing and biting procedure and improve the overall chewing experience
• Correct problems related to swallowing or/and speech
• Reduce extensive attrition and damage of the teeth
• Correct closure issues or bite fit problems (e.g. when the molars touch but the front teeth don’t touch – open bite. When the frontal upper or lower front teeth overlap the posterior teeth)
• Correct facial asymmetries, such as crossbites and overbites, underbites, small chins etc.
• Make the lips close easier and comfortably
• Relieve the pain that is caused by TMJ syndrome (disorders related to temporomandibular joints) and other jaw problems
• Repair injuries of the face or birth defects
• Improve the symptoms of the obstructive sleep apnea syndrome

Sometimes, efforts including actions such as having a 3D CT scanning, temporary orthodontic anchoring devices and other computer-guided tools might be useful to assist in the movement of your teeth, decrease the time you have your braces on or even eliminate the need for double jaw surgery but this doesn’t occur frequently.

On the other hand, Orthognathic Surgery requires solid procedures and prior preparation. Usually, braces have to be placed by an orthodontist before surgery. In most cases, braces are usually on for about a year or a little more before the scheduled Orthognathic surgery. Braces will help the teeth to level and align at the required positions.

An Orthognathic surgery is planned and performed in collaboration with your Orthodontist and a highly trained Oral and Maxillofacial Surgeon. They work closely together to decide the appropriate treatment plan. When planning your Corrective Jaw surgery, your doctors will need panoramic X-rays, pictures and models of your teeth because these are part of the planning for the jaw surgery. Sometimes, covering the teeth with crowns or reshaping of the teeth is essential to complete correction, depending on the way your teeth fit together. With the rapid development of technology, virtual surgical planning (VSP) can be used to guide the Oral and Maxillofacial Surgeon to correct and fit the jaw segment position during the procedure for an optimal result.

Generally, an Orthognathic surgery is safe when it is performed by an experienced oral & maxillofacial surgeon. However, some risks (remote scenario) of an orthognathic operation may include the following:

• Fracture of the jaw(s)
• Loss of blood
• Infection
• Injury of nerve(s)
• Loss of a piece of the jaw
• Need for root canal therapy on selected tooth/teeth
• Relapse of the jaw to the initial position
• Problems with jaw joint pain and bite fit

Like most surgeries that occur under general anesthesia, the next couple of days after surgery can be a little hard on you. A patient who undergoes an Orthognathic Surgery will possibly experience:

• Swelling (usually lasts for a few weeks)
• Discomfort (We rarely receive complaints about pain but discomfort)
• Difficulty in eating ( but this will be addressed with nutritional supplements and an appropriate diet)
• Mixed feelings until adjustment to the new facial appearance. A fluctuation of your sentimental state is reasonable until you adapt to your new look

Orthognathic Surgery may be performed on the upper jaw, lower jaw, chin or any combination of these. In nine out of ten cases of Orthognathic surgery, the operation is performed inside your mouth in order to avoid any external facial scars on your chin, jaw or around the region of mouth. However, sometimes small incisions might be required outside your mouth where no other choice is possible.

The Oral and Maxillo-facial surgeon proceeds with cuts in the jawbones and moves them into the new, correct position. As soon as the desired jaw movements are achieved, small bone plates, screws and possibly wires and rubber bands are used to secure the bones into their new position. (For those who are wondering how big those screws are, the only thing you  have to know is that they are even smaller than a bracket used for braces and they become integrated into the bone structure over time without even feeling them.)

Where additional bone is needed, your surgeon may add some more to the jaw by transferring bone from your hip, leg or rib and then it is carefully secured to the region with plates and screws. In some other cases, bone might be reshaped to provide a better fit but this is always subject to the needs of each case separately.

With the upper jaw surgery (maxillary osteotomy), we can correct:

• A receded or a protruded upper jaw
• Open bite
• Crossbite
• How much or how less the teeth should appear
• Midfacial Hypoplasia (Reduced facial growth of the middle of the face)

The doctor who is carrying the upper jaw surgery cuts the bone above the teeth so that the whole of the top jaw, including the palate and the upper teeth, can move as one part. Then the upper teeth and the jaw are being moved forward to fit properly with the lower teeth.

