Double Jaw Surgery (Bimaxillary Osteotomy)

Double jaw surgery (bimaxillary osteotomy) is a procedure to align or reshape your upper and lower jaws in a single procedure. It’s an option if you have:

• Severe malocclusion (bad bite) that affects your upper and lower jaws, making it hard for you to chew, speak or breathe. Most people have double jaw surgery when orthodontic treatment alone can’t correct their bite.
• Obstructive sleep apnea or difficulty breathing while you sleep. Surgery involves moving your upper and lower jaws forward to open your airway.
• Jaw issues like prognathism or retrognathism, which are when your upper and/or lower jaws are too big or too small.

Like other types of jaw surgery, this procedure is a long-term, coordinated process. You may need braces or orthodontic treatment for up to two years before your surgery. It may be three to six months before you recover from surgery.

Benefits and risks of double jaw surgery

Double jaw surgery may solve issues that orthodontic treatment can’t fix. It may help ease sleep apnea or change the shape or size of your jaw. But there are risks, including:

• Excessive bleeding during surgery
• Infection
• Nerve damage
• Bone damage
• Damage to your teeth
• Temporomandibular joint (TMJ) disorders that develop after surgery or get worse

Your oral surgeon will explain issues that double jaw surgery may cause and explain potential complications. Don’t hesitate to ask for more details and information.

What happens during double jaw surgery?

You’ll receive general anesthesia so you’re asleep during the procedure. Your surgeon will:

1. Make cuts inside your mouth
2. Make cuts in your jawbone.
3. Move your jawbone into its new position.
4. Remove, reshape or add bone as needed.
5. Use surgical screws, wire or plates to keep your jaw in the new spot.
6. Repeat the process with the other jaw.
7. Use stitches to close the cuts inside your mouth.

The procedure may take four to six hours to complete. Your surgeon may put temporary plastic splints on your teeth after surgery. The splints keep your relocated jaws in place. They also help distribute the pressure your teeth put on your jaw when you chew.

You’ll stay in the hospital for two days after surgery. Healing will take time and patience. Here’s what you can expect:

• You’ll be on a liquid diet for the first two weeks after surgery. You may try nutritional supplements. Or you can try blending tiny pieces of solid food with liquid, like water, broth or milk, to make a thin liquid you can sip.
• You’ll move to a soft-food diet for the next three to six weeks. Chewing puts pressure on your jaws. Your goal is to get enough nutrition to help your body heal while protecting your jaws. Consider options like mashed potatoes or very soft scrambled eggs or pasta.
• The lower part of your face may look swollen for several weeks after your surgery. You may have bruises. Your healthcare provider will recommend or prescribe pain medication.
• You’ll need to take it easy while you heal. Ask your surgeon about playing sports or other activities.

When should I call my healthcare provider?

Contact your surgeon if you:

• Have pain that medication doesn’t ease
• A fever higher than 100.4 degrees Fahrenheit (38.3 degrees Celsius)
• Pus or discharge from the cuts in your jaws