This procedure is pre-surgically determined with the assistance of specialized computer software and other modelling tools. This computerized planning can also determine whether additional work such as orthodontics, will be essential to help correct any differences that remain.

As for the open bite, this occurs when excess bone grows right above the molars and as a result of this growth, the flat surface of the region becomes angled. Usually, the doctor shaves away or even removes the excised bone to fix the open bite.

Finally, as soon as the jaw is realigned, the surgeon places plates and screws to hold the bone to the new position with these materials getting absorbed by the bone in time.

With the lower jaw surgery (mandibular osteotomy) we can correct:

• Receding lower jaw
• Protruding lower jaw

Your surgeon who performs the lower jaw surgery proceeds with cuts behind the molars and along the length down the jawbone in order to accomplish the transfer of the front of the jaw as one unit. Then, the jaw can be moved to the new position either backwards or forward, depending on the case. Again, special plates and screws are holding the jawbone together during the healing period whilst these small materials get absorbed by the bone in time.

You will be provided with instructions after the operation. Usually, these instructions include:

• Your new, temporary diet. What you can eat and what to avoid
• How to achieve good oral hygiene
• Avoiding tobacco
• Avoiding intensive activities
• Drugs and medications to control pain
• A timeline of when you can return to your work or/and studies
• When to return to work or school, which is usually in one to three weeks

When undergoing an Orthognathic Surgery, complete healing is typically a time-consuming procedure. Initial jaw healing usually takes about six weeks post-surgery to be achieved whilst complete healing can take up to three months after surgery. But, you don’t need to worry, because most patients choose to go back to their studies or work between one to three weeks after their Orthognathic surgery.

About six weeks after surgery, initial jaw healing occurs. This is when your Orthodontist comes back to finish the alignment of your teeth with your braces. However, this is not the end of the process, as the entire Orthodontic process may take several years to complete, including the time of the surgery and the time you have the braces on. When the braces are removed, your Orthodontic may use retainers to hold your teeth positions.

As already explained above, Orthognathic surgery corrects the alignment of your jaws and teeth. Therefore, an important operation like this one can result in:

• Improving the functionality of your jaws and teeth
• Bringing balance to the appearance of your lower face
• Benefiting your overall health by improving sleep, chewing, swallowing and breathing
• Improving speech impairments
• Beautifying overall appearance
• Raising your confidence and self-esteem
• Bringing harmony and a beautiful smile

Orthognathic Surgery is performed by the Oral and Maxillofacial Surgeon. But the surgery, apart from correcting the functionality of the stomatognathic system, it also delivers spectacular results as to the facial aesthetics. However, in some cases, perfection of the facial aesthetics may require combination of other procedures such as Blepharoplasty, Masseter Reduction, Buccal Fat Pad removal and Rhinoplasty.

As a reminder, please keep in mind that an Orthognathic Surgery may be performed on the upper jaw, lower jaw, chin or any combination of these. The procedure of Chin Surgery is also known as Genioplasty and it is most commonly performed to correct a deficient chin (small chin). A small chin often accompanies a receded lower jaw that sometimes looks severe.

In the same surgery, your surgeon can alter the jaw and restructure the chin. This is done by cutting a piece of the chin bone on the front of the jaw and then it is moved forward and finally secured in the new position, using the necessary plates and screws.

Blepharoplasty is the method that can correct imperfections around the eyes, perhaps the most sensitive part of the face as it is easier to accept the signs of time. It is one of the most common surgeries in facial aesthetics as it allows the reduction of wrinkles and circles around the eyes.

Rhinoplasty is also considered an operation of a dual nature and often reconstructive. On the one hand, it solves functional problems such as breathing, smelling, tasting or even sleeping, and on the other hand, it corrects the aesthetic appearance of the nose. It can be done at the same time and in combination with another operation on the face.

The buccal fat pad removal has become more and more popular in oral and maxillofacial surgery. It is a method that helps to get rid of chubby cheeks, unneseccary and unwanted face fat since the buccal fat pads tend not to respond to weight loss. In addition, this is a procedure that can also be performed at the same time as other facial procedures and it gives a more ‘conturing’ effect on the face.

Masseter Reduction, is the procedure where the lower muscle of the face is reduced. This method applies to patients who seek a softer, ‘less square’ facial shape and to those who experience facial asymmetry as a result of an overly large masseter muscle.